ABSTRACT

Background: Advance care planning conversations and preparations do not occur as frequently as they should. Framing advance care planning as a health behavior and an opportunity for community engagement can help improve community-dwellers’ intentions to have discussions and preparations regarding facing serious illness, death and dying.

Methods: A multi-setting confidential pre/post paper survey assessing advance care planning discussions and preparation intentions was given to community-dwelling citizens residing in the New York metropolitan area. Survey items were adapted from a previous end of life survey to include questions on chronic illnesses, important conversations, comfort levels and concerns about end of life. The intervention was a 1-hour presentation on advance care planning (importance, laws, effective communication and audience questions)

Results: Our study found significant interest in discussing advanced care planning across age groups. There were significant changes for participant intentions regarding: having conversations with loved ones, a health care proxy or similar document and none; as well as differences in participant intentions for discussions with caregiver, family, friends, primary physician and no-one.

Conclusion: Educating individuals on the importance of advance care planning may be effective in changing community dwellers’ intentions to start the conversation and put advanced care planning measures in place.

Abbreviations: ACP: Advance Care Planning; CHAT: Conversations Health and Treatments; EoL: End of Life; HCP: Health Care Proxy; MOLST: Medical Orders for Life-Sustaining Treatments; PCP: Primary Care Physician

摘要

背景: 预先护理计划对话和准备工作没有应有的频繁发生。将预先护理计划视为一种健康行为和社区参与的机会，有助于提高社区居民就面临严重疾病、死亡和临终问题进行讨论和准备的意愿。

方法：对居住在纽约大都市区的社区居民进行了一项评估预先护理计划讨论和准备意图的多设置保密前/后论文调查。调查项目改编自之前的临终调查，包括关于慢性病、重要对话、舒适度和对临终关怀的问题。干预是关于预先护理计划的 1 小时演讲（重要性、法律、有效沟通和听众问题）

结果：我们的研究发现，人们对讨论跨年龄组的高级护理计划非常感兴趣。参与者在以下方面的意图发生了重大变化：与亲人、医疗代理人或类似文件进行对话，但没有；以及参与者与看护人、家人、朋友、主治医师和其他人讨论的意图的差异。

结论：就预先护理计划的重要性对个人进行教育可能会有效地改变社区居民开始对话和实施预先护理计划措施的意图。

缩写： ACP：预先护理计划；聊天：对话健康和治疗；EoL：生命终结；HCP：医疗保健代理；MOLST：维持生命治疗的医嘱；PCP：初级保健医师