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Do surrogates predict patient preferences more accurately after a physician-led discussion about advance directives? A randomized controlled trial

dc.contributor.authorMartins, Catarina Sampaio
dc.contributor.authorSousa, Iva
dc.contributor.authorBarros, Cláudia
dc.contributor.authorPires, Alexandra
dc.contributor.authorCastro, Luísa
dc.contributor.authorSantos, Cristina da Costa
dc.contributor.authorNunes, Rui
dc.date.accessioned2022-12-13T18:11:51Z
dc.date.available2022-12-13T18:11:51Z
dc.date.issued2022-07
dc.description.abstractCaregivers frequently assume the role of surrogate decision-makers but often are unable to accurately predict patients’ preferences. This trial aims to find if the use of the Advance Directives documents as a communication tool, improves the agreement between patients and caregivers. This trial occurred in a palliative care service of a Portuguese hospital center. A prospective, single-blinded, controlled, randomized trial, enrolling patients and caregivers as a dyad was conducted. Participants individually fulfilled an Advance Directive document, in which patients reported their end-of-life preferences and caregivers reported their decisions as patients’ health surrogates. Dyads were randomly assigned to the Intervention or the Control group, in which the physician respectively promoted an open discussion about patients’ Advance Directives or evaluated patients’ clinical condition. Caregivers’ Advance Directives as surrogates were collected one month later. Proportions of agreement and Cohen’s κ were used to access agreement and reliability, respectively, between the dyads. Results from 58 dyads were analyzed. We observed an improvement in agreement between the caregivers’ answers and the patients’ wishes on two-thirds (8/12) of the answers, in the Intervention group, contrasting to one-quarter (3/12) of the answers, in the Control group, despite statistical significance in differences wasn´t obtained. Although not reaching statistical significance, the results suggest that discussions of advance directives with physicians may lead to better prepared surrogates.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationMartins, C. S., Sousa, I., Barros, C., Pires, A., Castro, L., da Costa Santos, C., & Nunes, R. (2022). Do surrogates predict patient preferences more accurately after a physician-led discussion about advance directives? A randomized controlled trial. BMC Palliative Care, 21(1), 122. https://doi.org/10.1186/s12904-022-01013-3pt_PT
dc.identifier.doihttps://doi.org/10.1186/s12904-022-01013-3pt_PT
dc.identifier.eissn1472-684X
dc.identifier.urihttp://hdl.handle.net/10400.22/21191
dc.language.isoengpt_PT
dc.publisherBMCpt_PT
dc.relation.publisherversionhttps://bmcpalliatcare.biomedcentral.com/articles/10.1186/s12904-022-01013-3pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectPalliative carept_PT
dc.subjectAdvance directivespt_PT
dc.subjectCaregiverspt_PT
dc.subjectDecision-makingpt_PT
dc.titleDo surrogates predict patient preferences more accurately after a physician-led discussion about advance directives? A randomized controlled trialpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage10pt_PT
oaire.citation.startPage1pt_PT
oaire.citation.titleBMC Palliative Carept_PT
oaire.citation.volume21pt_PT
person.familyNameCastro Guedes
person.givenNameMaria Luísa
person.identifier.ciencia-id7D19-EABE-CF3B
person.identifier.orcid0000-0002-1312-0154
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication59f421de-a393-47e4-83b1-fb436c35b797
relation.isAuthorOfPublication.latestForDiscovery59f421de-a393-47e4-83b1-fb436c35b797

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