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The aims of this study are to examine the effectiveness of a multi-media experiential training programme in advance care planning (ACP) for nursing staff in acute care settings. The main questions it aims to answer are:
Researchers will compare the participants in the intervention group (receive training programme) with those who are in the control group (receive no intervention) to evaluate the effectiveness of the programme.
The study adopts a cluster randomised controlled trial with 12 weeks (T2) and 24 weeks (T3) follow-ups. A total of 234 eligible nurses working in 26 acute care hospital wards will be randomised at ward level in a 1:1 ratio into either control or intervention arms. Guided by the Theory of Planned Behaviour, we will conduct path analysis to assess the role of nurses' knowledge, attitudes and confidence on the nurses' skill performance on decision support after the intervention.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention group | Experimental | will receive a multi-media experiential training programme. |
|
| control group | No Intervention | will NOT receive a multi-media experiential training programme |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Multi-media experiential training programme | Other |
|
| Measure | Description | Time Frame |
|---|---|---|
| Nurse's decision support skills as assessed by the Brief Decision Support Analysis Tool (DSAT10) | DSAT10 instrument is an observational feedback tool for evaluating decisional support interactions between health care workers and patients. The DSAT-10 includes 16 items divided into five domains of: Decision-Making Status; Knowledge of Options, Risks, and Benefits; Values Associated with Outcomes of Options. Scores range from zero to ten, with higher scores indicating more decisional support being verbalized during the patient-provider interaction. | Baseline |
| Nurse's decision support skills as assessed by the Brief Decision Support Analysis Tool (DSAT10) | DSAT10 instrument is an observational feedback tool for evaluating decisional support interactions between health care workers and patients. The DSAT-10 includes 16 items divided into five domains of: Decision-Making Status; Knowledge of Options, Risks, and Benefits; Values Associated with Outcomes of Options. Scores range from zero to ten, with higher scores indicating more decisional support being verbalized during the patient-provider interaction. | immediate post-intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Nurses' attitudes towards Advance Care Planning | Nurses' attitudes towards ACP will be measured by nine five-point Likert scale items with 1=strongly disagree and 5= strongly agree. Higher scores indicate a more positive attitude. The scale was developed and validated by Putman-Casdorph et al . The nine items cover topics such as the perceived helpfulness of ACP, and worries about the legal consequences of limiting treatment. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Carmen Chan Yip Wing-han | Chinese University of Hong Kong | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| United Christian Hospital | Kwun Tong | Hong Kong | ||||
| Queen Elizabeth Hospital |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 19525766 | Background | Putman-Casdorph H, Drenning C, Richards S, Messenger K. Advance directives: evaluation of nurses' knowledge, attitude, confidence, and experience. J Nurs Care Qual. 2009 Jul-Sep;24(3):250-6. doi: 10.1097/NCQ.0b013e318194fd69. | |
| 22348923 | Background | Siu MW, Cheung TY, Chiu MM, Kwok TY, Choi WL, Lo TK, Ting WM, Yu PH, Cheung CY, Wong JG, Shua SE. The preparedness of Hong Kong medical students towards advance directives and end-of-life issues. East Asian Arch Psychiatry. 2010 Dec;20(4):155-62. |
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|
| Baseline |
| Nurses' attitudes towards Advance Care Planning | Nurses' attitudes towards ACP will be measured by nine five-point Likert scale items with 1=strongly disagree and 5= strongly agree. Higher scores indicate a more positive attitude. The scale was developed and validated by Putman-Casdorph et al . The nine items cover topics such as the perceived helpfulness of ACP, and worries about the legal consequences of limiting treatment. | immediate post-intervention |
| Nurses' attitudes towards Advance Care Planning | Nurses' attitudes towards ACP will be measured by nine five-point Likert scale items with 1=strongly disagree and 5= strongly agree. Higher scores indicate a more positive attitude. The scale was developed and validated by Putman-Casdorph et al . The nine items cover topics such as the perceived helpfulness of ACP, and worries about the legal consequences of limiting treatment. | 12 weeks post-intervention |
| Nurses' knowledge of Advance Care Planning | Knowledge of advance care planning and advance directives will be assessed by a 10-item true / false questionnaire which is developed taking reference with Siu et al. and Yee et al. The knowledge test will be validated by an expert panel including academics and clinicians. | Baseline |
| Nurses' knowledge of Advance Care Planning | Knowledge of advance care planning and advance directives will be assessed by a 10-item true / false questionnaire which is developed taking reference with Siu et al. and Yee et al. The knowledge test will be validated by an expert panel including academics and clinicians. | immediate post-intervention |
| Nurses' knowledge of Advance Care Planning | Knowledge of advance care planning and advance directives will be assessed by a 10-item true / false questionnaire which is developed taking reference with Siu et al. and Yee et al. The knowledge test will be validated by an expert panel including academics and clinicians. | 12 weeks post-intervention |
| Nurses' knowledge of Advance Care Planning | Knowledge of advance care planning and advance directives will be assessed by a 10-item true / false questionnaire which is developed taking reference with Siu et al. and Yee et al. The knowledge test will be validated by an expert panel including academics and clinicians. | 24 weeks post-intervention |
| Nurses' level of confidence to conduct Advance Care Planning | Nurses' level of confidence to conduct ACP will be measured by a single item five-point Likert scale with 1= not confident at all to 5 = extremely confident . | Baseline |
| Nurses' level of confidence to conduct Advance Care Planning | Nurses' level of confidence to conduct ACP will be measured by a single item five-point Likert scale with 1= not confident at all to 5 = extremely confident . | immediate post-intervention |
| Nurses' level of confidence to conduct Advance Care Planning | Nurses' level of confidence to conduct ACP will be measured by a single item five-point Likert scale with 1= not confident at all to 5 = extremely confident . | 12 weeks post-intervention |
| Nurses' level of confidence to conduct Advance Care Planning | Nurses' level of confidence to conduct ACP will be measured by a single item five-point Likert scale with 1= not confident at all to 5 = extremely confident . | 24 weeks post-intervention |
| Nurses' satisfaction with the training programme | Nurses' satisfaction with the training programme will be assessed by an eight-item five-point Likert scale with 1=strongly disagree and 5= strongly agree at post-test only. Higher scores indicate higher satisfaction. The scale is developed with reference to So et al. and has been validated by an expert panel including academics and clinicians. | immediate post intervention |
| Actual experience of Advance Care Planning in the last 12 weeks | Actual experience in ACP discussion will be measured by this question: "How many times have you participated in ACP discussion with your patients in the last 12 weeks?" In addition, documentation of the ACP discussion in the last 12 weeks will be retrieved from patients' medical records. | Baseline |
| Actual experience of Advance Care Planning in the last 12 weeks | Actual experience in ACP discussion will be measured by this question: "How many times have you participated in ACP discussion with your patients in the last 12 weeks?" In addition, documentation of the ACP discussion in the last 12 weeks will be retrieved from patients' medical records. | 12 weeks post-intervention |
| Actual experience of Advance Care Planning in the last 12 weeks | Actual experience in ACP discussion will be measured by this question: "How many times have you participated in ACP discussion with your patients in the last 12 weeks?" In addition, documentation of the ACP discussion in the last 12 weeks will be retrieved from patients' medical records. | 24 weeks post-intervention |
| Adherence to patients' expressed preference for care | measured by this question: Please circle the following to describe health care professionals' adherence to patients' expressed preference for care : | 12 weeks post-intervention |
| Adherence to patients' expressed preference for care | measured by this question: Please circle the following to describe health care professionals' adherence to patients' expressed preference for care : | 24 weeks post-intervention |
| Mong Kok |
| Hong Kong |
| Prince of Wales Hospital | Shatin | Hong Kong |
| Shatin cheshire home | Shatin | Hong Kong |
| Shatin Hospital | Shatin | Hong Kong |
| Haven of Hope Hospital | Tseung Kwan O | Hong Kong |
| Tuen Mun Hospital | Tuenmen | Hong Kong |
| Grantham Hospital | Wong Chuk Hang | Hong Kong |
| 28945633 | Background | So WKW, Kwong ANL, Chen JMT, Chan JCY, Law BMH, Sit JWH, Chan CWH. A Theory-Based and Culturally Aligned Training Program on Breast and Cervical Cancer Prevention for South Asian Community Health Workers: A Feasibility Study. Cancer Nurs. 2019 Mar/Apr;42(2):E20-E30. doi: 10.1097/NCC.0000000000000543. |