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Advance Care Planning in Community-Dwelling Patients With Dementia
Givens JL, Sudore RL, Marshall GA, Dufour AB, Kopits I, Mitchell SL.. Journal of pain and symptom management, 2017-12-14
Topic: Risk, prevention and care in population studies
Context Little is known about advance care planning (ACP) among community-dwelling patients with dementia. Objectives To describe aspects of ACP among patients with dementia and examine the association between ACP and health care proxy (HCP) acceptance of patients' illness. Methods Cross-sectional observational survey of 62 HCPs of patients with dementia (N = 14 mild, N = 48 moderate/severe), from seven outpatient geriatric and memory disorder clinics in Boston. Aspects of ACP included HCP's report of patients' preferences for level of future care, communication with HCP and physician regarding care preferences, and proxy preparedness for shared decision making. The association between ACP and HCP acceptance with patients' illness was examined using the Peace, Equanimity, and Acceptance subscale of the Cancer Experience Scale. Results Eleven percent of proxies believed that the patient would want life-prolonging treatment, 31% a time-limited trial of curative treatment, and 47% comfort-focused care. Thirty-one percent reported that the patient had communicated with their physician regarding preferences for care, and 77% had communicated with the HCP. Forty-four percent of HCPs wanted more discussion with the patient regarding care preferences. The HCP having discussed care preferences with the patient was associated with greater acceptance of the patient's illness (P = 0.004). Conclusion Our findings support need for greater ACP discussions between patients and proxies. Discussions regarding goals of care are likely to benefit patients through delivery of care congruent with their wishes and HCPs in terms of greater acceptance of patients' illness.
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APA 7th
Givens, J. L., Sudore, R. L., Marshall, G. A., Dufour, A. B., Kopits, I., & Mitchell, S. L. (2018). Advance Care Planning in Community-Dwelling Patients With Dementia. Journal of pain and symptom management. https://doi.org/10.1016/j.jpainsymman.2017.12.473
Vancouver
Givens JL, Sudore RL, Marshall GA, Dufour AB, Kopits I, Mitchell SL. Advance Care Planning in Community-Dwelling Patients With Dementia. Journal of pain and symptom management. 2018. doi:10.1016/j.jpainsymman.2017.12.473. PMID: 29247754.
BibTeX
@article{givens2018-29247754,
author = {Givens, J. L. and Sudore, R. L. and Marshall, G. A. and Dufour, A. B. and Kopits, I. and Mitchell, S. L.},
title = {{Advance Care Planning in Community-Dwelling Patients With Dementia}},
journal = {Journal of pain and symptom management},
year = {2018},
doi = {10.1016/j.jpainsymman.2017.12.473},
pmid = {29247754},
url = {https://doi.org/10.1016/j.jpainsymman.2017.12.473}
}
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Key findings
- Results Eleven percent of proxies believed that the patient would want life-prolonging treatment, 31% a time-limited trial of curative treatment, and 47% comfort-focused care.
- The HCP having discussed care preferences with the patient was associated with greater acceptance of the patient's illness (P = 0.004).
- Conclusion Our findings support need for greater ACP discussions between patients and proxies.
Study details
- Study designcross-sectional
- Participants14
- Evidence strengthLow
How this study scored 52/100
Published in a peer-reviewed journal, and it is a snapshot of people at one point in time. Scored zero for effect reported and randomized / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multicenter collaboration, so those were left out: it earned 30 of the 58 points we could judge it on, which is 52 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of pain and symptom management) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 4 / 12 | A snapshot of people at one point in time |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2018 — within 10 year(s) of the newest study here |
| Sample size | 1 / 4 | 14 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multicenter collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 29247754) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 30 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 30 of the 58 points we could judge it on is 52 out of 100. |
| Total | 52 / 100 | — |
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