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A systematic evaluation of advance care planning patient educational resources.
Geriatr Nurs. 2019 Mar - Apr; 40(2):174-180.GN

Abstract

BACKGROUND

Advance care planning (ACP) conversations help individuals exercise autonomy and make informed decisions about their care. There are many ACP resources available to support the process of advance care planning, yet available resources not universally accepted and under-utilized in clinical practice.

OBJECTIVE

This study aims to systematically evaluate commonly available general ACP patient educational resources using a comprehensive approach to assess elements ranging from resource inclusion to health literacy.

DESIGN

Systematic evaluation of general ACP educational resources METHODS: ACP educational resources were systematically identified and evaluated for: Patient Education Materials Assessment Tool (PEMAT) score, Flesch-Kincaid reading ease and grade level, cost, languages available, and categories of content including Advance directive/Healthcare proxy, Physician Order for Life-Sustaining Treatment (POLST), Living will, values, preferences, and goals.

RESULTS

Educational resources (n = 20) were identified. These resources were classified as information resources, workbooks, interactive websites, or and activities/conversation guides. The average PEMAT understandability score was 86 (range 58-100) and the average actionability was 90 (range 40-100). Two resources met Flesch-Kincaid reading ease and grade level. Eight were available in English only, nine in two languages, and three in more than two languages. Three explicitly discussed completion of POLST forms. The majority of the resources adequately addressed the content of advanced directives and health care proxy, values, goals, and preferences for future care. The level of time commitment required to use each resource also varied considerably.

CONCLUSION

We present a comprehensive evaluation of resources to support ACP. Using the Transtheoretical Model, we provide a guide for the use of these educational resources based on patient readiness. This review allows clinicians to identify aspects of each resource that may be helpful in preparing older adults for future healthcare decsions. Our analysis has identified the need to continue to refine these educational resources so that they can reach a broad population with varying needs. Advance care planning (ACP) conversations help individuals exercise autonomy and make informed decisions about their care. There are many ACP educational resources available to support the process of advance care planning, yet available resources are not universally accepted and under-utilized in clinical practice. We present a comprehensive evaluation of 20 educational resources to support ACP. Educational resources were identified and evaluated for: Patient Education Materials Assessment Tool (PEMAT) score, Flesch-Kincaid reading ease and grade level, cost, languages available, and categories of content. Using the Transtheoretical Model, we provide a guide for the use of these educational resources based on patient readiness. This review allows clinicians to identify aspects of each resource that may be helpful in preparing older adults for future healthcare decisions. Our analysis has identified the need to continue to refine these educational resources so that they can reach a broad population with varying needs.

Authors+Show Affiliations

University of Massachusetts Boston, College of Nursing and Health Sciences, 100 William T. Morrissey Blvd., Boston, MA 02125-3393, United States. Electronic address: Priscilla.gazarian@umb.edu.University of Massachusetts Boston, College of Nursing and Health Sciences, 100 William T. Morrissey Blvd., Boston, MA 02125-3393, United States. Electronic address: Julie.cronin001@umb.edu.Northeastern University, Bouve College of Health Sciences, 360 Huntington Ave., Boston, MA 02115, United States. Electronic address: jdalto@bwh.harvard.edu.University of Massachusetts Boston, College of Nursing and Health Sciences, 100 William T. Morrissey Blvd., Boston, MA 02125-3393, United States. Electronic address: Kayla.baker001@umb.edu.University of Massachusetts Boston, College of Nursing and Health Sciences, 100 William T. Morrissey Blvd., Boston, MA 02125-3393, United States. Electronic address: Barbara.healy001@umb.edu.University of Massachusetts Boston, College of Nursing and Health Sciences, 100 William T. Morrissey Blvd., Boston, MA 02125-3393, United States. Electronic address: Winona.brudebaide001@umb.edu.University of Massachusetts Boston, College of Nursing and Health Sciences, 100 William T. Morrissey Blvd., Boston, MA 02125-3393, United States.

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

30318178

Citation

Gazarian, Priscilla K., et al. "A Systematic Evaluation of Advance Care Planning Patient Educational Resources." Geriatric Nursing (New York, N.Y.), vol. 40, no. 2, 2019, pp. 174-180.
Gazarian PK, Cronin J, Dalto JL, et al. A systematic evaluation of advance care planning patient educational resources. Geriatr Nurs. 2019;40(2):174-180.
Gazarian, P. K., Cronin, J., Dalto, J. L., Baker, K. M., Friel, B. J., Bruce-Baiden, W., & Rodriguez, L. Y. (2019). A systematic evaluation of advance care planning patient educational resources. Geriatric Nursing (New York, N.Y.), 40(2), 174-180. https://doi.org/10.1016/j.gerinurse.2018.09.011
Gazarian PK, et al. A Systematic Evaluation of Advance Care Planning Patient Educational Resources. Geriatr Nurs. 2019 Mar - Apr;40(2):174-180. PubMed PMID: 30318178.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A systematic evaluation of advance care planning patient educational resources. AU - Gazarian,Priscilla K, AU - Cronin,Julie, AU - Dalto,Jodi L, AU - Baker,Kayla M, AU - Friel,Barbara J, AU - Bruce-Baiden,Winona, AU - Rodriguez,Lesley Y, Y1 - 2018/10/11/ PY - 2018/07/23/received PY - 2018/09/14/revised PY - 2018/09/23/accepted PY - 2018/10/16/pubmed PY - 2019/8/15/medline PY - 2018/10/16/entrez KW - Advance Directives KW - Advance care planning KW - Communication KW - Decision aids KW - Decision making KW - Health literacy KW - PEMAT KW - Patient education KW - Patient education materials KW - Readability KW - Understandability SP - 174 EP - 180 JF - Geriatric nursing (New York, N.Y.) JO - Geriatr Nurs VL - 40 IS - 2 N2 - BACKGROUND: Advance care planning (ACP) conversations help individuals exercise autonomy and make informed decisions about their care. There are many ACP resources available to support the process of advance care planning, yet available resources not universally accepted and under-utilized in clinical practice. OBJECTIVE: This study aims to systematically evaluate commonly available general ACP patient educational resources using a comprehensive approach to assess elements ranging from resource inclusion to health literacy. DESIGN: Systematic evaluation of general ACP educational resources METHODS: ACP educational resources were systematically identified and evaluated for: Patient Education Materials Assessment Tool (PEMAT) score, Flesch-Kincaid reading ease and grade level, cost, languages available, and categories of content including Advance directive/Healthcare proxy, Physician Order for Life-Sustaining Treatment (POLST), Living will, values, preferences, and goals. RESULTS: Educational resources (n = 20) were identified. These resources were classified as information resources, workbooks, interactive websites, or and activities/conversation guides. The average PEMAT understandability score was 86 (range 58-100) and the average actionability was 90 (range 40-100). Two resources met Flesch-Kincaid reading ease and grade level. Eight were available in English only, nine in two languages, and three in more than two languages. Three explicitly discussed completion of POLST forms. The majority of the resources adequately addressed the content of advanced directives and health care proxy, values, goals, and preferences for future care. The level of time commitment required to use each resource also varied considerably. CONCLUSION: We present a comprehensive evaluation of resources to support ACP. Using the Transtheoretical Model, we provide a guide for the use of these educational resources based on patient readiness. This review allows clinicians to identify aspects of each resource that may be helpful in preparing older adults for future healthcare decsions. Our analysis has identified the need to continue to refine these educational resources so that they can reach a broad population with varying needs. Advance care planning (ACP) conversations help individuals exercise autonomy and make informed decisions about their care. There are many ACP educational resources available to support the process of advance care planning, yet available resources are not universally accepted and under-utilized in clinical practice. We present a comprehensive evaluation of 20 educational resources to support ACP. Educational resources were identified and evaluated for: Patient Education Materials Assessment Tool (PEMAT) score, Flesch-Kincaid reading ease and grade level, cost, languages available, and categories of content. Using the Transtheoretical Model, we provide a guide for the use of these educational resources based on patient readiness. This review allows clinicians to identify aspects of each resource that may be helpful in preparing older adults for future healthcare decisions. Our analysis has identified the need to continue to refine these educational resources so that they can reach a broad population with varying needs. SN - 1528-3984 UR - https://www.unboundmedicine.com/medline/citation/30318178/A_systematic_evaluation_of_advance_care_planning_patient_educational_resources_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0197-4572(18)30362-8 DB - PRIME DP - Unbound Medicine ER -