Table 1.

Thematic coding of study participant responses

Video arm				Verbatim response
Coding
Educational				It’s something I knew absolutely nothing about.
Qs/concerns				Don’t we have an advance directive in our medical record already? [explored with patient that there is a proxy, but no other directive]
Affirming				I am guided by my orthodox Jewish religious laws.
Affirming	Necessary early	Paradox		I don’t want to live like that. It’s worse to believe in a last ditch effort than to find out sooner that CPR doesn’t work.
Paradox				[Re: female narrator in video] She looks sad (patient); she’s being sincere (patient wife).
Helpful/acceptable				Why did I have all that apprehension? These questions are OK. This is nothing.
Educational	Necessary early	Paradox	MDs	I think everybody should have to watch that. I didn’t realize that. Very hard to see, but I like to be educated. Prolonging life: are you doing that for yourself or the patient?
Paradox				It’s scary (wife); it’s reality, this is common sense (patient).
Affirming				Life comes to an end at a certain point. The video reinforced what we felt inside.
Helpful/acceptable				That was easy.
Helpful/acceptable	Educational			Very informative, not only for the patient, but for family also.
Affirming	Necessary early	Paradox		Common sense: anyone would not want CPR in that state. Sometimes I don’t like to think that far in advance. Makes me feel worse about it: when it happens, it happens.
				But, best to be prepared with the information.
Narrative arm				Verbatim response
Coding
Necessary early				Would make sure to catch people on a good day and better do it early on, rather than when they are down and out.
Educational	Necessary early			We have to discuss it. We have not discussed it. I didn’t realize that that many people don’t leave the hospital [pediatrician’s wife].
Qs/concerns				What about pacemakers?
MDs				There was a time when doctors did not level with their patients, and that was a terrible time.
Affirming				Not offended—it’s reality.
Helpful/acceptable	Necessary early	MDs		Good to talk about it for the future. If you don’t talk about it, you’ll never know. You don’t know doctors care about you if you don’t talk about it.
Affirming	Paradox			It’s difficult for my family to accept my decision, but I want quality of life. It’s a tough decision, but we got through it.
Affirming				I don’t want my family to suffer.
Affirming	Necessary early	Paradox		You never know what the situation is (patient); we have to tailor a directive to the situation (son); but of course I don’t want to prolong this at this age if it’s hopeless (patient).
Qs/concerns	MDs			People sometimes think DNR means DNT (do-not-treat) [retired chemotherapy nurse].
Educational				I guess I didn’t realize that the heart is not the issue when you get really sick from cancer.
Affirming	Necessary early	Paradox		In my opinion, life support delays the mourning process. It’s not being realistic. It keeps you in denial. It’s important to know the facts. You have to talk about it.
Educational	Necessary early			It’s better to deal with these things when you’re reasonably healthy. You are less clouded—the fear is different. And like you said, you can always change your mind.
Necessary early	Paradox			Hard to make decisions until you’re there. Very good to talk about this, though.
Code key
Theme				Theme explanation
Necessary early				ACP should be started early
Affirming				Information about cardiopulmonary resuscitation (CPR) affirmed existing personal beliefs/knowledge/values
Paradox				Participants were apprehensive about advance care planning (ACP) but wanted to discuss it
Educational				Gaps in knowledge emerged
Helpful/acceptable				CPR information was helpful/acceptable
MDs				Physicians should be involved in ACP
Qs/Concerns				Medical questions arose

Each row represents individual study subjects who articulated comments and/or questions, and their articulations are listed here verbatim. Coding columns represent themes ultimately coded from the verbal responses.