Development of an Advance Care Planning Portal-Based Tool for Community-Dwelling Persons Living With Cognitive Impairment: The ACPVoice Tool.
Jennifer Gabbard, Ashley E Strahley, Nicholas M Pajewski and 9 others
PMID 36239407WHAT IT FOUND
Persons with mild cognitive impairment or mild dementia mostly understood advance care planning questions, but vague wording, past-focused questions, and narrow examples changed their answers.
Use current, plain terms and allow multiple answers.
Key findings
01Participants generally understood the advance care planning questions, but some items needed wording changes.
02Questions that asked what mattered most often drew past activities, so wording was changed to ask what is important currently.
03Examples in response options helped some people but also led others to skip goals that were relevant if the example did not fit, so examples were broadened and multiple answers were allowed.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was done at one academic medical center. The sample was small and may not represent all community-dwelling people with cognitive impairment. People with moderate to severe dementia, moderate to severe hearing loss, blindness, and non-English speakers were excluded. Some interviews were by telephone and participants had a hard copy in advance, which may have affected how their first responses were assessed. No portal usability or clinical outcomes were tested; the tool still needs usability testing and a pilot. Analysis was done by one researcher, with oversight from the principal investigator.
Declared interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
The easy way to misread this
Do not read this as proof that the ACPVoice portal tool improves advance care planning or patient outcomes. It was only tested through interviews for item comprehension and response problems, and the paper says usability testing and pilot use are next steps.