Dementia-specific Intervention of Advance Care Planning

University of Lausanne Hospitals2 个研究点分布在 1 个国家目标入组 60 人开始时间: 2018年8月3日最近更新: 2018年8月7日

适应症

干预措施

试验速览

阶段: 不适用
发起方
入组人数: 60
试验地点: 2
主要终点: Change in participants' anxiety and depression levels

研究概览研究设计入排标准研究组 & 干预措施结局指标研究者研究点记录与标识符相似试验

研究概览

简要总结

This is a pilot study that aims to create a dementia-specific intervention of advance care planning (ACP) and test its feasibility and acceptance with min 20 max 30 patient-relative dyads.

The intervention is adapted from the Multiprofessional advance care planning and shared decision-making for end of life care (MAPS) Trials 1 and 2 made at the Zurich University Hospital.

The study design is longitudinal (historic): all the dyads will be asked to go through the process (4 visits, see 9.3 Procedures at each visit).

详细描述

Study background and aims:

Advance care planning (ACP) is a structured communication process between an individual, his family, and his healthcare agent (if existing), facilitated by a healthcare provider. The aim is to identify the personal values of the individual, reflect on the meanings and consequences of anticipated illness scenarios, define goals and preferences of care for these situations, issue appropriate documents and legal instruments that will help direct future healthcare decisions, and review these steps at adequate intervals. ACP emphasizes communication in anticipation of a future deterioration of a person's health. Even though dementia entails the loss of decision-making capacity, advance care planning is yet to become widespread. This study aims to close the gap and create a dementia-specific ACP intervention that:

Support patient autonomy through advance care planning
Improve participants' satisfaction and perceived control;
Increase planning decisions and surrogate's knowledge of patients' preferences and values.

Procedure and measure:

Pre-intervention assessment (Visit 1):

研究设计

研究类型: Interventional
分配方式: Na
干预模型: Single Group
主要目的: Supportive Care
盲法: None

入排标准

年龄范围: 65 Years 至 100 Years（Older Adult）
性别: All
接受健康志愿者: 是

入选标准

•Patients older than 65 years
•Having been diagnosed with an early-stage dementia of Alzheimer's disease aetiology or mixed Alzheimer-vascular aetiology (Montreal cognitive assessement (MoCA) > 20 and Clinical dementia rating (CDR) < 1.5);
•Having been informed about the diagnosis by their treating physician and that are regularly followed by him/her;
•Patient that show interest in advance care planning or advance directives;
•Patients with psychiatric disorders can be included if their psychiatric symptoms are controlled and under the supervision of their psychiatrist at the Unit of psychogeriatric care;
•Retaining full decision-making capacity according to the MoCA > 20 or the clinical judgement a physician or psychologist. During the study, the PI and the facilitators will monitor patient's decision-making capacity clinically;
•Having the necessary French language competencies to engage in conversations;
•Having a close family caregiver over 18 years old, who is informed about the patient's diagnosis, possesses the before mentioned cognitive and communication skills, and is willingly to participate to this pilot intervention;
•Informed Consent for both members of the dyad as documented by signature;

排除标准

•Patients that have a dementia associated with fronto-temporal lobe degeneration;
•Patients that have mild cognitive impairments (MCI);
•Patients that have moderate to severe cognitive disorders, anosognosia or else, assessed clinically or through scales or based on in-person screening, that suggest decision-making capacity may be impaired;
•The patient or her/his caregiver decide to withdraw from the study;
•Enrolment of the investigator, his/her family members, employees and other dependent persons.
•Patients that have a dementia associated with fronto-temporal lobe degeneration;
•Patients that have MCI;
•Patients that have moderate to severe cognitive disorders, anosognosia or else, assessed clinically or through scales or based on in-person screening, that suggest decision-making capacity may be impaired;
•The patient or her/his caregiver decide to withdraw from the study;
•Enrolment of the investigator, his/her family members, employees and other dependent persons.

研究组 & 干预措施

Intervention

Experimental

see detailed description

干预措施: Dementia-specific advance care planning (Behavioral)