AAHPM: Patient-Centered Approach Fosters Cooperation

Respecting Choices program enhances agreement between patients, caregivers on end-of-life care

THURSDAY, Jan. 31 (HealthDay News) -- A patient-centered approach to advance care planning leads to enhanced agreement between patients and surrogates in situations involving end-stage heart and kidney failure, according to research presented this week at the annual meeting of the American Academy of Hospice and Palliative Medicine in collaboration with the Hospice and Palliative Nurses Association in Tampa Bay, Fla.

Bernard J. Hammes, Ph.D., of the Gundersen Lutheran Medical Center in La Crosse, Wis., and colleagues conducted a five-year study in which 312 adult patient/surrogate pairs were randomly assigned to either a Respecting Choices intervention group or a standard advance directives control group.

The researchers found that the intervention group was more likely than the control group to express agreement concerning the patient's care preferences, with ratios ranging from 2.7:1 to 6:1 for each of four presented situations. They also found that the intervention group was more knowledgeable about advance care planning than the control group.

"Knowledge gained from this research will be useful in redesigning the federally mandated assessment of advance directives into an improved process of advance care planning to better fit the spirit of the Patient Self-Determination Act," the authors conclude.

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