Effects of advance care education in cardiovascular rehabilitation programs: a prospective randomized study.

PURPOSE: To determine the effect of advance care education provided to patients enrolled in cardiovascular rehabilitation (CVR) programs and assess patients' acceptance of the educational program. METHODS: In a multicenter, prospective, randomized study, the authors administered two questionnaires 6...

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Publicado en:Journal of Cardiopulmonary Rehabilitation Vol. 21; no. 6; pp. 387 - 392
Autores principales: Heffner JE, Barbieri C
Formato: clinical trial research tables/charts Journal Article
Publicado: Lippincott Williams & Wilkins 2001 Nov-Dec
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 2001 Nov-Dec
      vid: 21
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      pub: Lippincott Williams & Wilkins
      place: Baltimore, Maryland
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        atl: Effects of advance care education in cardiovascular rehabilitation programs: a prospective randomized study.
      aug:
        au:
          Heffner JE
          Barbieri C
        affil: Professor of Medicine, Medical University of South Carolina, Pulmonary Division, 96 Jonathan Lucas Street, PO Box 250623, Charleston, SC 29425; heffnerj@musc.edu
      sug:
        subj:
          Patient Education
          Advance Directives Education
          Rehabilitation, Cardiac
          Clinical Trials
          Prospective Studies
          Questionnaires
          Chi Square Test
          Fisher's Exact Test
          T-Tests
          Wilcoxon Rank Sum Test
          McNemar's Test
          Odds Ratio
          Confidence Intervals
          Female
          Male
          Adult
          Middle Age
          Aged
          Aged, 80 and Over
          Living Wills
          Durable Power of Attorney
          Outcomes of Education
          Physician-Patient Relations
          Human
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Female
          Male
      ab: PURPOSE: To determine the effect of advance care education provided to patients enrolled in cardiovascular rehabilitation (CVR) programs and assess patients' acceptance of the educational program. METHODS: In a multicenter, prospective, randomized study, the authors administered two questionnaires 6 months apart to 284 patients enrolled in 14 CVR programs in 11 states. An educational group (99 subjects) participated in educational programs related to advance care planning and received advance directive forms after completing the first questionnaires; 185 subjects served as controls. Primary outcomes were completion of patient-physician discussions of end-of-life issues and patient confidence that their end-of-life wishes were understood by their physicians. Secondary outcomes were completion of formal advance directives and patient acceptance of the educational program. RESULTS: Both the educational and control groups demonstrated a larger proportion of patients at the end of the study, compared with the amount at the beginning of the study, who had completed living wills, durable powers of attorney for healthcare, and discussions with their physicians about advance directives and life support care. These outcomes were not observed more commonly after the educational intervention. Neither groups gained confidence, however, that their physicians understood their end-of-life wishes. Only 8.6% of patients had a negative response to the educational program. CONCLUSIONS: Advance care education is well received by patients enrolled in CVR programs. Enrollment in CVR promotes advance care planning to a small but measurable degree CVR rehabilitation programs appear to be acceptable sites for advance care planning but further research is needed to develop effective educational interventions.
      pubtype: Academic Journal
      doctype:
        clinical trial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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