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Making your wishes known

Megumi Inoue, Emily Ihara, Albert Terrillion
Using Andersen's health behavioral model as a framework, this study examined factors associated with the completion of advance directives and the behavior of sharing them with one's family and health care providers. Data were from the 2014 United States of Aging Survey ( N = 1,153; aged 60 or older), and multinomial logistic regression was used for analysis. We found that 73% of respondents had advance directives. However, 28% have not shared their advance directives with anyone. The sense of having completed a great deal of preparation for the future and the number of illnesses were found to be relevant to the behavior of sharing advance directives...
December 1, 2017: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
Michael J Green, Lauren J Van Scoy, Andrew J Foy, Renee R Stewart, Ramya Sampath, Jane R Schubart, Erik B Lehman, Anne E F Dimmock, Ashley M Bucher, Lisa S Lehmann, Alyssa F Harlow, Chengwu Yang, Benjamin H Levi
OBJECTIVE: To evaluate 2 strategies for preparing family members for surrogate decision-making. DESIGN: A 2 × 2 factorial, randomized controlled trial testing whether: (1) comprehensive online advance care planning (ACP) is superior to basic ACP, and (2) having patients engage in ACP together with family members is superior to ACP done by patients alone. SETTING: Tertiary care centers in Hershey, Pennsylvania, and Boston, Massachusetts. PARTICIPANTS: Dyads of patients with advanced, severe illness (mean age 64; 46% female; 72% white) and family members who would be their surrogate decision-makers (mean age 56; 75% female; 75% white)...
January 1, 2017: American Journal of Hospice & Palliative Care
Tracey Loscar
No abstract text is available yet for this article.
February 2016: EMS World
Jane R Schubart, Michael J Green, Lauren J Van Scoy, Erik Lehman, Elana Farace, Niraj J Gusani, Benjamin H Levi
BACKGROUND: People with cancer face complex medical decisions, including whether to receive life-sustaining treatments at the end of life. It is not unusual for clinicians to make assumptions about patients' wishes based on whether they had previously chosen to pursue curative treatment. OBJECTIVE: We hypothesized that cancer patients who initially underwent curative intent surgery (CIS) would prefer more aggressive end-of-life treatments compared to patients whose treatment was noncurative intent (non-CIT)...
December 2015: Journal of Palliative Medicine
Michael J Green, Jane R Schubart, Megan M Whitehead, Elana Farace, Erik Lehman, Benjamin H Levi
CONTEXT: Many physicians avoid advance care planning (ACP) discussions because they worry such conversations will lead to psychological distress. OBJECTIVES: To investigate whether engaging in ACP using online planning tools adversely affects hope, hopelessness, or anxiety among patients with advanced cancer. METHODS: Patients with advanced cancer and an estimated survival of two years or less (Intervention group) and a Control group were recruited at a tertiary care academic medical center (2007-2012) to engage in ACP using an online decision aid ("Making Your Wishes Known")...
June 2015: Journal of Pain and Symptom Management
Jane R Schubart, Benjamin H Levi, Fabian Camacho, Megan Whitehead, Elana Farace, Michael J Green
Despite widespread efforts to promote advance directives (ADs), completion rates remain low. Making Your Wishes Known: Planning Your Medical Future (MYWK) is an interactive computer program that guides individuals through the process of advance care planning, explaining health conditions and interventions that commonly involve life or death decisions, helps them articulate their values/goals, and translates users' preferences into a detailed AD document. The purpose of this study was to demonstrate that (in the absence of major life changes) the AD generated by MYWK reliably reflects an individual's values/preferences...
June 2012: Journal of Palliative Medicine
Benjamin H Levi, Michael J Green
In the face of mounting criticism against advance directives, we describe how a novel, computer-based decision aid addresses some of these important concerns. This decision aid, Making Your Wishes Known: Planning Your Medical Future, translates an individual's values and goals into a meaningful advance directive that explicitly reflects their healthcare wishes and outlines a plan for how they wish to be treated. It does this by (1) educating users about advance care planning; (2) helping individuals identify, clarify, and prioritize factors that influence their decision-making about future medical conditions; (3) explaining common end-of-life medical conditions and life-sustaining treatment; (4) helping users articulate a coherent set of wishes with regard to advance care planning-in the form of an advance directive readily interpretable by physicians; and (5) helping individuals both choose a spokesperson, and prepare to engage family, friends, and health care providers in discussions about advance care planning...
April 2010: American Journal of Bioethics: AJOB
Michael J Green, Benjamin H Levi
OBJECTIVE: To describe the development of an innovative, multi-media decision aid for advance care planning. BACKGROUND: Advance care planning is an important way for people to articulate their wishes for medical care when they are not able to speak for themselves. Living wills and other types of advance directives are the most commonly used tools for advance care planning, but have been criticized for being vague, difficult to interpret, and inconsistent with individuals' core beliefs and values...
March 2009: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
Sharon J Rolnick, Andrea Altschuler, Larissa Nekhlyudov, Joann G Elmore, Sarah M Greene, Emily L Harris, Lisa J Herrinton, Mary B Barton, Ann M Geiger, Suzanne W Fletcher
Although prophylactic mastectomy significantly reduces the incidence and recurrence of breast cancer, little is known about women's information needs before the procedure. We surveyed 967 women, from 6 healthcare systems, with bilateral or contralateral prophylactic mastectomy performed between 1979 and 1999. There were 2 open-ended questions: "What one thing do you wish you had known before your prophylactic mastectomy" and "Is there anything else you would like to share with us?" Three researchers categorized responses, and informational needs were ascertained...
July 2007: Cancer Nursing
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