BACKGROUND: The authors tested whether an educational video on the goals of care in advanced cancer (life-prolonging care, basic care, or comfort care) helped patients understand these goals and had an impact on their preferences for resuscitation. METHODS: A survey of 80 patients with advanced cancer was conducted before and after they viewed an educational video. The outcomes of interest included changes in goals of care preference and knowledge and consistency of preferences with code status. RESULTS: Before viewing the video, 10 patients (13%) preferred life-prolonging care, 24 patients (30%) preferred basic care, 29 patients (36%) preferred comfort care, and 17 patients (21%) were unsure. Preferences did not change after the video, when 9 patients (11%) chose life-prolonging care, 28 patients (35%) chose basic care, 29 patients (36%) chose comfort care, and, 14 patients (18%) were unsure (P = .28). Compared with baseline, after the video presentation, more patients did not want cardiopulmonary resuscitation (CPR) (71% vs 62%; P = .03) or ventilation (80% vs 67%; P = .008). Knowledge about goals of care and likelihood of resuscitation increased after the video (P < .001). Of the patients who did not want CPR or ventilation after the video augmentation, only 4 patients (5%) had a documented do-not-resuscitate order in their medical record (kappa statistic, -0.01; 95% confidence interval, -0.06 to 0.04). Acceptability of the video was high. CONCLUSIONS: Patients with advanced cancer did not change care preferences after viewing the video, but fewer wanted CPR or ventilation. Documented code status was inconsistent with patient preferences. Patients were more knowledgeable after the video, reported that the video was acceptable, and said they would recommend it to others. The current results indicated that this type of video may enable patients to visualize "goals of care," enriching patient understanding of worsening health states and better informing decision making.
BACKGROUND: The authors tested whether an educational video on the goals of care in advanced cancer (life-prolonging care, basic care, or comfort care) helped patients understand these goals and had an impact on their preferences for resuscitation. METHODS: A survey of 80 patients with advanced cancer was conducted before and after they viewed an educational video. The outcomes of interest included changes in goals of care preference and knowledge and consistency of preferences with code status. RESULTS: Before viewing the video, 10 patients (13%) preferred life-prolonging care, 24 patients (30%) preferred basic care, 29 patients (36%) preferred comfort care, and 17 patients (21%) were unsure. Preferences did not change after the video, when 9 patients (11%) chose life-prolonging care, 28 patients (35%) chose basic care, 29 patients (36%) chose comfort care, and, 14 patients (18%) were unsure (P = .28). Compared with baseline, after the video presentation, more patients did not want cardiopulmonary resuscitation (CPR) (71% vs 62%; P = .03) or ventilation (80% vs 67%; P = .008). Knowledge about goals of care and likelihood of resuscitation increased after the video (P < .001). Of the patients who did not want CPR or ventilation after the video augmentation, only 4 patients (5%) had a documented do-not-resuscitate order in their medical record (kappa statistic, -0.01; 95% confidence interval, -0.06 to 0.04). Acceptability of the video was high. CONCLUSIONS:Patients with advanced cancer did not change care preferences after viewing the video, but fewer wanted CPR or ventilation. Documented code status was inconsistent with patient preferences. Patients were more knowledgeable after the video, reported that the video was acceptable, and said they would recommend it to others. The current results indicated that this type of video may enable patients to visualize "goals of care," enriching patient understanding of worsening health states and better informing decision making.
Authors: Areej El-Jawahri; Lisa M Podgurski; April F Eichler; Scott R Plotkin; Jennifer S Temel; Susan L Mitchell; Yuchiao Chang; Michael J Barry; Angelo E Volandes Journal: J Clin Oncol Date: 2009-11-30 Impact factor: 44.544
Authors: A M O'Connor; D Stacey; V Entwistle; H Llewellyn-Thomas; D Rovner; M Holmes-Rovner; V Tait; J Tetroe; V Fiset; M Barry; J Jones Journal: Cochrane Database Syst Rev Date: 2003
Authors: Areej El-Jawahri; Michael K Paasche-Orlow; Dan Matlock; Lynne Warner Stevenson; Eldrin F Lewis; Garrick Stewart; Marc Semigran; Yuchiao Chang; Kimberly Parks; Elizabeth S Walker-Corkery; Jennifer S Temel; Hacho Bohossian; Henry Ooi; Eileen Mann; Angelo E Volandes Journal: Circulation Date: 2016-07-05 Impact factor: 29.690
Authors: Wendy G Anderson; Lynn A Flint; Jay R Horton; Kimberly Johnson; Michelle Mourad; Bradley A Sharpe Journal: J Hosp Med Date: 2013-11-08 Impact factor: 2.960
Authors: Simon M Cohen; Angelo E Volandes; Michele L Shaffer; Laura C Hanson; Daniel Habtemariam; Susan L Mitchell Journal: J Pain Symptom Manage Date: 2018-09-29 Impact factor: 3.612