Multiprofessional Advance Care Planning and Shared Decision-making for End of Life Care MAPS Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 115
- 试验地点
- 1
- 主要终点
- 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)
研究概览
简要总结
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).
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
- Triple (Participant, Care Provider, Investigator)
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 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
排除标准
- •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)
研究组 & 干预措施
Control Group
A routine care discharge planning with the social service
干预措施: Control Group (Other)
Advance Care Planning ACP
Patient get a decision aid video and library and up to 3 consultations with qualified Advance Care Planning Facilitators.
干预措施: Advance Care Planning ACP (Other)
结局指标
主要结局
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)
时间窗: during 2 weeks six months after discharge
次要结局
- Having an Advance directive(at discharge, during 2 weeks three months after discharge and during 2 weeks six months after discharge)
- Having an appointed surrogate decision maker(at discharge, during 2 weeks three month after discharge and during 2 weeks six month after discharge)
- Treatment against patients wishes(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(at discharge, during 2 weeks three months after discharge and during 2 weeks six months after discharge)
- Hospital Anxiety and Depression scale ("HADS")(discharge and during 2 weeks six months after discharge)
- end of live decisions on last place of care, antibiotics for pneumonia, feeding tube, intravenous fluids, dialysis, intubation and sedation,(during 2 weeks six months after discharge)
- decisional conflict scale ("DCS"), O Connor et al 1995(at discharge and during 2 Weeks six months after discharge)
- Satisfaction with information and care, (see Detering et al 2010)(at discharge)
- Any hospital stay(during 2 weeks three months after discharge and during 2 weeks six months after discharge)
- open question on important medical decisions being made(during 2 weeks three months after discharge)
- Decisions regarding end of life issues already having been made/taken place(during 2 weeks six months after discharge)