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J Crit Care. 2015 Dec;30(6):1418.e7-1418.e12. doi: 10.1016/j.jcrc.2015.09.001. Epub 2015 Sep 3.

Key stakeholders' perspectives on a Web-based advance care planning tool for advanced lung disease.

Author information

1
Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh PA; Clinical Research, Investigation, and Systems Modeling of Acute Illness (CRISMA) Center, University of Pittsburgh, Pittsburgh, PA. Electronic address: chiarchiaroj@upmc.edu.
2
Clinical Research, Investigation, and Systems Modeling of Acute Illness (CRISMA) Center, University of Pittsburgh, Pittsburgh, PA.
3
Section of Palliative Care and Medical Ethics, Department of Medicine, University of Pittsburgh, Pittsburgh PA.
4
Center for Bioethics and Health Law, University of Pittsburgh, Pittsburgh PA; Clinical Research, Investigation, and Systems Modeling of Acute Illness (CRISMA) Center, University of Pittsburgh, Pittsburgh, PA; Program on Ethics and Decision Making in Critical Illness, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA.

Abstract

PURPOSE:

There is a paucity of scalable advance care planning strategies that achieve the diverse goals of patients, families, and clinicians. We convened key stakeholders to gain their perspectives on developing a Web-based advance care planning tool for lung disease.

MATERIALS AND METHODS:

We conducted semistructured interviews with 50 stakeholders: 21 patients with lung disease, 18 surrogates, and 11 clinicians. Interviews explored stakeholders' desired content and design features of a Web-based advance care planning tool. Participants also rated the tool's acceptability and potential usefulness. We analyzed the interviews with modified grounded theory and validated themes through member checking.

RESULTS:

Stakeholders highly rated the acceptability (median, 5; interquartile range, 5-5) and potential usefulness (median, 5; interquartile range, 4-5) of a Web-based tool. Interviewees offered several suggestions: (1) use videos of medical scenarios and patient narratives rather than text, (2) include interactive content, and (3) allow the user control over how much they complete in 1 sitting. Participants identified challenges and potential solutions, such as how to manage the emotional difficulty of thinking about death and accommodate low computer literacy users.

CONCLUSIONS:

There is strong stakeholder support for the development of a Web-based advance care planning tool for lung disease.

KEYWORDS:

Communication; Decision making; End of life care; Public health

PMID:
26404957
PMCID:
PMC4628837
DOI:
10.1016/j.jcrc.2015.09.001
[Indexed for MEDLINE]
Free PMC Article

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