探索“ACP 终生棋盘游戏”对 4 期和 5 期慢性肾病患者的死亡准备和焦虑的影响：一项试点研究
2023年9月21日 更新者：National Cheng-Kung University Hospital
本研究旨在探讨参加“ACP生命棋盘游戏”对患有晚期慢性肾病的4-5期CKD患者的死亡准备、死亡焦虑、临终关怀偏好和干预认知的影响。中心。
研究概览
详细说明
本研究旨在探讨参加“ACP生命棋盘游戏”对患有晚期慢性肾病的4-5期CKD患者的死亡准备、死亡焦虑、临终关怀偏好和干预认知的影响。中心。
使用非随机双臂预测试和后测试准实验设计。
对照组患者接受常规护理，实验组患者终身接受常规护理和ACP棋盘游戏。
采用ACP棋盘游戏、死亡准备分量表、中国李克特死亡焦虑量表、自设问卷和简短访谈进行数据收集。
研究类型
介入性
注册 (实际的)
69
阶段
- 不适用
联系人和位置
本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。
学习地点
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Tainan、台湾、704
- National Cheng Kung University Hospital
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参与标准
研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
- 成人
- 年长者
接受健康志愿者
不
描述
纳入标准：
- 4-5期慢性肾病患者
- 中国国籍
- 20岁以上
- 意识清晰，能用普通话、台语沟通表达自己的意见
排除标准：
- 患者表示谈论死亡会让他们感到害怕或焦虑
- 医生评估患者病情处于感染性休克、血流动力学不稳定、哮喘、肺水肿、低氧血症或急性心肌梗死阶段
- 有接触或空气传播预防措施的患者
- 无法律行为能力的患者
学习计划
本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。
研究是如何设计的？
设计细节
- 主要用途：其他
- 分配：非随机化
- 介入模型：并行分配
- 屏蔽：单身的
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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实验性的：一般日常护理和终身 ACP 棋盘游戏
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研究对象将根据自己的意愿被分配到实验组或对照组。
愿意参加ACP棋盘游戏的人将被分配到实验组。
每场棋盘游戏的干预时间约为2小时。
这款 ACP 棋盘游戏共有 60 张牌；游戏的重点是了解参与者对卡牌选项的想法。
干预前后需要填写调查问卷。
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无干预：一般日常护理
“一般常规护理”是指当CKD 4-5期患者病情危重或生命临终时，肾脏医疗团队会向患者家属讲解DNR的内容（无需心肺复苏：包括气管插管、体外心脏按压、心脏电击、紧急药物注射、人工心脏起搏器调整等紧急治疗项目）、姑息治疗的概念（对临终患者进行支持性护理，缓解身体不适症状，以减轻身体、精神和心理负担）精神上的痛苦）或ACP。
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研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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死亡准备
大体时间：2小时
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死亡准备分量表共8个项目衡量死亡准备。该分量表总分范围为8-40。
它表明分数越高，死亡准备越好。
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2小时
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死亡焦虑
大体时间：2小时
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采用中国李克特死亡焦虑量表，共15个项目，采用李克特量表1至5（1表示完全不同意，2表示不同意，3表示一般，4表示同意，5表示完全同意），该量表的总分范围为15至75分。
总分越高，死亡焦虑程度越高。
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2小时
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临终关怀偏好
大体时间：2小时
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使用自制的 4-5 期 CKD 患者临终护理偏好调查问卷。
量表中有 2 个项目。
项目类型为多项选择，评分方法根据参与者选择的次数和百分比。
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2小时
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干预感知
大体时间：2小时
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采用自制问卷调查CKD 4-5期患者参加“ACP终身棋盘游戏”后的感受。
量表共有4个项目，采用1至5分的李克特评分法（1分表示完全不同意，2分表示不同意，3分表示既不同意也不不同意，4分表示同意，5分表示非常同意），评分方法基于参与者对平均值±标准差、频率和百分比统计的选项。
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2小时
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合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
出版物和有用的链接
负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。
一般刊物
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- Ang YG, Heng BH, Saxena N, Liew STA, Chong PN. Annual all-cause mortality rate for patients with diabetic kidney disease in Singapore. J Clin Transl Endocrinol. 2016 Jan 27;4:1-6. doi: 10.1016/j.jcte.2016.01.002. eCollection 2016 Jun.
- Axelsson L, Alvariza A, Lindberg J, Ohlen J, Hakanson C, Reimertz H, Furst CJ, Arestedt K. Unmet Palliative Care Needs Among Patients With End-Stage Kidney Disease: A National Registry Study About the Last Week of Life. J Pain Symptom Manage. 2018 Feb;55(2):236-244. doi: 10.1016/j.jpainsymman.2017.09.015. Epub 2017 Sep 21.
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- Cross SH, Lakin JR, Mendu M, Mandel EI, Warraich HJ. Trends in Place of Death for Individuals With Deaths Attributed to Advanced Chronic or End-Stage Kidney Disease in the United States. J Pain Symptom Manage. 2021 Jan;61(1):112-120.e1. doi: 10.1016/j.jpainsymman.2020.08.001. Epub 2020 Aug 10.
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- Desta BZ, Dadi AF, Derseh BT. Mortality in hemodialysis patients in Ethiopia: a retrospective follow-up study in three centers. BMC Nephrol. 2023 Jan 4;24(1):3. doi: 10.1186/s12882-022-03053-6.
- Douglas CA. Palliative care for patients with advance chronic kidney disease. J R Coll Physicians Edinb. 2014;44(3):224-31. doi: 10.4997/JRCPE.2014.309.
- Durepos P, Sussman T, Ploeg J, Akhtar-Danesh N, Punia H, Kaasalainen S. What Does Death Preparedness Mean for Family Caregivers of Persons With Dementia? Am J Hosp Palliat Care. 2019 May;36(5):436-446. doi: 10.1177/1049909118814240. Epub 2018 Dec 5.
- Galiana L, Oliver A, De Simone G, Linzitto JP, Benito E, Sanso N. A Brief Measure for the Assessment of Competence in Coping With Death: The Coping With Death Scale Short Version. J Pain Symptom Manage. 2019 Feb;57(2):209-215. doi: 10.1016/j.jpainsymman.2018.11.003. Epub 2018 Nov 15.
- Gonzalez AM, Gutman T, Lopez-Vargas P, Anumudu S, Arce CM, Craig JC, Dunn L, Eckardt KU, Harris T, Levey AS, Lightstone L, Scholes-Robertson N, Shen JI, Teixeira-Pinto A, Wheeler DC, White D, Wilkie M, Jadoul M, Winkelmayer WC, Tong A. Patient and Caregiver Priorities for Outcomes in CKD: A Multinational Nominal Group Technique Study. Am J Kidney Dis. 2020 Nov;76(5):679-689. doi: 10.1053/j.ajkd.2020.03.022. Epub 2020 May 31.
- Holley JL. Palliative care in end-stage renal disease: focus on advance care planning, hospice referral, and bereavement. Semin Dial. 2005 Mar-Apr;18(2):154-6. doi: 10.1111/j.1525-139X.2005.18208.x.
- Holley JL. Advance care planning in CKD/ESRD: an evolving process. Clin J Am Soc Nephrol. 2012 Jun;7(6):1033-8. doi: 10.2215/CJN.00580112. Epub 2012 Mar 29.
- Holley JL, Davison SN. Advance care planning for patients with advanced CKD: a need to move forward. Clin J Am Soc Nephrol. 2015 Mar 6;10(3):344-6. doi: 10.2215/CJN.00290115. Epub 2015 Feb 13. No abstract available.
- Hong YA, Chung S, Park WY, Bae EJ, Yang JW, Shin DH, Kim SW, Shin SJ; Committee on Ethical Issues of the Korean Society of Nephrology. Nephrologists' Perspectives on Decision Making About Life-Sustaining Treatment and Palliative Care at End of Life: A Questionnaire Survey in Korea. J Palliat Med. 2021 Apr;24(4):527-535. doi: 10.1089/jpm.2020.0248. Epub 2020 Sep 30.
- Hovland C. When Death With Dementia Is "A Memory Seared in My Brain": Caregivers' Recommendations to Health Care Professionals. J Appl Gerontol. 2020 Nov;39(11):1195-1202. doi: 10.1177/0733464819884267. Epub 2019 Oct 23.
- Hovland CA, Kramer BJ. Barriers and Facilitators to Preparedness for Death: Experiences of Family Caregivers of Elders with Dementia. J Soc Work End Life Palliat Care. 2019 Jan-Mar;15(1):55-74. doi: 10.1080/15524256.2019.1595811. Epub 2019 Apr 18.
- Khodarahimi S, Veiskarami HA, Mazraeh N, Sheikhi S, Rahimian Bougar M. Mental Health, Social Support, and Death Anxiety in Patients With Chronic Kidney Failure. J Nerv Ment Dis. 2021 Nov 1;209(11):809-813. doi: 10.1097/NMD.0000000000001386.
- Ladin K, Neckermann I, D'Arcangelo N, Koch-Weser S, Wong JB, Gordon EJ, Rossi A, Rifkin D, Isakova T, Weiner DE. Advance Care Planning in Older Adults with CKD: Patient, Care Partner, and Clinician Perspectives. J Am Soc Nephrol. 2021 Jun 1;32(6):1527-1535. doi: 10.1681/ASN.2020091298. Epub 2021 Apr 7.
- Liu L, Chan HY, Ho TC, Chow RS, Li MM, Cheung EW, Gu C, Wang Y. A serious game for engaging older adults in end-of-life care discussion: A mixed method study. Patient Educ Couns. 2023 Aug;113:107787. doi: 10.1016/j.pec.2023.107787. Epub 2023 May 3.
- Liu L, Zhao YY, Yang C, Chan HY. Gamification for promoting advance care planning: A mixed-method systematic review and meta-analysis. Palliat Med. 2021 Jun;35(6):1005-1019. doi: 10.1177/02692163211005343. Epub 2021 Mar 29.
- Loosman WL, Rottier MA, Honig A, Siegert CE. Association of depressive and anxiety symptoms with adverse events in Dutch chronic kidney disease patients: a prospective cohort study. BMC Nephrol. 2015 Sep 21;16:155. doi: 10.1186/s12882-015-0149-7.
- Luckett T, Spencer L, Morton RL, Pollock CA, Lam L, Silvester W, Sellars M, Detering KM, Butow PN, Tong A, Clayton JM. Advance care planning in chronic kidney disease: A survey of current practice in Australia. Nephrology (Carlton). 2017 Feb;22(2):139-149. doi: 10.1111/nep.12743.
- Maddalena V, O'Shea F, Barrett B. An Exploration of Palliative Care Needs of People With End-Stage Renal Disease on Dialysis: Family Caregiver's Perspectives. J Palliat Care. 2018 Jan;33(1):19-25. doi: 10.1177/0825859717747340. Epub 2017 Dec 27.
- Maniam R, Tan MP, Chong MC. End of life care preference among hemodialysis population: Revisit Q methodology. Patient Educ Couns. 2022 Jun;105(6):1495-1502. doi: 10.1016/j.pec.2021.09.026. Epub 2021 Sep 29.
- McLeod-Sordjan R. Death preparedness: a concept analysis. J Adv Nurs. 2014 May;70(5):1008-19. doi: 10.1111/jan.12252. Epub 2013 Sep 15.
- Merces CAMF, Souto JDSS, Zaccaro KRL, de Souza JF, Primo CC, Brandao MAG. Death Anxiety: Concept Analysis and Clarification of Nursing Diagnosis. Int J Nurs Knowl. 2020 Jul;31(3):218-227. doi: 10.1111/2047-3095.12260. Epub 2019 Sep 20.
- Miller-Lewis L, Tieman J, Rawlings D, Parker D, Sanderson C. Can Exposure to Online Conversations About Death and Dying Influence Death Competence? An Exploratory Study Within an Australian Massive Open Online Course. Omega (Westport). 2020 Jun;81(2):242-271. doi: 10.1177/0030222818765813. Epub 2018 Mar 26.
- Nair D, Bonnet K, Wild MG, Umeukeje EM, Fissell RB, Faulkner ML, Bahri NS, Bruce MA, Schlundt DG, Wallston KA, Cavanaugh KL. Psychological Adaptation to Serious Illness: A Qualitative Study of Culturally Diverse Patients With Advanced Chronic Kidney Disease. J Pain Symptom Manage. 2021 Jan;61(1):32-41.e2. doi: 10.1016/j.jpainsymman.2020.07.014. Epub 2020 Jul 22.
- Navise NH, Mokwatsi GG, Gafane-Matemane LF, Fabian J, Lammertyn L. Kidney dysfunction: prevalence and associated risk factors in a community-based study from the North West Province of South Africa. BMC Nephrol. 2023 Jan 30;24(1):23. doi: 10.1186/s12882-023-03068-7.
- Nelson-Becker H, Victor C. Dying alone and lonely dying: Media discourse and pandemic conditions. J Aging Stud. 2020 Dec;55:100878. doi: 10.1016/j.jaging.2020.100878. Epub 2020 Sep 23.
- O'Riordan J, Noble H, Kane PM, Smyth A. Advance care plan barriers in older patients with end-stage renal disease: a qualitative nephrologist interview study. BMJ Support Palliat Care. 2020 Dec;10(4):e39. doi: 10.1136/bmjspcare-2018-001759. Epub 2019 Jun 25.
- Oskoui T, Pandya R, Weiner DE, Wong JB, Koch-Weser S, Ladin K. Advance Care Planning Among Older Adults With Advanced Non-Dialysis-Dependent CKD and Their Care Partners: Perceptions Versus Reality? Kidney Med. 2020 Jan 31;2(2):116-124. doi: 10.1016/j.xkme.2019.11.002. eCollection 2020 Mar-Apr.
- Qiu Q, Zhang S, Lin X, Ban C, Yang H, Liu Z, Wang J, Wang T, Xiao S, Abdel-Khalek AM, Li X. Psychometric Properties of the Chinese Version of the Arabic Scale of Death Anxiety. Shanghai Arch Psychiatry. 2016 Jun 25;28(3):139-146. doi: 10.11919/j.issn.1002-0829.216033.
- Raghavan D, Holley JL. Conservative Care of the Elderly CKD Patient: A Practical Guide. Adv Chronic Kidney Dis. 2016 Jan;23(1):51-6. doi: 10.1053/j.ackd.2015.08.003.
- Rai NK, Wang Z, Drawz PE, Connett J, Murphy DP. CKD Progression Risk and Subsequent Cause of Death: A Population-Based Cohort Study. Kidney Med. 2023 Jan 21;5(4):100604. doi: 10.1016/j.xkme.2023.100604. eCollection 2023 Apr.
- Richards CA, Liu CF, Hebert PL, Ersek M, Wachterman MW, Reinke LF, Taylor LL, O'Hare AM. Family Perceptions of Quality of End-of-Life Care for Veterans with Advanced CKD. Clin J Am Soc Nephrol. 2019 Sep 6;14(9):1324-1335. doi: 10.2215/CJN.01560219. Epub 2019 Aug 29.
- Robbins RA. Death competency: a study of hospice volunteers. Death Stud. 1992 Nov-Dec;16(6):557-69. doi: 10.1080/07481189208252598.
- Saeed F, Sardar MA, Davison SN, Murad H, Duberstein PR, Quill TE. Patients' perspectives on dialysis decision-making and end-of-life care . Clin Nephrol. 2019 May;91(5):294-300. doi: 10.5414/CN109608.
- Sahan E, Eroglu MZ, Karatas MB, Mutluer B, Ugurpala C, Berkol TD. Death anxiety in patients with myocardial infarction or cancer. Egypt Heart J. 2018 Sep;70(3):143-147. doi: 10.1016/j.ehj.2018.04.003. Epub 2018 Apr 30.
- Sellars M, Clayton JM, Detering KM, Tong A, Power D, Morton RL. Costs and outcomes of advance care planning and end-of-life care for older adults with end-stage kidney disease: A person-centred decision analysis. PLoS One. 2019 May 31;14(5):e0217787. doi: 10.1371/journal.pone.0217787. eCollection 2019.
- Sellars M, Clayton JM, Morton RL, Luckett T, Silvester W, Spencer L, Pollock CA, Walker RG, Kerr PG, Tong A. An Interview Study of Patient and Caregiver Perspectives on Advance Care Planning in ESRD. Am J Kidney Dis. 2018 Feb;71(2):216-224. doi: 10.1053/j.ajkd.2017.07.021. Epub 2017 Nov 11.
- Sharif Nia H, Pahlevan Sharif S, Koocher GP, Yaghoobzadeh A, Haghdoost AA, Mar Win MT, Soleimani MA. Psychometric Properties of the Death Anxiety Scale-Extended among Patients with End-Stage Renal Disease. Omega (Westport). 2020 Feb;80(3):380-396. doi: 10.1177/0030222817733220. Epub 2017 Oct 5.
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- Van Scoy LJ, Green MJ, Reading JM, Scott AM, Chuang CH, Levi BH. Can Playing an End-of-Life Conversation Game Motivate People to Engage in Advance Care Planning? Am J Hosp Palliat Care. 2017 Sep;34(8):754-761. doi: 10.1177/1049909116656353. Epub 2016 Jul 12.
- Van Scoy LJ, Levi BH, Witt P, Bramble C, Richardson C, Putzig I, Levi AR, Wasserman E, Chinchilli V, Tucci A, Green MJ. Association of Participation in an End-of-Life Conversation Game With Advance Care Planning Behavior and Perspectives Among African American Individuals. JAMA Netw Open. 2020 May 1;3(5):e204315. doi: 10.1001/jamanetworkopen.2020.4315.
- Van Scoy LJ, Reading JM, Scott AM, Chuang C, Levi BH, Green MJ. Exploring the Topics Discussed During a Conversation Card Game About Death and Dying: A Content Analysis. J Pain Symptom Manage. 2016 Nov;52(5):655-662. doi: 10.1016/j.jpainsymman.2016.03.021. Epub 2016 Sep 17.
- Wasylynuk BA, Davison SN. An overview of advance care planning for patients with advanced chronic kidney disease: The basics. CANNT J. 2016 Jan-Mar;26(1):24-9.
- Wen FH, Hsieh CH, Chou WC, Su PJ, Hou MM, Shen WC, Chen JS, Chang WC, Tang ST. Factors associated with cancer patients' distinct death-preparedness states. Psychooncology. 2023 Jul;32(7):1048-1056. doi: 10.1002/pon.6146. Epub 2023 Apr 27.
- Yang CH, Wu CY, Low JTS, Chuang YS, Huang YW, Hwang SJ, Chen PJ. Exploring the Impact of Different Types of Do-Not-Resuscitate Consent on End-of-Life Treatments among Patients with Advanced Kidney Disease: An Observational Study. Int J Environ Res Public Health. 2021 Aug 2;18(15):8194. doi: 10.3390/ijerph18158194.
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始 (实际的)
2022年1月1日
初级完成 (实际的)
2023年2月28日
研究完成 (实际的)
2023年2月28日
研究注册日期
首次提交
2023年9月13日
首先提交符合 QC 标准的
2023年9月14日
首次发布 (实际的)
2023年9月21日
研究记录更新
最后更新发布 (实际的)
2023年9月25日
上次提交的符合 QC 标准的更新
2023年9月21日
最后验证
2023年9月1日
更多信息
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