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The Web-Based Advance Care Planning Program "Explore Your Preferences for Treatment and Care": Development, Pilot Study, and Before-and-After Evaluation
Department of Public Health, Erasmus MC, University Medical Center Rotterdam , Rotterdam , NL.ORCID iD: 0000-0003-2363-9416
Department of Public Health, Erasmus MC, University Medical Center Rotterdam , Rotterdam , NL.ORCID iD: 0000-0002-0538-5603
University of Borås, Faculty of Caring Science, Work Life and Social Welfare. Department of Public Health, Erasmus MC, University Medical Center Rotterdam , Rotterdam , NL; Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen , NL.ORCID iD: 0000-0002-1651-7544
Dutch College of General Practitioners , Utrecht , NL.ORCID iD: 0000-0002-3417-686X
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2022 (English)In: Journal of Medical Internet Research, E-ISSN 1438-8871, Vol. 24, no 12, article id e38561Article in journal (Refereed) Published
Abstract [en]

Background:

Web-based advance care planning (ACP) programs may support patients in thinking about and discussing their preferences for future treatment and care. However, they are not widely available, and only a limited number of programs are evidence based.

Objective:

We aimed to develop and evaluate an evidence-based, interactive web-based ACP program that guides users through the process of thinking about, discussing, and recording of preferences for treatment and care.

Methods:

The program “Explore your preferences for treatment and care” was developed, pilot-tested on feasibility, and subsequently evaluated; engagement in ACP was assessed before program completion and 2 months after program completion using the ACP Engagement Survey (score 1-5) among 147 persons with chronic disease. Usability (score 0-100) and user satisfaction (score 1-5) were also assessed.

Results:

ACP engagement increased from 2.8 before program completion to 3.0 two months after program completion (P<.001); contemplation about ACP increased from 2.6 to 2.8 (P=.003), and readiness for ACP increased from 2.2 to 2.5 (P<.001). No changes were found for knowledge about ACP (3.0-3.2; P=.07) and self-efficacy for ACP (3.8-3.8; P=.25). The program was perceived as usable (mean 70, SD 13), attractive (mean 3.8, SD 0.7), and comprehensible (mean 4.2, SD 0.6).

Conclusions:

We developed an evidence-based, interactive web-based ACP program in cocreation with patients, relatives, and health care professionals. Before-and-after evaluation showed that the program can support people in taking first steps in ACP and in reflecting on preferences for treatment and care, by guiding them through the process of ACP using a stepwise approach. Participants perceived the program as usable and understandable, and they were satisfied with the program and with the amount of information. Health care professionals may use the program as a tool to start ACP discussions with their patients. The program may increase awareness of ACP.

Place, publisher, year, edition, pages
2022. Vol. 24, no 12, article id e38561
Keywords [en]
advance care planning, internet-based intervention, decision aids, patient education, eHealth, health communication, patient-centered care, chronic disease
National Category
Nursing
Research subject
The Human Perspective in Care
Identifiers
URN: urn:nbn:se:hb:diva-29094DOI: 10.2196/38561ISI: 000915325800006PubMedID: PMC9758635Scopus ID: 2-s2.0-85143379724OAI: oai:DiVA.org:hb-29094DiVA, id: diva2:1717834
Available from: 2022-12-09 Created: 2022-12-09 Last updated: 2024-01-17Bibliographically approved

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van Dulmen, Sandra

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van der Smissen, DorisRietjens, Judith A Cvan Dulmen, SandraDrenthen, TonVrijaldenhoven-Haitsma, F Ragnhild M DWulp, Marijkevan der Heide, AgnesKorfage, Ida J
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