An evidence-based advance care planning programme to promote end-of-life care planning among patients with advanced diseases in the Emergency Department – a feasibility randomised controlled trial
试验速览
- 阶段
- Unknown
- 状态
- 尚未招募
- 入组人数
- 60
- 试验地点
- 1
- 主要终点
- Recruitment and retention rate
研究概览
简要总结
The study aims to examine the feasibility and acceptability of an evidence-based ACP programme among patients with advanced diseases in the Emergency Department. The objectives of the study are to determine the feasibility of conducting an ACP programme in the ED based on recruitment and attrition rate, to examine the acceptability of the intervention based on satisfaction survey and qualitative comments on patient’s experiences, and to examine the preliminary effect of the programme on patient reported ACP readiness and evidence of ACP documentation on medical record.
研究设计
- 研究类型
- Interventional
- 主要目的
- 随机平行对照
- 盲法
- None
入排标准
- 年龄范围
- 18 至 —（—）
- 性别
- All
入选标准
- •Subjects will be recruited from Emergency Medicine Wards, ED of two public hospitals in Kowloon West Cluster, Hong Kong. One of the ED is in Kwai Tsing District providing tertiary care while the other ED is located on Lantau Island providing tertiary and rehabilitation service.Participants are adult (18 years old or above) admitted to the EMW, Chinese-speaking, fulfill the two general and one
- •clinical criterion stipulated in the Supportive and Palliative Care Indicator Tools (SPICT™) (The University of Edinburgh,
- •. SPICT was developed as an instrument to identify patients at risk of dying within one year (Paulik et al., 2024).
- •It has a sensitivity of 0.65 (95% CI) and a specificity of 0.72 (95% CI) in detecting life-limiting conditions (Paulik et al.,
- •.By using this dual indicators approach, it allows a more comprehensive and personalized model of care for patients
- •with advanced illnesses (Paulik et al., 2024).
排除标准
- •Patients will be excluded if they are mentally incompetent determined based on the Diagnostic assessment Confusion
- •Assessment Method (3D-CAM) (Marcantonio et al., 2015). The Chinese version of 3D-CAM can be used as a reliable
- •and accurate instrument for delirium assessment, its sensitivity ranges from 85.7 to 100% and the specificity from 95.7
- •to 96.4% (Mu et al., 2020).
- •Patients who were non-Chinese speaking, non-communicable, refusal or unable to give consent, altered sensorium or
- •cognitive functions, physical unwell to receive the intervention, and with previous documented ACP or AMD will be
- •excluded from the study.
研究组 & 干预措施
Experimental Group
Patients in the intervention group will receive a ACP programme which include a six-minute video on introduction toACP, followed by a 30-minute discussion guided by a trained nurse on ACP as well as a pamphlet with written information on the same topic.
Control Group
Patient in the control group will receive usual care such as ward routine and fall prevention advice.
结局指标
主要结局
Recruitment and retention rate
Time spent in each intervention
次要结局
- ACP engagement
- Decisional Conflict
- Documentation of end-of-life care preferences
- Demographics and health conditions
- Qualitative Interview