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dc.contributor.authorVaccaro, Lisa-
dc.contributor.authorButow, Phyllis N-
dc.contributor.authorLee, Deborah-
dc.contributor.authorJohnson, Stephanie B-
dc.contributor.authorBell, Melanie-
dc.contributor.authorClayton, Josephine-
dc.contributor.authorDetering, Karen M-
dc.contributor.authorTattersall, Martin-
dc.identifier.citationBMJ supportive & palliative care 2019; 9(4): 397-403-
dc.description.abstractAssessing whether interventions are implemented as intended (fidelity) is critical to establishing efficacy in clinical research yet rarely applied in advance care planning (ACP) interventions. We aimed to develop and implement a fidelity audit tool for an ACP intervention. We developed a fidelity audit tool assessing: (A) content; (B) quality (general communication, eliciting EOL preferences and prognostic communication); and (C) family/caregiver involvement. We audited (double-coded) 55 audio-recordings of ACP discussions delivered to advanced cancer patients and caregivers, within a clinical trial. Fidelity to content was high: mean=9.38/11 but lower for the quality of general communication (mean=12.47/20), discussion of patient preferences (mean=4.67/7), prognosis (mean=3.9/6) and family/caregiver involvement (mean=2.67/4). Older patient age and caregiver religiosity were associated with higher fidelity. Higher fidelity to content was associated with the trial primary outcome of family caregiver report of patient wishes being discussed and met. Fidelity to content, but not quality, of the ACP intervention is strong. Communication skills training is critical for ACP interventionists. Adherence was higher with older patients and religious carers, factors that may influence acceptance of death and readiness to undertake ACP, making the discussion easier. ACTRN12613001288718.-
dc.subjectIntervention fidelity-
dc.subjectadvance care planning-
dc.titleFidelity is fundamental: intervention predictors in advance care plans in terminal cancer.-
dc.typeJournal Article-
dc.identifier.journaltitleBMJ supportive & palliative care-
dc.identifier.affiliationDepartment of Medical Oncology, University of Sydney and Royal Prince Alfred Hospital, Sydney, New South Wales, Australiaen
dc.identifier.affiliationSchool of Psychology, Centre for Medical Psychology and Evidence-based Decision-making, University of Sydney, Sydney, New South Wales, Australiaen
dc.identifier.affiliationCentre for Learning & Research in Palliative Care, Hammond Care, Greenwich Hospital and University of Sydney, Sydney, New South Wales, Australiaen
dc.identifier.affiliationFaculty of Medicine Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australiaen
dc.identifier.affiliationAdvance Care Planning Australia, Austin Health, Heidelberg, Victoria, Australiaen
dc.identifier.affiliationNuffield Department of Population Health, Wellcome Centre for Ethics and Humanities and Ethox Centre, University of Oxford, Oxford, UK-
dc.identifier.affiliationMel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA-
dc.type.austinJournal Article-
item.fulltextNo Fulltext-
item.openairetypeJournal Article- Care Planning-
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