Interactive Decision Aid for Advance Care Planning

预先护理计划的交互式决策辅助

• 批准号: 7478225
• 负责人: SHARON L TENNSTEDT
• 金额: $ 9.93万
• 依托单位: NEW ENGLAND RESEARCH INSTITUTES, INC.
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-04-15 至 2009-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7478225
• 关键词: Advance Care Planning; Advance Directives; Attention; Awareness; Caring; Communication; Computerized Medical Record; Computers; Decision Aid; Decision Making; Ensure; Evaluation; Family; Goals; Health; Health Personnel; Healthcare; Individual; Laws; Length; Living Wills; Modeling; Movement; Online Systems; Patients; Persons; Phase; Process; Production; Proxy; Public Policy; Range; Regulation; Schedule; Social Policies; Staging; Tablets; Visual; care preference; design; end of life; end of life care; experience; health literacy; improved; innovation; instrument; preference; programs; prototype; response; touchscreen

DESCRIPTION (provided by applicant): Widely publicized cases such as Terri Schiavo have raised awareness of the importance of advance care planning. However, while promoted through federal law and regulation, emphasis is placed on the completion of an advance directive (AD) document rather than on the informed decision making and communication essential to ensuring that end of life care preferences are honored. In fact, there is little evidence that having an AD alone results in improved or preferred care at the end of life. Consequently, the advance directive (or living will) as a public policy instrument has been called a failed social policy. Recently attention has been redirected to the process of advance care planning. In response, we propose an innovative interactive decision aid to help individuals not only make informed decisions about preferred treatment at end of life but also to communicate these preferences and decisions to their health care providers and families. The program will use video to provide visual depiction of several advance stage health states and options for end of life care treatment and to model effective communication with health care providers and family about preferences for care. Template documents for completing an AD and health care proxy will be provided for completion immediately or at a later date. The program will be presented on a tablet-PC, with the capability to be web-based allowing the inclusion of these documents in an electronic medical record. No other available program offers all of these features on a portable platform to maximize and facilitate use across a range of settings The Specific Aims of Phase I are to: 1) develop a content outline for the full program; 2) develop the design and format of the program; 3) develop a script and storyboard for one partial program module; 4) develop this section (prototype) for delivery on a tablet PC; 5) conduct a feasibility evaluation of the prototype; and 6) develop a plan and schedule for production of the full-length program in Phase II. PROJECT NARRATIVE Advance care planning is more than signing a document. It is a process. This interactive decision aide will help individuals not only make informed decisions about preferred treatment at end of life but also to communicate these preferences and decisions to their health care providers and families. The program will use video to present several advance stage health states and options for end of life care treatment and to model communication with health care providers and family about preferences for care.

描述（由申请人提供）：Terri Schiavo 等广为人知的案例提高了人们对预先护理计划重要性的认识。然而，虽然通过联邦法律和法规推动，但重点是完成预先指示（AD）文件，而不是确保尊重临终护理偏好所必需的知情决策和沟通。事实上，几乎没有证据表明仅患有 AD 就能改善临终护理或提供更好的护理。因此，预先指示（或生前遗嘱）作为公共政策工具被称为失败的社会政策。最近，人们的注意力已转移到预先护理计划的过程上。为此，我们提出了一种创新的交互式决策辅助工具，不仅可以帮助个人就临终时的首选治疗做出明智的决定，还可以将这些偏好和决定传达给他们的医疗保健提供者和家人。该计划将使用视频提供几种晚期健康状况的视觉描述和临终护理治疗的选择，并模拟与医疗保健提供者和家人关于护理偏好的有效沟通。将提供用于填写 AD 和医疗保健委托书的模板文件，以便立即或稍后完成。该程序将在平板电脑上呈现，具有基于网络的功能，允许将这些文档包含在电子病历中。没有其他可用的程序可以在便携式平台上提供所有这些功能，以最大限度地提高和促进在一系列设置中的使用。第一阶段的具体目标是：1）为整个程序制定内容大纲； 2）制定程序的设计和格式； 3) 为部分节目模块开发剧本和故事板； 4) 开发此部分（原型）以在平板电脑上交付； 5）对样机进行可行性评估； 6) 制定第二阶段完整节目的制作计划和时间表。项目叙述 预先护理计划不仅仅是签署一份文件。这是一个过程。这种交互式决策助手不仅可以帮助个人就临终时的首选治疗做出明智的决定，还可以将这些偏好和决定传达给他们的医疗保健提供者和家人。该计划将使用视频来展示几种晚期健康状况和临终关怀治疗的选择，并模拟与医疗保健提供者和家人就护理偏好进行沟通。