Effect of a Video-Supported Nurse-Led Advance Care Planning for Older Adults with Frailty: A Randomized Controlled Trial

Doris Y.P. Leung, Helen Y.L. Chan, Patrick K.C. Chiu and Raymond S.K. Lo

A chapter in New Research in Nursing - Education and Practice from IntechOpen

Abstract: This chapter reports the results of a parallel, double-blinded randomized controlled trial to examine the effect of video-supported nurse-led advance care planning (ACP) as compared with a health education program plus an ACP promotion leaflet on end-of-life decision-making outcomes in older adults with frailty. Outcomes were assessed at 1 month and 6 months after the intervention via telephone. Between December 2018 and January 2020, 449 older adults were screened for eligibility. The trial was terminated early after 105 subjects had been assigned (intervention: 51; control: 54) because of the COVID-19 pandemic and the end of the funding period. No significant between-group difference was found in the retention rate at 1 (41.2% vs. 38.9%) and 6 months (35.3% vs. 44.4%). In the intention-to-treat analysis, the ACP group reported a higher but non-significant advance directive completion rate (5.9% vs. 1.9%) and a significantly higher mean score in quality of communication about end-of-life care at 1 month estimated difference: 8.73 (1.16-16.30). There was no evidence of a difference in favorable outcomes of subjects receiving the video-supported, nurse-led ACP compared with those receiving active control. Results might have been confounded by high attrition, poor intervention completion, and reduced sample size due to the early termination of the study.

Keywords: advance care planning; advance directives; decision aids; decision-making; end-of-life communication; frailty; older adult (search for similar items in EconPapers)
JEL-codes: I11 (search for similar items in EconPapers)
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Persistent link: https://EconPapers.repec.org/RePEc:ito:pchaps:293802

DOI: 10.5772/intechopen.108857

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