- Primary Investigator:
Angelo E. Volandes - Primary Location:
Massachusetts General Hospital - Grant Type & Year:
Robert Derzon Fall 2006 - Publication:
Publication1
Purpose
Researchers are exploring the difference in elderly patients’ preferences for the level of medical care in advanced dementia and their health literacy when given a video as opposed to a verbal narrative on dementia. They will evaluate whether videos of other diseases can serve as a tool to assist clinicians in discussions of complex information with patients with low health literacy. Researchers propose to conduct a randomized trial studying ACP for elderly subjects using a video depiction of a patient with dementia compared to the traditional verbal narrative. Their primary outcome measure will be preferences for medical care for the two groups, the video arm and the verbal narrative arm. Predictors of end-of-life preferences will include health literacy, age, gender, race, ethnicity, religion, language, marital status and health status. A secondary outcome is the effect of the video and verbal narrative on knowledge and decisional conflict.
Findings
There was a highly statistically significant difference between the preferences of the two groups. Of the 100 subjects in the verbal narrative group, 35 subjects wished to have aggressive medical care if they had advanced dementia. At the six-week follow-up telephone interview, more than 20% of subjects changed their minds to a different preference. Of the 100 subjects in the video intervention group, only 10 subjects preferred aggressive care if they had advanced dementia; the vast majority of subjects chose comfort care. At the six-week follow-up telephone interview, only one subject (1%) changed his mind to another preference.
