Advance Care Planning Training for Nurses

Advance Care Planning Clinical Trial

Official title:

The Effectiveness of a Multi-media Experiential Training Programme in Advance Care Planning for Nurses Working in Acute Care Settings

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05625906
• Other study ID #: 2018.610
• Status: Recruiting
• Phase: N/A
• Start date: May 15, 2023
• Est. completion date: December 2024

Study information

• Verified date: March 2024
• Source: Chinese University of Hong Kong
• Contact: Mandy MK Tse
• Phone: 852-39433019
• Email: mankeitse[@]cuhk.edu.hk
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The aims of this study are to examine the effectiveness of a multi-media experiential training programme in advance care planning (ACP) for nursing staff in acute care settings. The main questions it aims to answer are:

• can the programme enhance nurses' decision-support skills

• can the programme strengthen nurses' knowledge and confidence, and improve their attitude toward ACP?

Researchers will compare the participants in the intervention group (receive training programme) with those who are in the control group (receive no intervention) to evaluate the effectiveness of the programme.

Description:

The study adopts a cluster randomised controlled trial with 12 weeks (T2) and 24 weeks (T3) follow-ups. A total of 234 eligible nurses working in 26 acute care hospital wards will be randomised at ward level in a 1:1 ratio into either control or intervention arms. Guided by the Theory of Planned Behaviour, we will conduct path analysis to assess the role of nurses' knowledge, attitudes and confidence on the nurses' skill performance on decision support after the intervention.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 234
• Est. completion date: December 2024
• Est. primary completion date: June 2024
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• registered nurse with at least two years' clinical experience

Exclusion Criteria:

• had prior specialty training in Advance Care Planning communication.

Related Conditions & MeSH terms

• Advance Care Planning

Intervention

Other:
• Multi-media experiential training programme
Webpage and mobile applications of training material on ACP, to be offered four weeks before the workshop A three-hour multimedia workshop (8-10 nurses per group) including enhanced lectures and a role play encounter with standardised patients. Immediate feedback on their quality of decision support skills will be given. The workshops will be delivered by an experienced advance practice nurse with a palliative care specialty. Writing a reflective journal after the role play with standardised patients

Locations

Country	Name	City	State
Hong Kong	United Christian Hospital	Kwun Tong
Hong Kong	Queen Elizabeth Hospital	Mong Kok
Hong Kong	Prince of Wales Hospital	Sha Tin
Hong Kong	Shatin cheshire home	Shatin
Hong Kong	Shatin Hospital	Shatin
Hong Kong	Haven of Hope Hospital	Tseung Kwan O
Hong Kong	Tuen Mun Hospital	Tuen Mun
Hong Kong	Grantham Hospital	Wong Chuk Hang

Sponsors (1)

Lead Sponsor	Collaborator
Chinese University of Hong Kong

Country where clinical trial is conducted

Hong Kong, 

References & Publications (3)

Putman-Casdorph H, Drenning C, Richards S, Messenger K. Advance directives: evaluation of nurses' knowledge, attitude, confidence, and experience. J Nurs Care Qual. 2009 Jul-Sep;24(3):250-6. doi: 10.1097/NCQ.0b013e318194fd69. — View Citation

Siu MW, Cheung TY, Chiu MM, Kwok TY, Choi WL, Lo TK, Ting WM, Yu PH, Cheung CY, Wong JG, Shua SE. The preparedness of Hong Kong medical students towards advance directives and end-of-life issues. East Asian Arch Psychiatry. 2010 Dec;20(4):155-62. — View Citation

So WKW, Kwong ANL, Chen JMT, Chan JCY, Law BMH, Sit JWH, Chan CWH. A Theory-Based and Culturally Aligned Training Program on Breast and Cervical Cancer Prevention for South Asian Community Health Workers: A Feasibility Study. Cancer Nurs. 2019 Mar/Apr;42(2):E20-E30. doi: 10.1097/NCC.0000000000000543. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Nurse's decision support skills as assessed by the Brief Decision Support Analysis Tool (DSAT10)	DSAT10 instrument is an observational feedback tool for evaluating decisional support interactions between health care workers and patients. The DSAT-10 includes 16 items divided into five domains of: Decision-Making Status; Knowledge of Options, Risks, and Benefits; Values Associated with Outcomes of Options. Scores range from zero to ten, with higher scores indicating more decisional support being verbalized during the patient-provider interaction.	Baseline
Primary	Nurse's decision support skills as assessed by the Brief Decision Support Analysis Tool (DSAT10)	DSAT10 instrument is an observational feedback tool for evaluating decisional support interactions between health care workers and patients. The DSAT-10 includes 16 items divided into five domains of: Decision-Making Status; Knowledge of Options, Risks, and Benefits; Values Associated with Outcomes of Options. Scores range from zero to ten, with higher scores indicating more decisional support being verbalized during the patient-provider interaction.	immediate post-intervention
Secondary	Nurses' attitudes towards Advance Care Planning	Nurses' attitudes towards ACP will be measured by nine five-point Likert scale items with 1=strongly disagree and 5= strongly agree. Higher scores indicate a more positive attitude. The scale was developed and validated by Putman-Casdorph et al . The nine items cover topics such as the perceived helpfulness of ACP, and worries about the legal consequences of limiting treatment.	Baseline
Secondary	Nurses' attitudes towards Advance Care Planning	Nurses' attitudes towards ACP will be measured by nine five-point Likert scale items with 1=strongly disagree and 5= strongly agree. Higher scores indicate a more positive attitude. The scale was developed and validated by Putman-Casdorph et al . The nine items cover topics such as the perceived helpfulness of ACP, and worries about the legal consequences of limiting treatment.	immediate post-intervention
Secondary	Nurses' attitudes towards Advance Care Planning	Nurses' attitudes towards ACP will be measured by nine five-point Likert scale items with 1=strongly disagree and 5= strongly agree. Higher scores indicate a more positive attitude. The scale was developed and validated by Putman-Casdorph et al . The nine items cover topics such as the perceived helpfulness of ACP, and worries about the legal consequences of limiting treatment.	12 weeks post-intervention
Secondary	Nurses' knowledge of Advance Care Planning	Knowledge of advance care planning and advance directives will be assessed by a 10-item true / false questionnaire which is developed taking reference with Siu et al. and Yee et al. The knowledge test will be validated by an expert panel including academics and clinicians.	Baseline
Secondary	Nurses' knowledge of Advance Care Planning	Knowledge of advance care planning and advance directives will be assessed by a 10-item true / false questionnaire which is developed taking reference with Siu et al. and Yee et al. The knowledge test will be validated by an expert panel including academics and clinicians.	immediate post-intervention
Secondary	Nurses' knowledge of Advance Care Planning	Knowledge of advance care planning and advance directives will be assessed by a 10-item true / false questionnaire which is developed taking reference with Siu et al. and Yee et al. The knowledge test will be validated by an expert panel including academics and clinicians.	12 weeks post-intervention
Secondary	Nurses' knowledge of Advance Care Planning	Knowledge of advance care planning and advance directives will be assessed by a 10-item true / false questionnaire which is developed taking reference with Siu et al. and Yee et al. The knowledge test will be validated by an expert panel including academics and clinicians.	24 weeks post-intervention
Secondary	Nurses' level of confidence to conduct Advance Care Planning	Nurses' level of confidence to conduct ACP will be measured by a single item five-point Likert scale with 1= not confident at all to 5 = extremely confident .	Baseline
Secondary	Nurses' level of confidence to conduct Advance Care Planning	Nurses' level of confidence to conduct ACP will be measured by a single item five-point Likert scale with 1= not confident at all to 5 = extremely confident .	immediate post-intervention
Secondary	Nurses' level of confidence to conduct Advance Care Planning	Nurses' level of confidence to conduct ACP will be measured by a single item five-point Likert scale with 1= not confident at all to 5 = extremely confident .	12 weeks post-intervention
Secondary	Nurses' level of confidence to conduct Advance Care Planning	Nurses' level of confidence to conduct ACP will be measured by a single item five-point Likert scale with 1= not confident at all to 5 = extremely confident .	24 weeks post-intervention
Secondary	Nurses' satisfaction with the training programme	Nurses' satisfaction with the training programme will be assessed by an eight-item five-point Likert scale with 1=strongly disagree and 5= strongly agree at post-test only. Higher scores indicate higher satisfaction. The scale is developed with reference to So et al. and has been validated by an expert panel including academics and clinicians.	immediate post intervention
Secondary	Actual experience of Advance Care Planning in the last 12 weeks	Actual experience in ACP discussion will be measured by this question: "How many times have you participated in ACP discussion with your patients in the last 12 weeks?" In addition, documentation of the ACP discussion in the last 12 weeks will be retrieved from patients' medical records.	Baseline
Secondary	Actual experience of Advance Care Planning in the last 12 weeks	Actual experience in ACP discussion will be measured by this question: "How many times have you participated in ACP discussion with your patients in the last 12 weeks?" In addition, documentation of the ACP discussion in the last 12 weeks will be retrieved from patients' medical records.	12 weeks post-intervention
Secondary	Actual experience of Advance Care Planning in the last 12 weeks	Actual experience in ACP discussion will be measured by this question: "How many times have you participated in ACP discussion with your patients in the last 12 weeks?" In addition, documentation of the ACP discussion in the last 12 weeks will be retrieved from patients' medical records.	24 weeks post-intervention
Secondary	Adherence to patients' expressed preference for care	measured by this question: Please circle the following to describe health care professionals' adherence to patients' expressed preference for care :	12 weeks post-intervention
Secondary	Adherence to patients' expressed preference for care	measured by this question: Please circle the following to describe health care professionals' adherence to patients' expressed preference for care :	24 weeks post-intervention