The effectiveness of a modified advance care planning programme

Area of Science:

• Gerontology
• Palliative Care
• Health Services Research

Background:

• Frailty is a common aspect of aging, particularly concerning in China's growing elderly population.
• Effective end-of-life care and quality of life for frail older adults are critical public health issues.
• Advance Care Planning (ACP) is established globally for improving end-of-life care but is underutilized in China.

Purpose of the Study:

• To assess the impact of a modified Advance Care Planning (ACP) intervention on frail older adults.
• Evaluate changes in certainty and preferences regarding end-of-life care.
• Examine effects on quality of life concerns and healthcare utilization.

Main Methods:

• A quasi-experimental, single-blind, control group design with pretest and repeated posttest.
• 148 frail older adults were recruited from two nursing homes in Zhejiang Province, China.
• Convenience sampling was used, with 74 participants in each group.

Main Results:

• The ACP program significantly increased autonomy in end-of-life care decision-making.
• Participants reported decreased decision-making conflicts regarding end-of-life care.
• Expression of end-of-life care preferences and concerns was notably enhanced.

Conclusions:

• The modified ACP intervention proved effective in promoting autonomy and open discussion of end-of-life issues.
• This approach helps overcome cultural reluctance to discuss death in Chinese society.
• The intervention is recommended for supporting end-of-life care decisions among frail older adults in China.