Document Detail


Could hypothetical scenarios enhance understanding on decision for life-sustaining treatment in non-demented Chinese older persons?
MedLine Citation:
PMID:  21069605     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: With increasing longevity, there is an increasing need for medical professionals to face situations in which explanation for decision on life-sustaining treatment (LST) would be required.
OBJECTIVES: As advance decision making for LST in case of severe medical illness may be unfamiliar for most of the Chinese elders, we aim to explore if procedures adopted to enhance the exposure to the issue concerned would bring about improvement in knowledge toward decision for LST.
METHOD: This was a cross-sectional study. The design was divided into three sections: (i) a pre-scenario knowledge assessment, (ii) scenario exposure (relating issues of LST using case vignettes), and (iii) a post-scenario assessment. The pre- and post-scenario assessment comprises 10 questions, exploring the understanding toward basic issues related to LST. The scenario exposure comprises two hypothetical case vignettes describing situations demanding decisions for LST. The knowledge level toward LST was assessed and compared before and after the presentation of the two vignettes.
RESULTS: One-hundred community dwelling older persons (aged over 60 years) were recruited. The scenario exposure improved the knowledge level of participants (paired samples t-test, p < 0.05). Participants who were younger and better educated were more likely to perform better in the knowledge test (bivariate correlation and logistic regression, p < 0.05).
CONCLUSIONS: The results demonstrated that hypothetical scenarios may help to enhance and facilitate the understanding of LST. The study should be carried forward to explore the applicability of enhancement procedure to facilitate the decision making for advance directives and LST in the older community.
Authors:
Ada W T Fung; Linda C W Lam; Victor W C Lui
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Aging & mental health     Volume:  14     ISSN:  1364-6915     ISO Abbreviation:  Aging Ment Health     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-11     Completed Date:  2011-02-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9705773     Medline TA:  Aging Ment Health     Country:  England    
Other Details:
Languages:  eng     Pagination:  994-9     Citation Subset:  IM    
Affiliation:
Department of Psychiatry, The Chinese University of Hong Kong, Shatin, NT, HKSAR. fung_wai_tung@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Advance Directives*
Aged
Aged, 80 and over
Asian Continental Ancestry Group / psychology
Comprehension
Cross-Sectional Studies
Decision Making*
Dementia / psychology
Female
Health Knowledge, Attitudes, Practice*
Humans
Life Support Care / psychology*
Logistic Models
Male
Middle Aged
Questionnaires
Socioeconomic Factors
Withholding Treatment

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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