Effects of an intervention to improve communication about end-of-life care among African Americans with chronic kidney disease.
Appl Nurs Res
; 23(2): 65-72, 2010 May.
Article
en En
| MEDLINE
| ID: mdl-20420992
ABSTRACT
The prevalence of and mortality from chronic kidney disease (CKD) are high among African Americans. Interventions to improve knowledge of the likely illness course and the benefits and risks of life-sustaining treatment at the end-of-life are needed for African Americans with CKD and their surrogate decision makers. Nineteen African Americans with stage 5 CKD and their surrogates were randomized to either patient-centered advance care planning (PC-ACP) or usual care. PC-ACP dyads showed greater improvement in congruence in end-of-life treatment preferences (p < .05) and higher perceived quality of communication (p < .05) than do control dyads, but the two groups did not differ on other primary outcomes or acceptability measures, such as perceptions of cultural appropriateness. At posttest, 80% of patients in the intervention group reported that they would choose to continue all life-sustaining treatments in a situation of a low chance of survival, whereas 28.6% of patients in the control group reported that they would make that choice. At posttest, 90% of patients in the intervention group reported that they would choose to undergo cardiopulmonary resuscitation even if the chance of surviving the attempt would be low, whereas 57% of patients in the control group reported that they would make that choice. PC-ACP can be effective in improving patient and surrogate congruence in end-of-life treatment preferences. However, the results suggest a need for further improvements in the intervention to enhance cultural appropriateness for African Americans with CKD.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Cuidado Terminal
/
Negro o Afroamericano
/
Comunicación
/
Atención Dirigida al Paciente
/
Planificación Anticipada de Atención
/
Fallo Renal Crónico
Tipo de estudio:
Clinical_trials
/
Prognostic_studies
/
Risk_factors_studies
Aspecto:
Patient_preference
Límite:
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Appl Nurs Res
Asunto de la revista:
ENFERMAGEM
Año:
2010
Tipo del documento:
Article