Preparing Patients and Family Caregivers for Medical Decision Making: Evaluating the Impact of a Systematic Social Work Driven Approach on Medical Power of Attorney Documentation, Knowledge, Attitudes and Beliefs
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 731
- 试验地点
- 2
- 主要终点
- Proportion of patients who decline to participate in the study
研究概览
简要总结
This trial evaluates the impact of a systemic social work driven approach on medical power of attorney documentation, knowledge, attitudes, and beliefs in participants with stage I-IV gynecological cancers. Social work counseling and education may help increase the number of participants who complete medical power of attorney documents. Counseling and education may also affect attitudes about decision-making and willingness to take part in these conversations in participants with stage I-IV gynecological cancers and their family members and/or caregivers.
详细描述
PRIMARY OBJECTIVES:
I. To evaluate medical power of attorney documents (MPOAD) completion rate after a systematic social work counseling and education clinical process.
SECONDARY OBJECTIVES:
I. To determine change in medical power of attorney (MPOA)/primary family caregivers' knowledge, attitudes and beliefs about conditions for quality surrogate medical decision-making (MDM).
II. To determine change in MPOA/primary family caregivers' knowledge of patients' values and goals for MDM.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Supportive Care
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Diagnosis of invasive gynecologic malignancy stages 1-
- •New patient in the Gynecologic Oncology Center.
- •Adequate capacity to understand and complete MPOAD in the opinion of the study investigator or research assistant.
- •Able to speak and understand English and/or Spanish.
- •Provision of Institutional Review Board (IRB)-approved informed consent.
- •Available MPOA or primary family caregiver who consents to study participation.
- •FAMILY CAREGIVER/MPOA
- •MPOA or if none documented in electronic health record (EHR), primary family caregiver, as designated by the patient.
- •Permission to contact provided by patient.
- •Adequate capacity to understand and complete study measures in the opinion of the study investigator or research assistant.
- •Provision of IRB-approved informed consent.
排除标准
- •Without a MPOA or available family caregiver.
结局指标
主要结局
Proportion of patients who decline to participate in the study
时间窗: Up to 3 months
Will be reported with 95% confidence intervals. Descriptive demographic and disease characteristics for patients who decline study participation but allow collection of demographic and disease characteristics will be compared to those of participating patients.
Proportion of participants who completed MPOAD within 3 months after the educational video
时间窗: Up to 3 months
Will be reported with 95% confidence intervals. Baseline and changes in MPOA/primary family caregivers' knowledge, attitudes and beliefs about conditions for quality surrogate MDM, in patients/primary family caregivers' self-efficacy and readiness for MPOA, and in patients/Primary family caregivers' knowledge of patients' values and goals for MDM, will be summarized and compared among the four patient groups: 1) had MPOAD at the consult already, 2) complete MPOAD at the first visit, 3) complete MPOAD after initial social work counselor visit and by 3 months, 4) do not complete MPOAD by 3 months, using Kruskal-Wallis test for continuous variables and either Chi-square test or Fisher's exact test for discrete variables, whenever appropriate. Univariate/multi-covariate logistic regression will be employed to evaluate the effect of potential factors on completion of MPOAD.
Willingness to participate in future advance care planning discussions
时间窗: Up to 3 months
Willingness to participate in future Advance Care Planning discussions for patients' values and goals important to MDM will be tabulated.
Proportion of patients who already have medical power of attorney (MPOAD) at consult
时间窗: Up to 3 months
Will be reported with 95% confidence intervals. Baseline and changes in MPOA/primary family caregivers' knowledge, attitudes and beliefs about conditions for quality surrogate medical decision-making (MDM), in patients/primary family caregivers' self-efficacy and readiness for MPOA, and in patients/Primary family caregivers' knowledge of patients' values and goals for MDM, will be summarized and compared among the four patient groups: 1) had MPOAD at the consult already, 2) complete MPOAD at the first visit, 3) complete MPOAD after initial social work counselor visit and by 3 months, 4) do not complete MPOAD by 3 months, using Kruskal-Wallis test for continuous variables and either Chi-square test or Fisher's exact test for discrete variables, whenever appropriate. Univariate/multi-covariate logistic regression will be employed to evaluate the effect of potential factors on completion of MPOAD.
Proportion of patients who completed MPOAD at the first social work counselor visit
时间窗: Up to 3 months
Will be reported with 95% confidence intervals. Baseline and changes in MPOA/primary family caregivers' knowledge, attitudes and beliefs about conditions for quality surrogate MDM, in patients/primary family caregivers' self-efficacy and readiness for MPOA, and in patients/Primary family caregivers' knowledge of patients' values and goals for MDM, will be summarized and compared among the four patient groups: 1) had MPOAD at the consult already, 2) complete MPOAD at the first visit, 3) complete MPOAD after initial social work counselor visit and by 3 months, 4) do not complete MPOAD by 3 months, using Kruskal-Wallis test for continuous variables and either Chi-square test or Fisher's exact test for discrete variables, whenever appropriate. Univariate/multi-covariate logistic regression will be employed to evaluate the effect of potential factors on completion of MPOAD.
Proportion of participants who completed MPOAD after the first educational video
时间窗: Up to 3 months
Will be reported with 95% confidence intervals. Baseline and changes in MPOA/primary family caregivers' knowledge, attitudes and beliefs about conditions for quality surrogate MDM, in patients/primary family caregivers' self-efficacy and readiness for MPOA, and in patients/Primary family caregivers' knowledge of patients' values and goals for MDM, will be summarized and compared among the four patient groups: 1) had MPOAD at the consult already, 2) complete MPOAD at the first visit, 3) complete MPOAD after initial social work counselor visit and by 3 months, 4) do not complete MPOAD by 3 months, using Kruskal-Wallis test for continuous variables and either Chi-square test or Fisher's exact test for discrete variables, whenever appropriate. Univariate/multi-covariate logistic regression will be employed to evaluate the effect of potential factors on completion of MPOAD.
次要结局
未报告次要终点