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Delivering prognostic news to older people with chronic disease: What format preference and level of involvement in decision making? A hospital survey

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posted on 2023-05-31, 03:57 authored by Ebony T Lewis, Kathrine Hammill, Rebekah Culbert, Madeleen van der Merwe, Ashlyn SahayAshlyn Sahay, Robin Turner, Magnolia Cardona
Shared decision making near end of life is a balancing act of communicating prognosis to patients and their surrogates/families and engaging them in considering value-concordant management choices. This cross-sectional survey aimed to determine the format in which older patients with chronic illnesses would prefer to receive prognostic information on their treatment options and disease progression, and their desired level of engagement in decision making. With a 60% participation rate, 139 inpatients in two hospitals and five surrogates were presented with six hypothetical scenarios with a randomly assigned sequence: verbal and written summary, graph, table, photo, video, and pamphlet. The majority (76%) of respondents chose the traditional verbal communication of prognosis by their doctor with a written summary as a reference and to share with family; the second choice was a condition-specific pamphlet (63%). Many found the graph and photo to be distressing (36% and 42%, respectively). Most (71%) wanted to know everything about their condition trajectory, and 63% chose shared decision making rather than completely autonomous or full delegation to clinicians or family. There were no gender differentials between wanting to know it all, supporting shared decision making or the preferred format for breaking news (p > 0.05). Older hospitalized patients with chronic conditions are willing to discuss end-of-life issues, learn about their prognosis, and be involved in shared decision making. Innovative formats such as graphs, videos, or photos were not welcome as part of the prognostic discussion.31 January 2023

History

Volume

11

Issue

3

Start Page

1

End Page

15

Number of Pages

15

eISSN

2227-9032

ISSN

2227-9032

Publisher

MDPI

Publisher License

CC BY

Additional Rights

CC BY 4.0

Language

en

Peer Reviewed

  • Yes

Open Access

  • Yes

Acceptance Date

2023-01-31

External Author Affiliations

University of Otago, NZ; University of New South Wales; Western Sydney University; Bond University

Era Eligible

  • Yes

Medium

Electronic

Journal

Healthcare

Article Number

444

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