J Hare1, C Nelson. 1. Department of Human Development, Family Sciences, Oregon State University, Corvallis 97331-5106.
Abstract
OBJECTIVE: To test the efficacy of two intervention methods that aimed to increase the percentage of adult clinic patients who completed living wills and placed them on file with their physicians within a four-month period. DESIGN: There were one control and two intervention groups. Surveys were separated by age and gender categories and randomly selected for the final sample. SETTING: The internal medicine outpatient clinic of a large tertiary hospital. PARTICIPANTS: All patients who visited the clinic were asked whether they would be willing to fill out a survey. The final sample included 167 adult patients who comprised three study groups. INTERVENTIONS: The first intervention relied solely on a booklet that described the Minnesota Living Will Act, general information concerning advance directives, and medical interventions that could be considered extraordinary if used for a patient in a terminal condition. The second intervention relied on both the booklet and repeated physician-initiated discussions with the patient about the probable value of a living will. MAIN RESULTS: The booklet/physician intervention was found to be significantly more effective than either the booklet-only intervention or no intervention (p less than 0.05 and 0.01, respectively). CONCLUSIONS: The physician intervention used in this population could be undertaken in any primary care clinic. Time spent in discussion before a crisis may be significantly shorter and qualitatively better than time spent in discussion with families who must make decisions during a crisis.
OBJECTIVE: To test the efficacy of two intervention methods that aimed to increase the percentage of adult clinic patients who completed living wills and placed them on file with their physicians within a four-month period. DESIGN: There were one control and two intervention groups. Surveys were separated by age and gender categories and randomly selected for the final sample. SETTING: The internal medicine outpatient clinic of a large tertiary hospital. PARTICIPANTS: All patients who visited the clinic were asked whether they would be willing to fill out a survey. The final sample included 167 adult patients who comprised three study groups. INTERVENTIONS: The first intervention relied solely on a booklet that described the Minnesota Living Will Act, general information concerning advance directives, and medical interventions that could be considered extraordinary if used for a patient in a terminal condition. The second intervention relied on both the booklet and repeated physician-initiated discussions with the patient about the probable value of a living will. MAIN RESULTS: The booklet/physician intervention was found to be significantly more effective than either the booklet-only intervention or no intervention (p less than 0.05 and 0.01, respectively). CONCLUSIONS: The physician intervention used in this population could be undertaken in any primary care clinic. Time spent in discussion before a crisis may be significantly shorter and qualitatively better than time spent in discussion with families who must make decisions during a crisis.
Entities:
Keywords:
Death and Euthanasia; Empirical Approach
Authors: John Song; Melanie M Wall; Edward R Ratner; Dianne M Bartels; Nancy Ulvestad; Lillian Gelberg Journal: J Gen Intern Med Date: 2008-09-18 Impact factor: 5.128
Authors: Lawrence S Wissow; Amy Belote; Wade Kramer; Amy Compton-Phillips; Robert Kritzler; Jonathan P Weiner Journal: J Gen Intern Med Date: 2004-09 Impact factor: 5.128