Knowledge of Living Will in Patients With Rheumatic Diseases

Study Overview
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Brief Summary
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The living will is a legal document derived from a communication and deliberation process, medical ethical aspect, currently regulated in Mexico by the General Health Law and the Health Law of Mexico City. Knowledge of living will in the population with chronic diseases, including rheumatic diseases, has been little addressed. Most patients do not know what the living will document is, so they do not carry it out and others, despite knowing it, have a passive attitude toward doing it.

Detailed Description
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A study will be carried out on patients with rheumatic diseases and healthy family controls. Patients will be selected from those attending the Department of Immunology and Rheumatology in Mexico City outpatient department, including consecutive cases. The patients will be assessed for their quality of life and disability. Patients and controls will be evaluated on the knowledge of living will, their perceptions about specific health outcomes, sociodemographic characteristics, comorbidities, and psychiatric pathology.

Official Title
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Knowledge of Living Will in Patients With Rheumatic Diseases. A Case-control Study

Conditions
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Rheumatic Disorder

Intervention / Treatment
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* Other: Health Assessment Questionnaire (HAQ)
* Other: Depression, Anxiety and Stress Scale (DASS-21)
* Other: Brief Resilient Coping Scale
* Other: WHOQOL-BREF
* Other: Routine assessment of patient index data 3 (RAPID-3)
* Other: Rheumatic disease comorbidity index
* Other: Living will questionnaire
* Other: Perceptions of Health Outcomes Questionnaire


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Cases Patients with a rheumatic disease diagnostic by a rheumatologist Patients with rheumatic diseases attending the Department of Immunology and Rheumatology in Mexico City outpatient department Patients who agree to participate in the study, who complete and sign the informed consent Controls Relative of a patient with rheumatic diseases of the same sex and age ± 5 years, without known rheumatic and/or chronic disease and without the use of pharmacological treatment for more than 7 days during the month before study entry. Exclusion Criteria: Cases Patients with severe diseases or in palliative care by a rheumatologist Controls - Withdrawal of the study

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 100 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Cases<br>Patients with rheumatic diseases from the outpatient clinic at a tertiary care level in Mexico City | Other: Health Assessment Questionnaire (HAQ)<br>* The HAQ is based on five patient-centered dimensions: disability, pain, medication effects, costs of care, and mortality<br>Other: Depression, Anxiety and Stress Scale (DASS-21)<br>* DASS-21 is a set of three self-report scales designed to measure the emotional states of depression, anxiety, and stress. Each of the three DASS-21 scales contains 7 items, divided into subscales with similar content<br>Other: Brief Resilient Coping Scale<br>* Brief Resilient Coping Scale is a 4-item measure designed to capture tendencies to cope with stress in a highly adaptive manner<br>Other: WHOQOL-BREF<br>* WHOQOL-BREF is a 26-item instrument consisting of four domains: physical health, psychological health, social relationships, and environmental health; it also contains QOL and general health items<br>Other: Routine assessment of patient index data 3 (RAPID-3)<br>* RAPID- 3 measures: function, pain, and patient global estimate of status. Each of the 3 individual measures is scored 0 to 10, for a total of 30<br>Other: Rheumatic disease comorbidity index<br>* It is rated from 0 to 9 and comprises 11 comorbid conditions including lung disease, cardio-vascular disease, hypertension, diabetes, fracture, depression, cancer, and gastrointestinal ulcer<br>Other: Living will questionnaire<br>* A questionnaire with 17 items about knowledge of the living will.<br>Other: Perceptions of Health Outcomes Questionnaire<br>* A questionnaire with 7 items about the probability of quitting the job, getting an infectious disease, requiring emergency medical attention, hospitalization or intensive care, dependence and death.<br>|
| Controls<br>Two patients´ relatives of the same sex, age ± five years and who are known to be healthy | Other: Health Assessment Questionnaire (HAQ)<br>* The HAQ is based on five patient-centered dimensions: disability, pain, medication effects, costs of care, and mortality<br>Other: Depression, Anxiety and Stress Scale (DASS-21)<br>* DASS-21 is a set of three self-report scales designed to measure the emotional states of depression, anxiety, and stress. Each of the three DASS-21 scales contains 7 items, divided into subscales with similar content<br>Other: Brief Resilient Coping Scale<br>* Brief Resilient Coping Scale is a 4-item measure designed to capture tendencies to cope with stress in a highly adaptive manner<br>Other: WHOQOL-BREF<br>* WHOQOL-BREF is a 26-item instrument consisting of four domains: physical health, psychological health, social relationships, and environmental health; it also contains QOL and general health items<br>Other: Rheumatic disease comorbidity index<br>* It is rated from 0 to 9 and comprises 11 comorbid conditions including lung disease, cardio-vascular disease, hypertension, diabetes, fracture, depression, cancer, and gastrointestinal ulcer<br>Other: Living will questionnaire<br>* A questionnaire with 17 items about knowledge of the living will.<br>Other: Perceptions of Health Outcomes Questionnaire<br>* A questionnaire with 7 items about the probability of quitting the job, getting an infectious disease, requiring emergency medical attention, hospitalization or intensive care, dependence and death.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Knowledge of the living will with the living will questionnaire (locally development) | To evaluate the knowledge of the living will, using the living will questionnaire (locally development), among the patients with rheumatic diseases and healthy controls. | 1 day At study inclusion (After their rheumatology consultation) | 
| Perceptions of Health Outcomes with the perceptions of health outcomes questionnaire (locally development) | To evaluate the perceptions of the of health outcomes using the perceptions of health outcomes questionnaire (locally development), among the patients with rheumatic diseases and healthy controls | 1 day At study inclusion (After their rheumatology consultation) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Rheumatic diseases, living will