Utilizing Advance Care Planning Videos to Empower Perioperative Cancer Patients and Families
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 92
- 试验地点
- 1
- 主要终点
- Measured ACP Content in the Presurgical Consent Visit
研究概览
简要总结
Through close engagement with our patient and family member co-investigators, the investigators have developed a video-based advance care planning aid for cancer patients and their family members who are preparing for major surgery. In this study, patients are randomized to see either the intervention video (involving advance care planning-related content) or a control video (no advance care planning-related content) prior to surgery. The investigators hypothesize that the video will lead to more and better preoperative discussions between the patient and surgeon that are related to advance care planning. The investigators also hypothesize that seeing the advance care planning-related video will decrease perioperative anxiety and depression scores.
详细描述
Many cancer patients pursue aggressive surgery in the hope of cancer cure or life prolongation. However, in doing so, patients and families may avoid advance care planning; they do not discuss specific goals and wishes should disease progress despite surgery. Moreover, a subset of patients become critically ill following surgery, and family members must make life-and-death decisions without knowing patient wishes. Preoperative advance care planning-facilitating patient and family discussions concerning perioperative goals, hopes, and fears-could empower patients and families to better choose which therapies and procedures they want outside of the initial surgery and for the months following surgery. Advance care planning aids exist, but none were developed for or evaluated in a surgical patient population. Furthermore, video-based advance care planning tools are an innovative way to better empower patients and families. Previous research shows that, with the aid of an advance care planning video, patients and families are more knowledgeable about treatment options and more comfortable with making decisions. Moreover, when better educated, these patients and families frequently choose less aggressive therapies.
However, video-based advance care planning tools have not been developed or tested in a surgical patient population. The investigators have developed and now will evaluate a video-based advance care planning aid for cancer patients and families pursing aggressive surgical cancer treatment. The investigators hypothesize that, in patients and family members, the video-based decision aid will facilitate better preoperative discussions about advance care planning between the patient and surgeon and decrease anxiety and depression after surgery.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Supportive Care
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients aged 18 and older of study surgeons who are scheduled to have a surgical procedure identified by study surgeons to the study team.
- •Patients willing to give informed consent, ability to speak English, reasonably able to read a newspaper or book (without sight impairment); reasonable able to listen to radio, television (without hearing impairment).
排除标准
- •Age <18 years old, non-English speaking patients who are not identified by participating surgeons
研究组 & 干预措施
Intervention
Advance care planning video
干预措施: Advance care planning video (Behavioral)
Control
Control video - no advance care planning content
干预措施: Control video (Behavioral)
结局指标
主要结局
Measured ACP Content in the Presurgical Consent Visit
时间窗: Approximately one week after study enrollment.
The RIAS scoring system using an audio-recording of a conversation to evaluate conversation content.
Measured Patient Centeredness in the Presurgical Consent Visit
时间窗: Approximately one week after study enrollment.
The RIAS scoring system using an audio-recording of a conversation to evaluate the nature of the conversation between surgeon and patient. The patient-centeredness summary score is a ratio of statements that reflect the psychosocial and socio-emotional elements of exchange about the lived illness experience of patients relative to statements that reflect a more biomedical and disease focused perspective. This score reflects the encounter as a whole, rather than an individual's dialogue. A value greater than one indicates a more patient-centered encounter; whereas, a value less than one indicates a more biomedical encounter.
次要结局
- Hospital Anxiety and Depression Scores Across Study Arms Throughout the Study Period(Enrollment, one week after enrollment, one week after surgery, one month after surgery)
- Iowa Goals of Care Across Study Arms Throughout the Study Period(Enrollment, one week after enrollment, one week after surgery, one month after surgery)
- Helpfulness of the Video Across Study Arms(One week after enrollment)
- Comfort With the Video Across Study Arms(One week after enrollment)
- Recommendation of the Video to Others Across Study Arms(One week after enrollment)
- Patient and Provider Satisfaction Scores Across Study Arms(One week after enrollment)
- Prevalence of Participants Who Acknowledge Having Named a Surrogate Decision Maker Across Study Arms Throughout the Study Period(Enrollment, one month after surgery)
- Prevalence of Participants Who Acknowledge Having a Conversation With Their Surrogate Decision Maker Regarding Advance Care Planning Across Study Arms Throughout the Study Period(Enrollment, one month after surgery)