End Stage Disease
Conditions
Keywords
Advance Care Planning, Motivational Interviewing, Pallative Care
Brief summary
This proposed study is designed to test the effects of motivational interviewing (MI) in increasing the uptake of ACP behaviours among patients with palliative care needs. A randomised controlled trial with repeated blinded outcome assessment will be conducted to assess the effects of a MI-tailored ACP (MI-ACP) programme on palliative care patients recruited from the outpatient palliative care clinics and home palliative care services of two hospitals. A total of 204 patients will be recruited and randomly assigned to experimental and control groups. The patients in the experimental group will receive a MI-ACP programme facilitated by a trained nurse, whereas the patients in the control group will receive usual care. Primary outcome is the behavioural changes in ACP. Secondary outcomes are perceived stress, decisional conflict and quality of life. Study outcomes will be measured at baseline, 1 month and 3 months after enrolment.
Interventions
BEHAVIORALMotivational Interviewing tailored Advance Care Planning
The trained interventionist who is experienced in MI techniques will explore their illness experiences, emotions and beliefs about their health conditions and future care in an empathetic manner and explore their ambivalence for ACP behaviours.
Sponsors
Haven of Hope Hospital
United Christian Hospital
Food and Health Bureau, Hong Kong
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
DOUBLE (Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* 18 years of age or over * newly referred to palliative care services * with a palliative performance scale (PPS) score of 60 or above; and * with full level of consciousness
Exclusion criteria
* uncommunicable because of sensory impairment or language barrier * cognitively impaired * are receiving active psychiatric treatment * already had signed an advance directive
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Advance Care Planning Behaviour | Baseline, 1 month and 3 months follow up | Behaviour changes in ACP behaviours measured using a questionnaire. It included 4 items about different ACP behavior on a 5-point Likert scale. The higher score means the higher level of readiness for the behaviours. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Decisional conflict | Baseline, 1 month and 3 months follow up | Decisional conflict regarding end-of-life care is measured by the SURE test, a questionnaire with 4-item on knowledge and support for medical decision making. The higher score means the less decisional conflict. |
| Perceived stress | Baseline, 1 month and 3 months follow up | Perceived stress is measured by a 10-item Perceived Stress Scale, a questionnaire, using a 5-point Likert scale. The higher score means the higher level of stress. |
| Quality of life | Baseline, 1 month and 3 months follow up | Quality of life is measured by using a 23-item modified Quality of Life Concerns in the End of Life Questionnaire. The 23 items are rated on a 4-point Likert scale. The higher score means the better quality of life. |
Countries
Hong Kong
Outcome results
None listed