A video-supported nurse-led advance care planning on end-of-life decision-making among frail older patients : protocol for a randomized controlled trial

Abstract

Aim: To examine the effect of a video‐supported nurse‐led advance care planning to frail geriatric patients on end‐of‐life decision‐making outcomes in patients and their carers. Design: This is a double‐blinded randomized controlled trial with parallel arms. Methods: The protocol was approved by the Institutional Review Board of the participating hospital on 1 August 2018. Frail elders and their carer if any are enrolled during hospitalization, and undergo randomization after discharged. The intervention group receives a 2‐week video‐supported nurse‐led advance care planning programme (N = 149) while the control group receives a 2‐week health education program at home (N = 149). Follow‐up surveys via telephone at 1 and 6 months measure outcomes regarding end‐of‐life decision‐making from both the patients and the carers. Conclusion: Advance care planning discussion is to understand patient's values, preferences and treatment for care on their anticipation of future deterioration. Treatment options for end‐of‐life care may not be well‐received especially elders because in the discussion process, technical medical terms are presented in an abstract, hypothetical way that are hard to understand. The present study aims to evaluate the effect of a nurse‐led advance care planning supplementing with a video showing end‐of‐life treatment options to promote end‐of‐life care decision‐making among frail geriatric patients. Impact: The results will help identify effective elements of advance care planning and inform the development of an evidence?based structured advance care planning intervention in response to the need for quality end‐of‐life care. Trial registration: Chinese Clinical Trial Registry ChiCTR‐IOR‐17012341