| Description |
More than 1,500 people die of cancer each day. The majority of people, including those in hospice care, die without a living will, without designating a surrogate decision maker, and without communicating their health-care wishes. To date, education has been the sole focus of facilitating the completion of advance care plans. The purpose of this exploratory, quasi-experimental study was to test the feasibility and efficacy of a novel autobiographical memory (ABM) intervention to promote advance care planning (ACP) with older persons with terminally ill cancer in hospice care. Using a two-phase study design, data were collected from two independent groups. Data were collected on the ACP outcomes from a control group in Phase 1. Phase 2 introduced the ABM intervention to the experimental group and collected data on ACP outcomes and the ABM intervention. The findings showed the study was feasible with no attrition by screening with a reliable prognostic tool, accessing data from the electronic medical record, and designing processes and procedures to minimize the challenges and barriers of end-of-life research. Using Mann-Whitney U test, the experimental group, which had received the ABM intervention, had a higher statistically significant likelihood of communicating about the decision for antibiotics (U (48) = 211.00, Z = -2.83, p = 0.005) compared to the control group. There was a meaningful trend toward significance with five other variables: decision making about a feeding tube (U (48) = 231.00, Z = -1.86, p = 0.063), IV therapy (U (48) = 203.00, Z = -2.28, p = 0.023), and communicating about the decision for a feeding tube (U (48) = 234.50, Z = -2.37, p = 0.018), blood (U (48) = 250.00, Z = -1.68, p = 0.094), and an Out of Hospital Do Not Resuscitate form (U (48) = 262.50, Z = -2.06, p = 0.039). iv In conclusion, utilizing an ABM intervention may be effective in influencing the decision making and communication of ACP for terminally ill participants with cancer. Further research studies are needed with the ABM intervention and with the ACP Survey, including reliability studies. |
