Effect of a disease-specific planning intervention on surrogate understanding of patient goals for future medical treatment.

Journal of the American Geriatrics Society
Karin T KirchhoffRoger L Brown

Abstract

To determine whether a disease-specific planning process can improve surrogate understanding of goals of patients with life-limiting illnesses for future medical treatments. A multisite randomized controlled trial conducted between January 1, 2004 and July 31, 2007. Six outpatient clinics of large community or university health systems in three Wisconsin cities. Competent, English-speaking adults aged 18 and older with chronic congestive heart failure or chronic renal disease and their surrogate decision-makers. Trained health professionals conducted a structured, patient-centered interview intended to promote informed decision-making and to result in the completion of a document clarifying the goals of the patient with regard to four disease-specific health outcome situations and the degree of decision-making latitude granted to the surrogate. Surrogate understanding of patient goals for care with regard to four expected, disease-specific outcomes situations and of the degree of surrogate latitude in decision-making. Three hundred thirteen patient-surrogate pairs completed the study. As measured according to kappa scores and in all four situations and in the degree of latitude, intervention group surrogates demonstrated a sign...Continue Reading

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