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Utilizing Advance Care Planning Videos to Empower Perioperative Cancer Patients and Families

2015-07-07 09:08:23 | BioPortfolio

Summary

Through close engagement with our patient and family member co-investigators, we 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. We hypothesize that the video will lead to more and better preoperative discussions between the patient and surgeon that are related to advance care planning. We also hypothesize that seeing the advance care planning-related video will decrease perioperative anxiety and depression scores.

Description

Many cancer patients pursue aggressive surgery in the hope of cancer cure or life prolongation. However, in doing so, patients and families often 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. We have developed and now will evaluate a video-based advance care planning aid for cancer patients and families pursing aggressive surgical cancer treatment. We 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.

Study Design

Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Supportive Care

Conditions

Cancer

Intervention

Advance care planning video

Status

Not yet recruiting

Source

Sidney Kimmel Comprehensive Cancer Center

Results (where available)

View Results

Links

Published on BioPortfolio: 2015-07-07T09:08:23-0400

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Medical and Biotech [MESH] Definitions

Discussions with patients and/or their representatives about the goals and desired direction of the patient's care, particularly end-of-life care, in the event that the patient is or becomes incompetent to make decisions.

Declarations by patients, made in advance of a situation in which they may be incompetent to decide about their own care, stating their treatment preferences or authorizing a third party to make decisions for them. (Bioethics Thesaurus)

Compliance by health personnel or proxies with the stipulations of ADVANCE DIRECTIVES (or similar directives such as RESUSCITATION ORDERS) when patients are unable to direct their own care.

A food service control process involving scheduling of meals in advance.

Used with articles which include video files or clips, or for articles which are entirely video.

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