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An Educational Intervention to Increase Diabetic Patients' Readiness to Discuss Advance Directives in Primary Care

Fuller, Sheila and Gilbert, Sarah and Katz, Katie and Downey, Wendy (2020) An Educational Intervention to Increase Diabetic Patients' Readiness to Discuss Advance Directives in Primary Care. [Dissertation]

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Abstract

Background: Diabetes is a chronic condition with an unpredictable disease trajectory associated with multiple complications and shortened life expectancy. Diabetic patients require frequent office visits to monitor their disease and these visits provide an excellent opportunity for patients to discuss not only their current health status, but also inquire about potential disease progression and options for care in the future, advance care planning. Objective: The purpose of this study is to explore whether providing advance care planning education to diabetic patients in the primary care setting, earlier in their disease process, will improve their readiness to discuss advance directives with their family and providers prior to experiencing a health crisis. Methods: A pretest posttest design involving a sample of N = 34 adult, diabetic patients presenting for routine office visits compared patients’ readiness to discuss advance directives with the Advance Care Planning Engagement Survey, 4–item version, before and after receiving education using the Five Wishes® advance directive form. Results: The mean pretest advance care planning readiness score (M = 15, SD + 4 Likert points) increased to (M = 17, SD + 3 points) after receiving education. Conclusions: Providing advance care planning education to diabetic patients during routine office visits does improve their readiness to discuss advance directives with family and providers. The increase in readiness led to 32% of the sample completing the Five Wishes® form within two weeks and an additional 56% intending to complete a form within three months. Implications for practice: By providing advance care planning education, diabetic patients feel empowered to discuss advance directives with their family and providers earlier in their disease process, while still healthy and capable of making these decisions for themselves. Keywords: Diabetes, diabetes management, advance care planning, advance directives, patient education, Five Wishes®, advance care planning readiness, primary care.

Item Type: Dissertation
Subjects: B Philosophy. Psychology. Religion > BJ Ethics
R Medicine > RC Internal medicine
R Medicine > RT Nursing
Divisions: UNSPECIFIED
Depositing User: Sheila Fuller
Date Deposited: 17 Sep 2020 14:40
Last Modified: 17 Sep 2020 14:40
URI: http://wagner.radford.edu/id/eprint/609

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