Идёт набор NCT06090240

Motivational Interviewing to Enhance Advance Care Planning for Older Adults and Caregivers After Emergency Visits

Без фазы С лечением Older Adults Advance Care Planning Advance Directives Family Members

Ориентир для пациента и семьи

Простыми словами

Автоматическая сводка по структурированным данным реестра. Она помогает сориентироваться, но не заменяет официальный протокол или оценку врача.

Что изучают: В протоколе указаны: Dyadic MI-ACP intervention, Elderly alone MI-ACP.
Кому может быть актуально: Состояния в реестре: Older Adults, Advance Care Planning, Advance Directives, Family Members. Базовые параметры: Без ограничений · Все.
Что важно проверить: Возраст, диагноз и пол — только базовые ориентиры. Предыдущее лечение, анализы и другие обязательные условия указаны ниже в критериях участия.
Где проводится: Гонконг
Следующий шаг: Сохраните исследование, покажите его лечащему врачу и уточните актуальный статус у исследовательского центра. Расходы, документы и поездка →

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Официальное название

Maximizing Teachable Moments: Motivational Interviewing (MI) to Enhance Advance Care Planning (ACP) for Older Adults and Caregivers After Emergency Visits - A Mixed-Method Randomized Controlled Trial

Обзор

This study aims to evaluate the effectiveness of a motivational interviewing (MI) intervention in enhancing advance care planning (ACP) among older adults who have visited the Emergency Room (ER) in the past six months and their family caregivers. The main question it aims to answer is: The effectiveness of the MI-based ACP intervention implemented within six months of an ER visit on improving older adults' advance directives (AD) completion rate. Compared to participants in the control group who will only receive a self-education booklet, participants in the intervention group will receive a motivational interview educational intervention to see the effectiveness of an MI-based ACP intervention implemented within six months following an emergency room visit regarding the completion of AD for older adults.

Подробное описание

Targeted issue: At present no feasible method exists to empower older adults following ER visits to engage in ACP in Hong Kong.

Population: The target group will be dyads comprising older adults who have had ER visits within the previous six months and their family caregivers.

Intervention: An MI-based ACP intervention our team developed.

Main study aim: To investigate the effectiveness of an MI-based ACP intervention implemented within six months following an emergency room visit on completion of AD for older adults compared to a self-education group.

Study method: Investigators will recruit eligible participants from two largest public hospitals, including the geriatric outpatient clinic of Queen Mary Hospital (IRB Ref: UW23-402) and the accident \& emergency department of Queen Elizabeth Hospital (IRB Ref: KC/KE-23-0058/ER-1). A parallel RCT (allocation ratio= 1:1) with a post-trial qualitative study will be adopted and three follow-up time points at 3-, 6- and 12-month post-intervention. Participants in the intervention group will receive a dyadic motivational interview educational intervention, while participants in the comparison group will receive the pictorial ACP educational booklet for self-learning only. Patients unable to nominate a family caregiver will receive the elderly alone motivational interview educational intervention. Completion of AD and health service utilization will be assessed at three follow-up time points. In addition, a post-intervention interview, regarding stakeholders' views on the relevance, effectiveness, and experience of the intervention., will be conducted.

Вмешательства

Поведенческое Dyadic MI-ACP intervention
Motivational Interviewing on Advance Care Planning Intervention: Dyads of older adults and family caregivers will receive three MI-based ACP counselling sessions: (1) a preparatory session, (2) motivation session, and (3) planning session. The preparatory session will take 10-15 minutes, and the following two sessions in weeks 2 and 3 will last 30-45 minutes each. Before each session, the nurse interventionist will first assess the dyad's readiness to engage in ACP based on the state of change a
Поведенческое Elderly alone MI-ACP
Older adults in this arm will receive an MI-based education intervention our team developed.

Первичные конечные точки

Older adults' readiness for ACP [Срок оценки: before the intervention (T0), and 3-month (T1), 6-month (T2), and 12-months (T3) post intervention.]

Вторичные конечные точки (8)

Family caregivers' readiness for ACP [Срок оценки: before the intervention (T0), and 3-month (T1), 6-month (T2), and 12-months (T3) post intervention.]
Older adults' emotional perception of ACP [Срок оценки: before the intervention (T0), and 3-month (T1), 6-month (T2), and 12-months (T3) post intervention.]
Older adults' and family caregivers' decisional conflict [Срок оценки: before the intervention (T0), and 3-month (T1), 6-month (T2), and 12-months (T3) post intervention.]
Older adults and family caregivers' congruence in goal of EOL care [Срок оценки: before the intervention (T0), and 3-month (T1), 6-month (T2), and 12-months (T3) post intervention.]
Older adults' completion of AD documentation [Срок оценки: before the intervention (T0), and 3-month (T1), 6-month (T2), and 12-months(T3) post intervention .]
Older adults' health service utilization [Срок оценки: 3-month (T1), 6-month (T2), and 12-months (T3) post intervention.]
Older adults' and family caregivers' baseline characteristics [Срок оценки: before the intervention (T0)]
Older adults and family caregivers' experience with the Nurse Navigation Program [Срок оценки: 3-month (T1) post intervention]

Критерии участия

The target group will be dyads comprising older adults who have had ER visits within the previous six months and their family caregivers. A dyad is defined as one older adult and one primary family caregiver of the older adult.

For older adults:

Критерии включения

Aged 65 or older
At least one episode of ER visit in the last six months
Has a family caregiver to be present during the intervention
Able to communicate in Chinese

Критерии исключения

Has completion of an AD
Moderate to severe cognitive impairment or diagnosis of dementia, as identified in health records
Communication problems (e.g., deafness or aphasia)

For family caregivers:

Критерии включения

Aged 18 or above
Immediate or extended family member or friend nominated by an eligible older adult participant as primary caregiver
Able to communicate in Chinese