A Culturally Sensitive Values-Guided Aid for End of Life Decision-Making - Full Text View

Purpose

The goal of this research agenda is to improve the quality of end-of-life care by explicitly identifying values that will guide the decision-making process, with a particular emphasis on the role of ethnic, racial and cultural factors.

Condition	Intervention
Congestive Heart Failure Chronic Obstructive Pulmonary Disease Cirrhosis Colon Carcinoma Lung Cancer	Behavioral: Individual interviews re: end-of-life decision-making Behavioral: Values history discussion w/physician & patient/surrogate

Study Type:	Observational
Study Design:	Observational Model: Cohort Time Perspective: Prospective
Official Title:	A Culturally Sensitive Values-Guided Aid for End of Life Decision-Making

Resource links provided by NLM:

Genetics Home Reference related topics: North American Indian childhood cirrhosis

MedlinePlus related topics: COPD (Chronic Obstructive Pulmonary Disease) Cancer Cirrhosis Heart Failure Hospice Care Lung Cancer

U.S. FDA Resources

Further study details as provided by Department of Veterans Affairs:

Primary Outcome Measures:

Observational study - end of life decision making [ Time Frame: 6 months ] [ Designated as safety issue: No ]

Enrollment:	203
Study Start Date:	December 2004
Study Completion Date:	September 2009
Primary Completion Date:	September 2009 (Final data collection date for primary outcome measure)

Groups/Cohorts	Assigned Interventions
Group 1 patients and surrogates	Behavioral: Individual interviews re: end-of-life decision-making 38 interviews with patients and 33 interviews with surrogates were conducted Behavioral: Values history discussion w/physician & patient/surrogate 128 patient/physician values history discussions were taped, also 4 case studies with surrogates were completed.

Show Detailed Description

Eligibility

Ages Eligible for Study:	55 Years and older
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No
Sampling Method:	Non-Probability Sample

Study Population

Primary care clinic at a large tertiary VA Medical Center

Criteria

Inclusion Criteria:

Eligible patients will be at risk for 6-12 month mortality and have one of the following diagnoses:
- congestive heart failure, with ejection fraction of <25%;
- severe chronic obstructive pulmonary disease/emphysema with dependence on oxygen;
- chronic liver disease with cirrhosis and ascites;
- colon carcinoma with liver metastases; or
- non-small cell cancer of the lung, stage III or IV.
All participants will be age 55 years or older and will be recruited through the clinics at the Houston VAMC.

Exclusion Criteria:

Patients with dementia
Patients less than 55 years old

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00122135

Locations

United States, Texas
Michael E DeBakey VA Medical Center
Houston, Texas, United States, 77030

Sponsors and Collaborators

Department of Veterans Affairs

Investigators

Principal Investigator:

Ursula K. Braun, MD MPH

Michael E DeBakey VA Medical Center

More Information

Publications:

Poon IO, Lal L, Brown EN, Braun UK. The impact of pharmacist-managed oral anticoagulation therapy in older veterans. J Clin Pharm Ther. 2007 Feb;32(1):21-9.

Braun UK, Beyth RJ, Ford ME, McCullough LB. Defining limits in care of terminally ill patients. BMJ. 2007 Feb 3;334(7587):239-41. Review. No abstract available.

Braun UK, McCullough LB, Beyth RJ, Wray NP, Kunik ME, Morgan RO. Racial and ethnic differences in the treatment of seriously ill patients: a comparison of African-American, Caucasian and Hispanic veterans. J Natl Med Assoc. 2008 Sep;100(9):1041-51.

Braun UK, Kunik ME, Pham C. Treating depression in terminally ill patients can optimize their physical comfort at the end of life and provide them the opportunity to confront and prepare for death. Geriatrics. 2008 Jun;63(6):25-7. Review.

Braun UK, Beyth RJ, Ford ME, McCullough LB. Voices of African American, Caucasian, and Hispanic surrogates on the burdens of end-of-life decision making. J Gen Intern Med. 2008 Mar;23(3):267-74. Epub 2008 Jan 3.

Braun UK, Naik AD, McCullough LB. Reconceptualizing the experience of surrogate decision making: reports vs genuine decisions. Ann Fam Med. 2009 May-Jun;7(3):249-53.

Responsible Party:	Department of Veterans Affairs
ClinicalTrials.gov Identifier:	NCT00122135 History of Changes
Other Study ID Numbers:	IIR 02-224
Study First Received:	July 18, 2005
Last Updated:	April 18, 2013
Health Authority:	United States: Federal Government

Keywords provided by Department of Veterans Affairs:

end-of-life care
clinical decision-making
values inventory
racial disparities

Additional relevant MeSH terms:

Carcinoma
Heart Failure
Liver Cirrhosis
Fibrosis
Lung Diseases
Respiration Disorders
Pulmonary Disease, Chronic Obstructive
Lung Neoplasms
Lung Diseases, Obstructive
Colonic Neoplasms
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Neoplasms
Heart Diseases
Cardiovascular Diseases

Liver Diseases
Digestive System Diseases
Pathologic Processes
Respiratory Tract Diseases
Respiratory Tract Neoplasms
Thoracic Neoplasms
Neoplasms by Site
Colorectal Neoplasms
Intestinal Neoplasms
Gastrointestinal Neoplasms
Digestive System Neoplasms
Gastrointestinal Diseases
Colonic Diseases
Intestinal Diseases

ClinicalTrials.gov processed this record on May 23, 2013