Multiprofessional Advance Care Planning and Shared Decision Making for End of Life Care

N/ACompletedNCT01914848

University of Zurich115 enrolled

Overview

Multiprofessional Advance Care Planning and shared decision making for end of live care for terminal patients and their relatives. The aim of this study is to develop, implement and test a complex intervention for improving patients' preparation for and participation in end of life decisions. In cooperation with local, national and international partners, the investigators will focus on strategies to enhance advance care planning and shared decision making on end of life issues, and documentation and transferability of end of life decisions across health care settings in coordinated approach involving patients, their families and care givers (in and out of hospital).

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

TRIPLE

Enrollment

115

Conditions

Palliative Patients Surrogate Decision Maker

Interventions

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion criteria: -patients in which the treating physician on the ward would not be surprised if the patient died during the next year (surprise question of Weissman et al 2011) * male and female patients above 18 years of age * signed informed consent after being informed * patients able to appoint a surrogate decision maker (SM) and/or responsible physician to be contacted after discharge Exclusion criteria: -patients not capable of speaking german * patients having no responsible physician to be contacted after discharge and no relative/future surrogate decision maker (SM) * inhouse patients being discharged within the next 2 days or ambulatory patients not regularly coming to the wards (at least every two month) * patients assessed by their physician to be in obvious denial of their situation (illness/prognosis)

Outcomes

Primary Outcomes

end of life wish on resuscitation known (if alive) or fulfilled(if dead) after 6 month by responsible physician and/or surrogate decision maker (SM)

Time frame: during 2 weeks six months after discharge

Secondary Outcomes

end of live decisions on last place of care, antibiotics for pneumonia, feeding tube, intravenous fluids, dialysis, intubation and sedation,

Time frame: during 2 weeks six months after discharge

decisional conflict scale ("DCS"), O Connor et al 1995

Time frame: at discharge and during 2 Weeks six months after discharge

Satisfaction with information and care, (see Detering et al 2010)

Time frame: at discharge

Hospital Anxiety and Depression scale ("HADS")

Time frame: discharge and during 2 weeks six months after discharge

Having an Advance directive

Time frame: at discharge, during 2 weeks three months after discharge and during 2 weeks six months after discharge

Having an appointed surrogate decision maker

Time frame: at discharge, during 2 weeks three month after discharge and during 2 weeks six month after discharge

Any hospital stay

Time frame: during 2 weeks three months after discharge and during 2 weeks six months after discharge

Decisions regarding end of life issues already having been made/taken place

Time frame: during 2 weeks six months after discharge

open question on important medical decisions being made

Time frame: during 2 weeks three months after discharge

Treatment against patients wishes

Time frame: during 2 weeks three months after discharge and during 2 weeks six months after discharge, or 3 month after death

Distress of Patients or relatives because of content of the consultation

Time frame: at discharge, during 2 weeks three months after discharge and during 2 weeks six months after discharge

Multiprofessional Advance Care Planning and Shared Decision Making for End of Life Care

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes