Anest. intenziv. Med. 2022;33(3-4):141-147 | DOI: 10.36290/aim.2022.028

Evaluation of the Utility of the Advance Care Planning and Decision­‑Making Supportive ToolOriginal Article

Slezáčková A.^{1, 2}, Malatincová T.^{1, 2}, Rusinová K.³, Kopecký O.³, Kuře J.¹

¹ Ústav lékařské etiky, Lékařská fakulta Masarykovy univerzity v Brně

² Ústav psychologie a psychosomatiky, Lékařská fakulta Masarykovy univerzity v Brně

³ Klinika paliativní medicíny 1. LF UK a VFN v Praze

Objectives: To evaluate the effectiveness of ARS - a newly developed instrument designed for advance care planning for patients with advanced serious illness - in clinical settings, to examine potential differences in perceived effectiveness of ARS between experts and practitioners, and to determine areas in which ARS is perceived as most useful.

Design: Survey; descriptive and correlational study. Setting: Departments of anaesthesiology, resuscitation, intensive medicine, neurology, infectious diseases, and internal medicine, at university and district hospitals.

Material and methods: Ten experts with extensive experience in the field and 20 practitioners instructed to use ARS in their everyday practice rated the usefulness of ARS on several criteria. Data were analysed using descriptive statistics, principal component analysis, correlation analyses, and t-tests.

Results: Both groups generally perceived ARS as undemanding and easy to understand. However, compared to practitioners, experts were much more unanimous in rating ARS highly in the composite criteria of Lower Cognitive Load and Communication Facilitation (Cohen's d = 1.70 and 1.14; p < 0.01). Years of clinical experience were negatively, albeit non-significantly, related to Lower Cognitive Load ratings in practitioners (Spearman's ρ = -0.37, p = 0.13). Ratings of this criterion were generally higher at hospital departments without any previously implemented procedures for advance care planning and decision-making (d = 1.86, p < 0.001).

Conclusion: Both experts and practitioners generally rated ARS as easy to follow, undemanding, and potentially useful. Implementation of the instrument in practice might increase the quality of medical care for patients with advanced serious illness.

Keywords: advance care planning, clinical decision making, communication, end of life, patient preference.

Received: May 26, 2022; Revised: September 5, 2022; Accepted: September 13, 2022; Published: October 27, 2022  Show citation