Effects of Intervention on Hope, Anxiety, and Attitudes and Behavioral Intentions of Advance Care Planning in Older Adults With Cancer

Study Overview
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Brief Summary
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The study aims to explore the impact of advance care planning on the attitudes, behavioral intentions, hopes, and anxiety of elderly people with cancer on advance care planning with the assistance of the Advance Care Consultation for the Elderly manual.

Detailed Description
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The experimental group used the cartoon version of the Advance Care Consultation for the Elderly manual to guide the ACP process. The process included three parts: an introduction to ACP, an introduction to terminal medical care, and a discussion of what the participants wanted to do about their own health in the past, present, and future required medical care. The estimated time to lead and conduct the ACP conversation is approximately 40 minutes. The control group maintained routine care. The measurement tools are the Advance Care Planning Attitude Scale, Behavioral Intention Scale, Chinese version of Situational Anxiety Inventory-Situational Anxiety Inventory (STAI-S), and Hope State Inventory (Herth Hope Index, HHI) ). There are three measurement time points: pre-test, two weeks after intervention, and one month after intervention. Expected research results: It is expected that intervention measures can improve the positive attitudes and behavioral intentions of elderly people with cancer towards ACP while maintaining their sense of hope without increasing anxiety. It is hoped that the intervention of ACP can enhance the exploration of their own medical preferences and values by the elderly with cancer, and help them become more aware of their own choices and needs when facing treatment decisions in the future.

Official Title
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Effects of Intervention on Hope, Anxiety, and Attitudes and Behavioral Intentions of Advance Care Planning in Older Adults With Cancer

Conditions
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Advance Care Planning

Intervention / Treatment
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* Behavioral: Handbook for Geriatric Prearranged Medical Care Consultation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Cancer patients aged 65 years or older. Patients currently undergoing cancer treatment. Clear consciousness and able to communicate in Mandarin or Taiwanese. Score of 8 points or higher (inclusive) on the Short Portable Mental State Questionnaire (SPMSQ). Exclusion Criteria: Individuals with a score of 7 points or lower (inclusive) on the Short Portable Mental State Questionnaire (SPMSQ). Individuals who have not been informed about their cancer diagnosis.

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: Supportive Care
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Handbook for Geriatric Prearranged Medical Care Consultation<br>The experimental group utilized a cartoon version of the Advance Care Consultation for the Elderly manual to facilitate the ACP process, which encompassed three components: an introduction to ACP, an overview of terminal medical care, and a discussion about the participants' preferences for their past, current, and future required medical care. | Behavioral: Handbook for Geriatric Prearranged Medical Care Consultation<br>* The experimental group utilized a cartoon version of the Advance Care Consultation for the Elderly manual to facilitate the ACP process, which encompassed three components: an introduction to ACP, an overview of terminal medical care, and a discussion about the participants' preferences for their past, current, and future required medical care. There are three measurement time points: pre-test, two weeks after intervention, and one month after intervention.<br>|
| No Intervention: Control group<br>No Intervention: standard clinical care | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Attitude Scale | The questionnaire is scored using a 5-point Likert scale. There are a total of 12 questions, resulting in a total score ranging from 24 to 120, with responses ranging from strongly disagree (1 point) to strongly agree (5 points) . A higher score indicates a more positive attitude among the elderly towards advance care planning. | three measurement time points: pre-test, two weeks after intervention, and one month after intervention. | 
| Behavioral Intention Scale | The scale is scored using a 5-point Likert scale. There are a total of six questions, resulting in a total score ranging from 6 to 30, with responses ranging from very unlikely (1 point) to very likely (5 points) | three measurement time points: pre-test, two weeks after intervention, and one month after intervention. | 
| State Anxiety, A-State，STAI-S | The scale consists of 20 questions, each with 4 options: completely does not fit, fits slightly, fits, and fits very well. Out of these, 10 questions are positively framed (3, 4, 6, 7, 9, 12, 13, 14, 17, and 18). The scoring is as follows: 1 point for completely does not fit, 2 points for fits slightly, 3 points for fits, and 4 points for fits very well. The remaining ten questions are negatively framed, and scoring is reversed, with 4 points for completely does not fit, 3 points for fits slightly, 2 points for fits, and 1 point for fits very well. The total score ranges from 20 to 80 points. A higher score indicates a higher level of anxiety, with scores of 20 to 39 indicating mild anxiety, 40 to 59 indicating moderate anxiety, and 60 to 80 indicating severe anxiety. | three measurement time points: pre-test, two weeks after intervention, and one month after intervention. | 
| Herth Hope Index, HHI | The scale is scored using a 4-point Likert scale, with 1 point indicating strongly disagree and 4 points indicating strongly agree, resulting in a total score ranging from 12 to 48 points. | three measurement time points: pre-test, two weeks after intervention, and one month after intervention. |