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Development and Validation of the ACP-CAT for Assessing the Quality of Advance Care Planning Communication.
Yuen, Jacqueline K; Kelley, Amy S; Gelfman, Laura P; Lindenberger, Elizabeth E; Smith, Cardinale B; Arnold, Robert M; Calton, Brook; Schell, Jane; Berns, Stephen H.
Afiliación
  • Yuen JK; Department of Medicine, The University of Hong Kong, Hong Kong SAR, China. Electronic address: jkyuen@hku.hk.
  • Kelley AS; Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Geriatric Research Education and Clinical Center, James J. Peters VA Medical Center, Bronx, New York, USA.
  • Gelfman LP; Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Geriatric Research Education and Clinical Center, James J. Peters VA Medical Center, Bronx, New York, USA.
  • Lindenberger EE; Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Geriatric Research Education and Clinical Center, James J. Peters VA Medical Center, Bronx, New York, USA.
  • Smith CB; Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Arnold RM; Division of General Internal Medicine, University of Pittsburgh, Pittsburg, Pennsylvania, USA.
  • Calton B; Division of Palliative Medicine, University of California, San Francisco, California, USA.
  • Schell J; Division of Renal-Electrolyte, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
  • Berns SH; Division of Palliative Medicine, University of Vermont, Burlington, Vermont, USA.
J Pain Symptom Manage ; 59(1): 1-8.e3, 2020 01.
Article en En | MEDLINE | ID: mdl-31520727
CONTEXT: High-quality advance care planning (ACP) discussions are important to ensure patient receipt of goal-concordant care; however, there is no existing tool for assessing ACP communication quality. OBJECTIVES: The objective of this study was to develop and validate a novel instrument that can be used to assess ACP communication skills of clinicians and trainees. METHODS: We developed a 20-item ACP Communication Assessment Tool (ACP-CAT) plus two summative items. Randomized rater pairs assessed residents' performances in video-recorded standardized patient encounters before and after an ACP training program using the ACP-CAT. We tested the tool for its 1) discriminating ability, 2) interrater reliability, 3) concurrent validity, 4) feasibility, and 5) raters' satisfaction. RESULTS: Fifty-eight pre/post-training video recordings from 29 first-year internal medicine residents at Mount Sinai Hospital were evaluated. ACP-CAT reliably discriminated performance before and after training (median score 6 vs. 11, P < 0.001). For both pre/post-training encounters, interrater reliability was high for ACP-CAT total scores (intraclass correlation coefficient or ICC = 0.83 and 0.82) and the summative items Overall impression of ACP communication skills (ICC = 0.73 and 0.80) and Overall ability to respond to emotion (ICC = 0.83 and 0.82). Concurrent validity was shown by the strong correlation between ACP-CAT total score and both summative items. Raters spent an average of 4.8 minutes to complete the ACP-CAT, found it feasible, and were satisfied with its use. CONCLUSION: ACP-CAT provides a validated measure of ACP communication quality for assessing video-recorded encounters and can be further studied for its applicability with clinicians in different clinical contexts.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Relaciones Médico-Paciente / Comunicación / Planificación Anticipada de Atención Tipo de estudio: Clinical_trials Límite: Adult / Female / Humans / Male Idioma: En Revista: J Pain Symptom Manage Asunto de la revista: NEUROLOGIA / PSICOFISIOLOGIA / TERAPEUTICA Año: 2020 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Relaciones Médico-Paciente / Comunicación / Planificación Anticipada de Atención Tipo de estudio: Clinical_trials Límite: Adult / Female / Humans / Male Idioma: En Revista: J Pain Symptom Manage Asunto de la revista: NEUROLOGIA / PSICOFISIOLOGIA / TERAPEUTICA Año: 2020 Tipo del documento: Article Pais de publicación: Estados Unidos