• Li-Shan Ke, Wen-Yu Hu, Ching-Yu Chen, Chieh-Yu Liu, and Tai-Yuan Chiu.
• National Taipei University of Nursing and Health Sciences, School of Nursing, Taipei, Taiwan; Taipei Veterans General Hospital, Department of Nursing, Taipei, Taiwan; National Taiwan University, College of Medicine, School of Nursing, Taipei, Taiwan. Electronic address: lishan@ntunhs.edu.tw.
• Patient Educ Couns. 2021 Apr 1; 104 (4): 815-825.

ObjectiveThis study sought to develop a decision aid with cartoon pictures and evaluate its effectiveness in increasing consistency between elderly individuals and their surrogates regarding end-of-life care.MethodsA pre-post quasi-experimental design was adopted using the Life Support Preferences Questionnaire. The intervention had two components: (1) increasing participants' knowledge of medical treatments related to end-of-life care, and (2) sharing their end-of-life wishes. The experimental group received an intervention, whereas the control group received usual care.ResultsA total of 110 participants in 55 pairs of elderly individuals with average aged 86.4 and their surrogates (27 in the experimental group, 28 in the control group) were recruited from a veterans hospital in northern Taiwan. Nearly 90 % of elderly individuals were male. The multiple linear regression showed that the inconsistent gap between elderly individuals and their surrogates in the experimental group decreased 12 points than the control group after controlling the covariances (B = -12.116, p = 0.032).ConclusionThe intervention improved the consistency between elderly individuals and their surrogates regarding end-of-life care.Practice ImplicationsA decision aid with cartoon pictures may support the discussion of end-of-life care in older Asian populations.Copyright © 2020 Elsevier B.V. All rights reserved.

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