Tongyao Wang, Mu-Hsing Ho, Nick Tse, Chia-Chin Lin
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Abstract
Background: It is important to engage family caregivers strategically and earlier in the Advance Care Planning (ACP) process. However, there is a lack of supportive information and education for family members on ACP. This study aimed to evaluate the feasibility and preliminary efficacy of a nurse-led motivational interviewing ACP intervention for family caregivers of older adults in nursing homes.
Methods: This was a quasi-experimental study with a post-trial qualitative study (N = 50). Fifty family caregivers of nursing home residents in Hong Kong, China, were first recruited to the intervention group and then the control group in a 1:1 ratio. The intervention was a 3-session, nurse-led program with a motivational interviewing approach to improving their knowledge and understanding of ACP. The control group had no intervention. We evaluated feasibility outcomes with the logistics data and a semi-structured post-intervention qualitative interview and evaluated preliminary efficacy outcomes using the stages of change scale, the ACP readiness measurement, and a measurement of family caregivers' quality of life before and after the intervention.
Results: The participation rate was 56%, and the overall attendance rate of the intervention group was up to 100%. Compared to the control group, the intervention group had significant increases in ACP knowledge, confidence, and stages of change for ACP activity score, except communication skills. Family members recognized their need for ACP information to be prepared as caregivers, and many reported the intervention improved their knowledge and attitude towards ACP and had a stronger desire to sign advance directives.
Conclusions: A nurse-led motivational interviewing intervention is feasible and effective for improving ACP readiness of family caregivers. Nurses play a vital role in preparing the family caregivers for end-of-life care decision-making for their loved ones. Our data inform future ACP interventions for family caregivers of older adults living in nursing homes.
Trial registration: This trial was registered at ClinicalTrials.gov with the following registration number NCT05901506 on June 13th, 2023.
期刊介绍：
BMC Nursing is an open access, peer-reviewed journal that considers articles on all aspects of nursing research, training, education and practice.
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