The American journal of hospice & palliative care
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Am J Hosp Palliat Care · Nov 2019
Randomized Controlled TrialEfficacy of Motivational Interviewing to Enhance Advance Directive Completion in Latinos With Chronic Illness: A Randomized Controlled Trial.
End-of-life (EOL) care for Latinos with chronic illness is a critically important problem. Latinos with chronic illness suffer worse health outcomes and poorer quality of care due to various issues occurring in care delivery systems. Latinos are less likely than non-Hispanic whites to prepare an advance directive (AD) for health-care decision-making that impacts treatment decisions for when EOL is near. Advance care planning (ACP) interventions tailored specifically for Latinos have rarely been implemented. ⋯ When using MI to motivate individuals toward ACP EOL conversations other factors are important to consider. Further research is needed, especially among Latinos to understand best practices for ACP education and counseling for EOL care.
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Am J Hosp Palliat Care · Sep 2018
Randomized Controlled Trial Multicenter StudyFamily Caregivers' Characterization of Conversations Following an ACP Event.
Advance care planning (ACP) has been shown to benefit patients and families, yet little is known about how an ACP event impacts communication and conversation about end-of-life treatment wishes and the content of such conversations between patients and family caregivers. ⋯ The ACP events promote conversation regarding quality of life, general wishes at the end of life, and specific medical wishes. Barriers to conversation following ACP were similar to barriers to ACP in general, suggesting that a more intentional focus on addressing these barriers pre- and post-ACP may be necessary to improve communication.
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Am J Hosp Palliat Care · Jun 2018
Randomized Controlled Trial Multicenter StudyA Randomized Controlled Trial of Strategies to Improve Family Members' Preparedness for Surrogate Decision-Making.
To evaluate 2 strategies for preparing family members for surrogate decision-making. ⋯ The disconnect between confidence and performance raises questions about how to prepare family members to be surrogate decision-makers.
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Am J Hosp Palliat Care · May 2018
Randomized Controlled TrialA Descriptive Analysis of End-of-Life Conversations With Long-Term Glioblastoma Survivors.
Early, high-quality serious illness (SI) conversations are critical for patients with glioblastoma (GBM) but are often mistimed or mishandled. ⋯ Patients with GBM had multiple goals/priorities with potential treatment implications, but documentation showed SI conversations occurred relatively late and infrequently reflected patient goals/priorities.
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Am J Hosp Palliat Care · Jan 2018
Randomized Controlled TrialSelf-Assessment Scores Improve After Simulation-Based Palliative Care Communication Skill Workshops.
We conducted a randomized trial of a simulation-based multisession workshop to improve palliative care communication skills (Codetalk). Standardized patient assessments demonstrated improved communication skills for trainees receiving the intervention; however, patient and family assessments failed to demonstrate improvement. This article reports findings from trainees' self-assessments. ⋯ Simulation-based communication training was associated with improved self-assessed competency in overall and specific communication skills in this randomized trial. Further research is needed to fully understand the importance and limitations of self-assessed competence in relation to other outcomes of improved communication skill.