Table 7.
Descriptive statistics for congruence by five situations at two time points for patient/family dyads randomized to Advance Care Planning (ACP): Direction of congruence as patients changed preferences for end-of-life care
| Situation | Agreement post-Session 1 | Agreement at 12 months | N (%) |
|---|---|---|---|
| Situation 1 (A prolonged hospital stay) at two time points (N = 74a) | Continuing all treatments | Continuing all treatments | 45 (60.8) |
| Continuing all treatments | Limiting all treatments | 3 (4.1) | |
| Limiting all treatments | Limiting all treatments | 24 (32.4) | |
| Limiting all treatments | Continuing all treatments | 2 (2.7) | |
| Situation 2 (Treatments extend life by no more than 2-3 months and the side effects are serious) at two points (N = 63 a) | Continuing all treatments | Continuing all treatments | 33 (52.4) |
| Continuing all treatments | Limiting all treatments | 2 (3.2) | |
| Limiting all treatments | Limiting all treatments | 27 (42.9) | |
| Limiting all treatments | Continuing all treatments | 1 (1.6) | |
| Situation 3 (Physical disabilities-can’t walk and/or talk and would need 24 h nursing care) at two time points (N = 58 a) | Continuing all treatments | Continuing all treatments | 28 (48.3) |
| Continuing all treatments | Limiting all treatments | 6 (10.3) | |
| Limiting all treatments | Limiting all treatments | 21 (36.2) | |
| Limiting all treatments | Continuing all treatments | 3 (5.2) | |
| Situation 4 (Cognitive disabilities-would not know who you are, where you are, or who you are with and need 24 h nursing care) at two time points (N = 53a) | Continuing all treatments | Continuing all treatments | 17 (32.1) |
| Continuing all treatments | Limiting all treatments | 3 (5.7) | |
| Limiting all treatments | Limiting all treatments | 31 (58.5) | |
| Limiting all treatments | Continuing all treatments | 2 (3.8) | |
| Situation 5 (CPR attempt in all circumstances, if doctor recommends; want CPR if heart stops; or don’t attempt CPR, but allow a natural death.) at two time points (N = 47 a) | Choice 1 | Choice 1 | 4 (8.5) |
| Choice 1 | Choice 2 | 2 (4.3) | |
| Choice 1 | Choice 3 | 3 (6.4) | |
| Choice 2 | Choice 2 | 23 (48.9) | |
| Choice 2 | Choice 1 | 3 (6.4) | |
| Choice 2 | Choice 3 | 4 (8.5) | |
| Choice 3 | Choice 3 | 8 (17.0) | |
| Choice 3 | Choice 1 | 0 (0.0) | |
| Choice 3 | Choice 2 | 0 (0.0) |
3 Choices for Situation 5: (1) I want CPR attempted unless my physician determines any of one of the following:I have an incurable illness or injury and am dying: OR I have no reasonable chance of survival if my heart stops: OR I have little chance of long-term survival if my heart stops and the process of resuscitation would cause significant suffering. (2) I want CPR attempted if my heart stops; (3) I do not want CPR attempted if my heart stops, but rather, want to permit a natural death
Sample size for each situation differs, as data are only reported for those ACP dyads that were congruent at both time points to illustrate the direction of changed end-of-life treatment preferences, if and when changes occurred