End-of-life Decision Making, Hospice, Hospice Decision Making
Conditions
Keywords
Hospice, End-of-life, Patient decision aid, Shared decision making
Brief summary
The goal of this project is to determine the feasibility and acceptability of a hospice decision aid among a diverse population of older adults at multiple stages of illness (Aim 1) and to determine the preliminary efficacy of the hospice decision aid on decision quality, hospice knowledge, and values-concordance (Aim 2). By testing the feasibility, acceptability, and preliminary efficacy of a novel hospice Patient Decision Aid (PTDa) in a diverse population of older adults, additionally the study will simultaneously explore barriers to PtDA implementation in both an outpatient primary care and inpatient palliative care setting. The study will also gather sufficient pilot data to support a subsequent effectiveness/implementation trial and thus address the absence of quality of SDM interventions for end-of-life care decision-making.
Interventions
OTHERHospice Decision Aids
Paper and video hospice decision aid
Sponsors
National Institute on Aging (NIA)
University of Colorado, Denver
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* 65 or older. * At least one life-limiting illness or syndrome.
Exclusion criteria
* Non-English speakers. * Patients with cognitive Impairments preventing ability to provide informed consent. * Patients on isolation precautions due to resistant bacteria or impaired immune function.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Hospice Knowledge Scale | 1 month follow-up | Hospice Knowledge Scale is a 23-item true/false scale that measures patient knowledge about hospice care. Each question is worth 1 point with possible scores ranging from 0 to 23. Higher scores indicate more knowledge. |
| Hospice Beliefs and Attitudes Scale | 1-Month follow up | 8-item scale developed to measure beliefs and attitudes towards hospice care. It has a Cronbach's α = .74 for the scale, indicating a good degree of internal reliability. Scores from 8 to 40. Higher scores indicate better opinions of hospice. . |
| Decision Self Efficacy Scale | 1 month Follow up | Is an 11-item instrument that one's self-confidence in decision making. This scale is a validated scale with a Cronbach's alpha of 0.92 and correlates with DCS subscale of being informed (r=0.47). Scored from 0-100 with higher scores indicating more decision self efficacy. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Control Participants did not review the intervention (i.e. Hospice Decision Aid) | 43 |
| Intervention Participants will receive hospice decisional support materials and be asked to review them. Participants will provide feedback on tools and complete feasibility, efficacy and knowledge assessments.
Hospice Decision Aids: Paper and video hospice decision aid | 88 |
| Total | 131 |
Baseline characteristics
| Characteristic | Control | Intervention | Total |
|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 43 Participants | 88 Participants | 131 Participants |
| Age, Categorical Between 18 and 65 years | 0 Participants | 0 Participants | 0 Participants |
| Decision Self Efficacy Scale | 92 units on a scale | 87 units on a scale | 89 units on a scale |
| Ethnicity (NIH/OMB) Hispanic or Latino | 4 Participants | 6 Participants | 10 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 28 Participants | 69 Participants | 97 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 11 Participants | 13 Participants | 24 Participants |
| Hospice Beliefs and Attitudes Scale | 29 units on a scale | 29 units on a scale | 29 units on a scale |
| Hospice Knowledge Test | 18 units on a scale | 18 units on a scale | 18 units on a scale |
| Region of Enrollment United States | 43 participants | 88 participants | 131 participants |
| Sex: Female, Male Female | 28 Participants | 56 Participants | 84 Participants |
| Sex: Female, Male Male | 15 Participants | 32 Participants | 47 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 0 | 0 / 0 |
| other Total, other adverse events | 0 / 0 | 0 / 0 |
| serious Total, serious adverse events | 0 / 0 | 0 / 0 |
Outcome results
Primary
Decision Self Efficacy Scale
Is an 11-item instrument that one's self-confidence in decision making. This scale is a validated scale with a Cronbach's alpha of 0.92 and correlates with DCS subscale of being informed (r=0.47). Scored from 0-100 with higher scores indicating more decision self efficacy.
Time frame: 1 month Follow up
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Control | Decision Self Efficacy Scale | 87 units on a scale |
| Intervention | Decision Self Efficacy Scale | 94 units on a scale |
Primary
Hospice Beliefs and Attitudes Scale
8-item scale developed to measure beliefs and attitudes towards hospice care. It has a Cronbach's α = .74 for the scale, indicating a good degree of internal reliability. Scores from 8 to 40. Higher scores indicate better opinions of hospice. .
Time frame: 1-Month follow up
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Control | Hospice Beliefs and Attitudes Scale | 32 units on a scale |
| Intervention | Hospice Beliefs and Attitudes Scale | 33 units on a scale |
Primary
Hospice Knowledge Scale
Hospice Knowledge Scale is a 23-item true/false scale that measures patient knowledge about hospice care. Each question is worth 1 point with possible scores ranging from 0 to 23. Higher scores indicate more knowledge.
Time frame: 1 month follow-up
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Control | Hospice Knowledge Scale | 18 score on a scale |
| Intervention | Hospice Knowledge Scale | 17 score on a scale |