Impact of a Systematic Social Work Driven Approach on Medical Power of Attorney Documentation, Knowledge, Attitudes, and Beliefs in Participants With Stage I-IV Gynecological Cancers
Preparing Patients and Family Caregivers for Medical Decision Making: Evaluating the Impact of a Systematic Social Work Driven Approach on Medical Power of Attorney Documentation, Knowledge, Attitudes and Beliefs
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
PRIMARY OBJECTIVES:
I. To evaluate medical power of attorney documents (MPOAD) completion rate after a systematic social work counseling and education clinical process.
SECONDARY OBJECTIVES:
I. To determine change in medical power of attorney (MPOA)/primary family caregivers' knowledge, attitudes and beliefs about conditions for quality surrogate medical decision-making (MDM).
II. To determine change in MPOA/primary family caregivers' knowledge of patients' values and goals for MDM.
III. Evaluate patients' and MPOA/primary family caregivers' willingness to participate in future advance care planning discussions to discuss patients' values and goals important to MDM.
IV. Evaluate predictors of patient subgroups most likely to respond to the social work counseling and education clinical process.
V. Explore aspects of the Spanish language version of the advance care planning engagement survey to inform future validation studies.
OUTLINE:
Participants (patients and family caregiver/MPOA) complete questionnaires about knowledge, attitudes, and beliefs of MPOAD. Participants without a MPOAD watch a 4-minute educational video about the importance of the role of MPOA.
After completion of intervention, participants are followed up at 3 months.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Texas
-
Houston, Texas, United States, 77030
- M D Anderson Cancer Center
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- PATIENTS
- Diagnosis of invasive gynecologic malignancy stages 1-4.
- New patient in the Gynecologic Oncology Center.
- Adequate capacity to understand and complete MPOAD in the opinion of the study investigator or research assistant.
- Able to speak and understand English and/or Spanish.
- Provision of Institutional Review Board (IRB)-approved informed consent.
- Available MPOA or primary family caregiver who consents to study participation.
- FAMILY CAREGIVER/MPOA
- MPOA or if none documented in electronic health record (EHR), primary family caregiver, as designated by the patient.
- Permission to contact provided by patient.
- Adequate capacity to understand and complete study measures in the opinion of the study investigator or research assistant.
- Provision of IRB-approved informed consent.
Exclusion Criteria:
- Without a MPOA or available family caregiver.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Supportive Care (questionnaires, educational video)
Participants (patients and family caregiver/MPOA) complete questionnaires about knowledge, attitudes, and beliefs of MPOAD.
Participants without a MPOAD watch a 4-minute educational video about the importance of the role of MPOA.
|
Ancillary studies
Complete questionnaires about MPOAD
Watch educational video
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Proportion of patients who decline to participate in the study
Time Frame: Up to 3 months
|
Will be reported with 95% confidence intervals.
Descriptive demographic and disease characteristics for patients who decline study participation but allow collection of demographic and disease characteristics will be compared to those of participating patients.
|
Up to 3 months
|
|
Proportion of patients who already have medical power of attorney (MPOAD) at consult
Time Frame: Up to 3 months
|
Will be reported with 95% confidence intervals.
Baseline and changes in MPOA/primary family caregivers' knowledge, attitudes and beliefs about conditions for quality surrogate medical decision-making (MDM), in patients/primary family caregivers' self-efficacy and readiness for MPOA, and in patients/Primary family caregivers' knowledge of patients' values and goals for MDM, will be summarized and compared among the four patient groups: 1) had MPOAD at the consult already, 2) complete MPOAD at the first visit, 3) complete MPOAD after initial social work counselor visit and by 3 months, 4) do not complete MPOAD by 3 months, using Kruskal-Wallis test for continuous variables and either Chi-square test or Fisher's exact test for discrete variables, whenever appropriate.
Univariate/multi-covariate logistic regression will be employed to evaluate the effect of potential factors on completion of MPOAD.
|
Up to 3 months
|
|
Proportion of patients who completed MPOAD at the first social work counselor visit
Time Frame: Up to 3 months
|
Will be reported with 95% confidence intervals.
Baseline and changes in MPOA/primary family caregivers' knowledge, attitudes and beliefs about conditions for quality surrogate MDM, in patients/primary family caregivers' self-efficacy and readiness for MPOA, and in patients/Primary family caregivers' knowledge of patients' values and goals for MDM, will be summarized and compared among the four patient groups: 1) had MPOAD at the consult already, 2) complete MPOAD at the first visit, 3) complete MPOAD after initial social work counselor visit and by 3 months, 4) do not complete MPOAD by 3 months, using Kruskal-Wallis test for continuous variables and either Chi-square test or Fisher's exact test for discrete variables, whenever appropriate.
Univariate/multi-covariate logistic regression will be employed to evaluate the effect of potential factors on completion of MPOAD.
|
Up to 3 months
|
|
Proportion of participants who completed MPOAD after the first educational video
Time Frame: Up to 3 months
|
Will be reported with 95% confidence intervals.
Baseline and changes in MPOA/primary family caregivers' knowledge, attitudes and beliefs about conditions for quality surrogate MDM, in patients/primary family caregivers' self-efficacy and readiness for MPOA, and in patients/Primary family caregivers' knowledge of patients' values and goals for MDM, will be summarized and compared among the four patient groups: 1) had MPOAD at the consult already, 2) complete MPOAD at the first visit, 3) complete MPOAD after initial social work counselor visit and by 3 months, 4) do not complete MPOAD by 3 months, using Kruskal-Wallis test for continuous variables and either Chi-square test or Fisher's exact test for discrete variables, whenever appropriate.
Univariate/multi-covariate logistic regression will be employed to evaluate the effect of potential factors on completion of MPOAD.
|
Up to 3 months
|
|
Proportion of participants who completed MPOAD within 3 months after the educational video
Time Frame: Up to 3 months
|
Will be reported with 95% confidence intervals.
Baseline and changes in MPOA/primary family caregivers' knowledge, attitudes and beliefs about conditions for quality surrogate MDM, in patients/primary family caregivers' self-efficacy and readiness for MPOA, and in patients/Primary family caregivers' knowledge of patients' values and goals for MDM, will be summarized and compared among the four patient groups: 1) had MPOAD at the consult already, 2) complete MPOAD at the first visit, 3) complete MPOAD after initial social work counselor visit and by 3 months, 4) do not complete MPOAD by 3 months, using Kruskal-Wallis test for continuous variables and either Chi-square test or Fisher's exact test for discrete variables, whenever appropriate.
Univariate/multi-covariate logistic regression will be employed to evaluate the effect of potential factors on completion of MPOAD.
|
Up to 3 months
|
|
Willingness to participate in future advance care planning discussions
Time Frame: Up to 3 months
|
Willingness to participate in future Advance Care Planning discussions for patients' values and goals important to MDM will be tabulated.
|
Up to 3 months
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Donna S Zhukovsky, M.D. Anderson Cancer Center
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 2016-0704 (Other Identifier: M D Anderson Cancer Center)
- NCI-2018-01745 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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