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BMJ Open. 2016 Jun 23;6(6):e010375. doi: 10.1136/bmjopen-2015-010375.

Measuring engagement in advance care planning: a cross-sectional multicentre feasibility study.

Author information

1
Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada.
2
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
3
Clinical Evaluation Research Unit, Kingston General Hospital, Kingston, Ontario, Canada Department of Public Health, Queen's University, Kingston, Ontario, Canada.
4
San Francisco Veterans Affairs Medical Center, San Francisco, California, USA Department of Medicine, Division of Geriatrics, University of California San Francisco, San Francisco, California, USA.
5
Covenant Health Palliative Institute, Edmonton, Alberta, Canada.
6
School of Nursing, University of British Columbia, Kelowna, British Columbia, Canada.
7
Radiation Therapy Program, British Columbia Cancer Agency, Vancouver Cancer Centre, Vancouver, Canada.
8
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada Department of Medicine, McMaster University, Hamilton, Ontario, Canada.

Abstract

OBJECTIVES:

To assess the feasibility, acceptability and clinical sensibility of a novel survey, the advance care planning (ACP) Engagement Survey, in various healthcare settings.

SETTING:

A target sample of 50 patients from each of primary care, hospital, cancer care and dialysis care settings.

PARTICIPANTS:

A convenience sample of patients without cognitive impairment who could speak and read English was recruited. Patients 50 and older were eligible in primary care; patients 80 and older or 55 and older with clinical markers of advanced chronic disease were recruited in hospital; patients aged 19 and older were recruited in cancer and renal dialysis centres.

OUTCOMES:

We assessed feasibility, acceptability and clinical sensibility of the ACP Engagement Survey using a 6-point scale. The ACP Engagement Survey measures ACP processes (knowledge, contemplation, self-efficacy and readiness) on 5-point Likert scales and actions (yes/no).

RESULTS:

196 patients (38-96 years old, 50.5% women) participated. Mean (±SD) time to administer was 48.8±19.6 min. Mean acceptability scores ranged from 3.2±1.3 in hospital to 4.7±0.9 in primary care, and mean relevance ranged from 3.5±1.0 in hospital to 4.9±0.9 in dialysis centres (p<0.001 for both). The mean process score was 3.1±0.6 and the mean action score was 11.2±5.6 (of a possible 25).

CONCLUSIONS:

The ACP Engagement Survey demonstrated feasibility and acceptability in outpatient settings but was less feasible and acceptable among hospitalised patients due to length. A shorter version may improve feasibility. Engagement in ACP was low to moderate.

KEYWORDS:

advance care planning; communication; measurement; survey

PMID:
27338877
PMCID:
PMC4932285
DOI:
10.1136/bmjopen-2015-010375
[Indexed for MEDLINE]
Free PMC Article

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