Pilot Evaluation of Hospice Decision Support Tools

Study Overview
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Brief Summary
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The goal of this project is to determine the feasibility and acceptability of a hospice decision aid among a diverse population of older adults at multiple stages of illness (Aim 1) and to determine the preliminary efficacy of the hospice decision aid on decision quality, hospice knowledge, and values-concordance (Aim 2). By testing the feasibility, acceptability, and preliminary efficacy of a novel hospice Patient Decision Aid (PTDa) in a diverse population of older adults, additionally the study will simultaneously explore barriers to PtDA implementation in both an outpatient primary care and inpatient palliative care setting. The study will also gather sufficient pilot data to support a subsequent effectiveness/implementation trial and thus address the absence of quality of SDM interventions for end-of-life care decision-making.

Official Title
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Pilot Evaluation of Hospice Decision Support Tools

Conditions
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Hospice, End-of-life Decision Making, Hospice Decision Making

Intervention / Treatment
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* Other: Hospice Decision Aids


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 65 or older. At least one life-limiting illness or syndrome. Exclusion Criteria: Non-English speakers. Patients with cognitive Impairments preventing ability to provide informed consent. Patients on isolation precautions due to resistant bacteria or impaired immune function.

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Control<br> | |
| Other: Intervention<br>Participants will receive hospice decisional support materials and be asked to review them. Participants will provide feedback on tools and complete feasibility, efficacy and knowledge assessments. | Other: Hospice Decision Aids<br>* Paper and video hospice decision aid<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Hospice Knowledge Scale | Hospice Knowledge Scale is a 23-item true/false scale that measures patient knowledge about hospice care. Each question is worth 1 point with possible scores ranging from 0 to 23. Higher scores indicate more knowledge. | 1 month follow-up | 
| Hospice Beliefs and Attitudes Scale | 8-item scale developed to measure beliefs and attitudes towards hospice care. It has a Cronbach's α = .74 for the scale, indicating a good degree of internal reliability. Scores from 8 to 40. Higher scores indicate better opinions of hospice. . | 1-Month follow up | 
| Decision Self Efficacy Scale | Is an 11-item instrument that one's self-confidence in decision making. This scale is a validated scale with a Cronbach's alpha of 0.92 and correlates with DCS subscale of being informed (r=0.47). Scored from 0-100 with higher scores indicating more decision self efficacy. | 1 month Follow up | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Hospice, End-of-life, Patient decision aid, Shared decision making