Applying the transtheoretical model to health care proxy completion

Area of Science:

• Health Behavior Science
• Medical Decision Making
• Public Health Interventions

Background:

• Advance directives, such as health care proxies, are crucial for end-of-life wishes.
• Current interventions have limited success in increasing advance directive completion.
• Health behavior models like the Transtheoretical Model (TTM) can explain decision-making processes.

Purpose of the Study:

• To assess the Transtheoretical Model's (TTM) applicability to completing a health care proxy (HCP).
• To understand the stages and processes involved in HCP decision-making.

Main Methods:

• Administered four TTM measures (stages of change, processes of change, decisional balance, self-efficacy) to 566 adults.
• Utilized analyses of variance to test relationships between TTM variables.

Main Results:

• Experiential and behavioral processes of change were lowest in precontemplation, peaking in preparation.
• Pros and cons scores crossed over before the preparation stage, consistent with prior research.
• Self-efficacy increased across stages, notably from precontemplation to preparation.

Conclusions:

• The TTM provides a framework for understanding health care proxy completion.
• Developed models can inform stage-based interventions to promote HCP completion.