Development and preliminary usability testing of an electronic conversation guide incorporating patient values and prognostic information in preparation for older people's decision-making near the end of life
Initiating end-of-life conversations can be daunting for clinicians and overwhelming for patients and families. This leads to delays in communicating prognosis and preparing for the inevitable in old age, often generating potentially harmful overtreatment and poor-quality deaths. We aimed to develop...
| Main Authors: | , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-09-01
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| Series: | Internet Interventions |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S221478292300043X |
| _version_ | 1797740870488817664 |
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| author | Magnolia Cardona Ebony T. Lewis Alex Bannach-Brown Genevieve Ip Janice Tan Eyza Koreshe Joshua Head Jin Jie Lee Shirley Rangel Lorraine Bublitz Connor Forbes Amanda Murray Isabella Marechal-Ross Nikita Bathla Ruth Kusnadi Peter G. Brown Hatem Alkhouri Maree Ticehurst Nigel H. Lovell |
| author_facet | Magnolia Cardona Ebony T. Lewis Alex Bannach-Brown Genevieve Ip Janice Tan Eyza Koreshe Joshua Head Jin Jie Lee Shirley Rangel Lorraine Bublitz Connor Forbes Amanda Murray Isabella Marechal-Ross Nikita Bathla Ruth Kusnadi Peter G. Brown Hatem Alkhouri Maree Ticehurst Nigel H. Lovell |
| author_sort | Magnolia Cardona |
| collection | DOAJ |
| description | Initiating end-of-life conversations can be daunting for clinicians and overwhelming for patients and families. This leads to delays in communicating prognosis and preparing for the inevitable in old age, often generating potentially harmful overtreatment and poor-quality deaths. We aimed to develop an electronic resource, called Communicating Health Alternatives Tool (CHAT) that was compatible with hospital medical records software to facilitate preparation for shared decision-making across health settings with older adults deemed to be in the last year of life.The project used mixed methods including: literature review, user-directed specifications, web-based interface development with authentication and authorization; clinician and consumer co-design, iterative consultation for user testing; and ongoing developer integration of user feedback. An internet-based conversation guide to facilitate clinician-led advance care planning was co-developed covering screening for short-term risk of death, patient values and preferences, and treatment choices for chronic kidney disease and dementia. Printed summary of such discussion could be used to begin the process in hospital or community health services. Clinicians, patients, and caregivers agreed with its ease of use and were generally accepting of its contents and format. CHAT is available to health services for implementation in effectiveness trials to determine whether the interaction and documentation leads to formal decision-making, goal-concordant care, and subsequent reduction of unwanted treatments at the end of life. |
| first_indexed | 2024-03-12T14:18:44Z |
| format | Article |
| id | doaj.art-aac3cdcf90934ceb8a08905694ce6392 |
| institution | Directory Open Access Journal |
| issn | 2214-7829 |
| language | English |
| last_indexed | 2024-03-12T14:18:44Z |
| publishDate | 2023-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Internet Interventions |
| spelling | doaj.art-aac3cdcf90934ceb8a08905694ce63922023-08-20T04:37:59ZengElsevierInternet Interventions2214-78292023-09-0133100643Development and preliminary usability testing of an electronic conversation guide incorporating patient values and prognostic information in preparation for older people's decision-making near the end of lifeMagnolia Cardona0Ebony T. Lewis1Alex Bannach-Brown2Genevieve Ip3Janice Tan4Eyza Koreshe5Joshua Head6Jin Jie Lee7Shirley Rangel8Lorraine Bublitz9Connor Forbes10Amanda Murray11Isabella Marechal-Ross12Nikita Bathla13Ruth Kusnadi14Peter G. Brown15Hatem Alkhouri16Maree Ticehurst17Nigel H. Lovell18Graduate School of Biomedical Engineering, University of New South Wales, Sydney, Australia; Institute for Evidence-Based Healthcare, Bond University, Robina, Australia; Gold Coast Hospital and Health Service, Professorial Unit, Southport, Australia; Corresponding author at: Graduate School of Biomedical Engineering, The University of New South Wales, Kensington, Sydney, Australia; Institute for Evidence-Based Healthcare, Bond University, 14 University Dr, Robina, QLD 4226, Australia.School of Population Health, Faculty of Medicine & Health, University of New South Wales, Sydney, Australia; School of Psychology, Faculty of Science, University of New South Wales, Sydney, NSW, AustraliaInstitute for Evidence-Based Healthcare, Bond University, Robina, AustraliaSchool of Population Health, Faculty of Medicine & Health, University of New South Wales, Sydney, AustraliaSchool of Population Health, Faculty of Medicine & Health, University of New South Wales, Sydney, AustraliaInsideOut Institute, Faculty of Medicine & Health, The University of Sydney, Camperdown, AustraliaGraduate School of Biomedical Engineering, University of New South Wales, Sydney, AustraliaGraduate School of Biomedical Engineering, University of New South Wales, Sydney, AustraliaGold Coast Hospital and Health Service, Professorial Unit, Southport, AustraliaGold Coast Hospital and Health Service, Professorial Unit, Southport, AustraliaInstitute for Evidence-Based Healthcare, Bond University, Robina, AustraliaInstitute for Evidence-Based Healthcare, Bond University, Robina, AustraliaNorthern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, AustraliaSchool of Population Health, Faculty of Medicine & Health, University of New South Wales, Sydney, AustraliaSchool of Population Health, Faculty of Medicine & Health, University of New South Wales, Sydney, AustraliaGraduate School of Biomedical Engineering, University of New South Wales, Sydney, AustraliaAgency for Clinical Innovation, Emergency Care Institute, Chatswood, AustraliaSchool of Population Health, Faculty of Medicine & Health, University of New South Wales, Sydney, Australia; Mark Moran Aged Care, Little Bay, New South Wales, AustraliaGraduate School of Biomedical Engineering, University of New South Wales, Sydney, AustraliaInitiating end-of-life conversations can be daunting for clinicians and overwhelming for patients and families. This leads to delays in communicating prognosis and preparing for the inevitable in old age, often generating potentially harmful overtreatment and poor-quality deaths. We aimed to develop an electronic resource, called Communicating Health Alternatives Tool (CHAT) that was compatible with hospital medical records software to facilitate preparation for shared decision-making across health settings with older adults deemed to be in the last year of life.The project used mixed methods including: literature review, user-directed specifications, web-based interface development with authentication and authorization; clinician and consumer co-design, iterative consultation for user testing; and ongoing developer integration of user feedback. An internet-based conversation guide to facilitate clinician-led advance care planning was co-developed covering screening for short-term risk of death, patient values and preferences, and treatment choices for chronic kidney disease and dementia. Printed summary of such discussion could be used to begin the process in hospital or community health services. Clinicians, patients, and caregivers agreed with its ease of use and were generally accepting of its contents and format. CHAT is available to health services for implementation in effectiveness trials to determine whether the interaction and documentation leads to formal decision-making, goal-concordant care, and subsequent reduction of unwanted treatments at the end of life.http://www.sciencedirect.com/science/article/pii/S221478292300043XEnd of lifeDecision-makingChronic diseasePatient-centred careInternet-based interventionOlder adults |
| spellingShingle | Magnolia Cardona Ebony T. Lewis Alex Bannach-Brown Genevieve Ip Janice Tan Eyza Koreshe Joshua Head Jin Jie Lee Shirley Rangel Lorraine Bublitz Connor Forbes Amanda Murray Isabella Marechal-Ross Nikita Bathla Ruth Kusnadi Peter G. Brown Hatem Alkhouri Maree Ticehurst Nigel H. Lovell Development and preliminary usability testing of an electronic conversation guide incorporating patient values and prognostic information in preparation for older people's decision-making near the end of life Internet Interventions End of life Decision-making Chronic disease Patient-centred care Internet-based intervention Older adults |
| title | Development and preliminary usability testing of an electronic conversation guide incorporating patient values and prognostic information in preparation for older people's decision-making near the end of life |
| title_full | Development and preliminary usability testing of an electronic conversation guide incorporating patient values and prognostic information in preparation for older people's decision-making near the end of life |
| title_fullStr | Development and preliminary usability testing of an electronic conversation guide incorporating patient values and prognostic information in preparation for older people's decision-making near the end of life |
| title_full_unstemmed | Development and preliminary usability testing of an electronic conversation guide incorporating patient values and prognostic information in preparation for older people's decision-making near the end of life |
| title_short | Development and preliminary usability testing of an electronic conversation guide incorporating patient values and prognostic information in preparation for older people's decision-making near the end of life |
| title_sort | development and preliminary usability testing of an electronic conversation guide incorporating patient values and prognostic information in preparation for older people s decision making near the end of life |
| topic | End of life Decision-making Chronic disease Patient-centred care Internet-based intervention Older adults |
| url | http://www.sciencedirect.com/science/article/pii/S221478292300043X |
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