Motivational Interviewing Tailored Programme for Promoting Advance Care Planning Behaviours

Effects of a Motivational Interviewing Tailored Programme for Promoting Advance Care Planning Behaviours Among Patients With Palliative Care Needs: A Randomised Controlled Trial

This proposed study is designed to test the effects of motivational interviewing (MI) in increasing the uptake of ACP behaviours among patients with palliative care needs. A randomised controlled trial with repeated blinded outcome assessment will be conducted to assess the effects of a MI-tailored ACP (MI-ACP) programme on palliative care patients recruited from the outpatient palliative care clinics and home palliative care services of two hospitals. A total of 204 patients will be recruited and randomly assigned to experimental and control groups. The patients in the experimental group will receive a MI-ACP programme facilitated by a trained nurse, whereas the patients in the control group will receive usual care. Primary outcome is the behavioural changes in ACP. Secondary outcomes are perceived stress, decisional conflict and quality of life. Study outcomes will be measured at baseline, 1 month and 3 months after enrolment.

Study Overview

• Status: Completed
• Conditions: End Stage Disease
• Intervention / Treatment: Behavioral: Motivational Interviewing tailored Advance Care Planning

• Study Type: Interventional
• Enrollment (Actual): 204
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Hong Kong
  • Kwun Tong, Hong Kong
    • United Christian Hospital
  • Tseung Kwan O, Hong Kong
    • Haven of Hope Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• 18 years of age or over
• newly referred to palliative care services
• with a palliative performance scale (PPS) score of 60 or above; and
• with full level of consciousness

Exclusion Criteria:

• uncommunicable because of sensory impairment or language barrier
• cognitively impaired
• are receiving active psychiatric treatment
• already had signed an advance directive

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Experimental group; Participants in the experimental group will receive a MotivationaI Interviewing tailored ACP programme.	Behavioral: Motivational Interviewing tailored Advance Care Planning; The trained interventionist who is experienced in MI techniques will explore their illness experiences, emotions and beliefs about their health conditions and future care in an empathetic manner and explore their ambivalence for ACP behaviours.
No Intervention: Control group; The participants in the control group will receive usual care offered by the palliative care team under study and its affiliated day care centres, home care team and outpatient clinics.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Advance Care Planning Behaviour	Behaviour changes in ACP behaviours measured using a questionnaire. It included 4 items about different ACP behavior on a 5-point Likert scale. The higher score means the higher level of readiness for the behaviours.	Baseline, 1 month and 3 months follow up

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Decisional conflict	Decisional conflict regarding end-of-life care is measured by the SURE test, a questionnaire with 4-item on knowledge and support for medical decision making. The higher score means the less decisional conflict.	Baseline, 1 month and 3 months follow up
Perceived stress	Perceived stress is measured by a 10-item Perceived Stress Scale, a questionnaire, using a 5-point Likert scale. The higher score means the higher level of stress.	Baseline, 1 month and 3 months follow up
Quality of life	Quality of life is measured by using a 23-item modified Quality of Life Concerns in the End of Life Questionnaire. The 23 items are rated on a 4-point Likert scale. The higher score means the better quality of life.	Baseline, 1 month and 3 months follow up

Collaborators and Investigators

• Sponsor: Food and Health Bureau, Hong Kong
• Collaborators: United Christian Hospital; Haven of Hope Hospital
• Investigators: Principal Investigator: Helen N Chan, PhD, Chinese University of Hong Kong

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2018
• Primary Completion (Actual): December 31, 2019
• Study Completion (Actual): December 31, 2019

Study Registration Dates

• First Submitted: November 11, 2019
• First Submitted That Met QC Criteria: November 12, 2019
• First Posted (Actual): November 14, 2019

Study Record Updates

• Last Update Posted (Actual): April 17, 2020
• Last Update Submitted That Met QC Criteria: April 15, 2020
• Last Verified: April 1, 2020

More Information

Terms related to this study

• Keywords: Motivational Interviewing; Advance Care Planning; Pallative Care
• Other Study ID Numbers: 14168417

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No