The effectiveness of a modified advance care planning programme

Background:Frailty is a natural consequence of the aging process. With the increasing aging population in Mainland China, the quality of life and end-of-life care for frail older people need to be taken into consideration. Advance Care Planning has also been used worldwide in long-term facilities, h...

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Published in:Nursing ethics
Authors: Deng, Renli (Author) ; Zhang, Jianghui (Author) ; Chen, Liuliu (Author) ; Miao, Jiarui (Author) ; Duan, Jiazhong (Author) ; Qiu, Yeyin (Author) ; Leung, Doris (Author) ; Chan, Helen (Author) ; Lee, Diana TF (Author)
Format: Electronic Article
Language:English
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Published: Sage 2020
In: Nursing ethics
Further subjects:B Advance Care Planning
B nursing home
B Quality of life
B frail older people
B end-of-life care
Online Access: Volltext (lizenzpflichtig)
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Summary:Background:Frailty is a natural consequence of the aging process. With the increasing aging population in Mainland China, the quality of life and end-of-life care for frail older people need to be taken into consideration. Advance Care Planning has also been used worldwide in long-term facilities, hospitals and communities to improve the quality of end-of-life care, increase patient and family satisfaction, and reduce healthcare costs and hospital admissions in Western countries. However, it has not been practiced in China.Research objective:This study aimed to evaluate the effectiveness of a modified Advance Care Planning intervention in certainty of end-of-life care, preferences for end-of-life care, quality of life concerns, and healthcare utilization among frail older people.Research design:This study used a quasi-experimental design, with a single-blind, control group, pretest and repeated posttest approach.Participants and research context:A convenience sample of 74 participates met the eligibility criteria in each nursing home. A total of 148 frail older people were recruited in two nursing homes in Zhejiang Province, China.Ethical considerations:The study received ethical approval from the Clinical Research Ethics Committee, the Faculty of Medicine, and The Chinese University of Hong Kong, CREC Ref. No: 2016.059.Findings:The results indicated the Advance Care Planning programme was effective at increasing autonomy in decision making on end-of-life care issues, decreasing decision-making conflicts over end-of-life care issues, and increasing their expression about end-of-life care.Discussion:This study promoted the participants’ autonomy and broke through the inherent custom of avoiding talking about death in China.Conclusion:The modified Advance Care Planning intervention is effective and recommended to support the frail older people in their end-of-life care decision in Chinese society.
ISSN:1477-0989
Contains:Enthalten in: Nursing ethics
Persistent identifiers:DOI: 10.1177/0969733020922893