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35. Dyadic advance care planning: systematic review of patient–caregiver interventions and effects

Author

Liu, Xiaohang, Wang, Tongyao, Cheung, Denise Shuk Ting, Chau, Pui Hing, Ho, Mu-Hsing, Han, Yuanxia, and Lin, Chia-Chin

Abstract

IntroductionFamily caregiver’s involvement in advance care planning (ACP) is essential to provide high-quality end-of-life (EOL) care and to ease the surrogate decision-making burden. However, no systematic review has focused on existing ACP interventions involving patients and their families.AimTo systematically summarise current ACP interventions involving patients and their families.MethodsFive English and two Chinese databases were searched from inception to September 2022. The eligible studies were experimental studies describing original data. The Joanna Briggs Institute critical appraisal tools assessed the methodological quality. Narrative synthesis was conducted for data analysis.ResultsIn total, twenty-eight articles were included. Fifteen studies were randomised controlled trials, and the rest 13 studies were quasi-experimental studies. The data synthesis identified: (1) Key intervention components: strategies to promote ACP, ACP discussion and follow-up, as well as the role of family caregivers; (2) Effects on intended outcomes: interventions have shown benefit on completion of ACP actions, while inconsistent findings were found on the process outcomes and quality of EOL care. In addition, a logic model for patient–caregiver dyadic ACP was created, and the underlying mechanisms of action included well-preparation, open discussion and adequate support for plan/action.ConclusionsThis review provides comprehensive evidence about patient–caregiver dyadic ACP, a promising intervention to better prepare for EOL communication and decision-making. A logic model has been mapped to give a preliminary indication for future implementation. More empirical studies are needed to improve this model and culturally adapt it in a real-world setting.

Published
2024
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42. Preferences for end‐of‐life care: A cross‐sectional survey of Chinese frail nursing home residents.

Author

Xu, Xinyi, Chau, Pui Hing, Cheung, Denise Shuk Ting, Ho, Mu‐Hsing, and Lin, Chia‐Chin

Subjects
CAREGIVER attitudes, TERMINAL care, CAREGIVERS, CONFIDENCE intervals, CROSS-sectional method, FAMILIES, PATIENTS' attitudes, HEALTH literacy, SURVEYS, DESCRIPTIVE statistics, DATA analysis software, ODDS ratio, LOGISTIC regression analysis
Abstract

Aim and Objectives: To assess (1) the experience, knowledge and preferences of end‐of‐life care among frail nursing home residents and (2) the preferences of residents' family caregivers. Background: Globally, nursing homes are becoming an important place where many older people will receive their end‐of‐life care. Thus, assessing the end‐of‐life care preferences among nursing home residents is crucial. Design: Cross‐sectional survey. Methods: Residents aged ≥65 years, with frail or pre‐frail status (n = 286) in 34 nursing homes were interviewed using a structured questionnaire. Descriptive statistics were used to describe the outcomes and regression analyses were used to evaluate factors related to the outcomes. Kappa statistics were used to examine the agreement between the preferences among 21 residents and their family caregivers. The manuscript was guided by the STROBE checklist. Results: 5.9% and 10.5% of the participants had heard of advance care planning and advance directive respectively. After explanations of the terms by the research team, 42.3% of the participants preferred advance care planning, whereas 22.0% preferred advance directive. The top reason for not preferring advance care planning/advance directive is perceiving them as 'not necessary'. Nursing homes were the most preferred place to receive end‐of‐life care (41.6%). Whereas hospitals were the most preferred place for death (36.0%). The agreement among resident and family caregiver dyads ranged from none to minimal in most outcomes. Conclusions: This study revealed the lack of awareness around advance care planning and advance directive among frail nursing home residents. Future research should focus on developing effective educational interventions to enhance the residents' awareness of these topics. Relevance to clinical practice: To increase awareness among nursing home residents, more educational programs should be implemented. Frail older residents might not see the relevance of advance care planning; interventions need to include both current and future care to increase its relevance. [ABSTRACT FROM AUTHOR]

Published
2023
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47. Patient‐centred, self‐administered acupressure for Chinese advanced cancer patients experiencing fatigue and co‐occurring symptoms: A pilot randomised controlled trial.

Author

Cheung, Denise Shuk Ting, Yeung, Wing Fai, Chau, Pui Hing, Lam, Tai Chung, Yang, Mingxiao, Lai, Kithelia, Ip, Chun Yat, Lao, Lixing, and Lin, Chia‐Chin

Subjects
*CANCER pain, *HEALTH education, *PATIENT-centered care, *ACUPRESSURE, *HEALTH outcome assessment, *SELF medication, *CANCER patients, *TUMOR classification, *RANDOMIZED controlled trials, *MENTAL depression, *QUALITY of life, *FATIGUE (Physiology), *TUMORS, *INSOMNIA, *ANXIETY, *STATISTICAL sampling, *CHINESE medicine, *SYMPTOMS
Abstract

Objectives: To evaluate the feasibility and potential effects of patient‐centred self‐administered acupressure for alleviating fatigue and co‐occurring symptoms among Chinese advanced cancer patients receiving treatment. Methods: Thirty advanced cancer patients who screened positive for moderate/severe fatigue with symptoms of insomnia and/or pain were recruited from a hospital in Hong Kong. They were randomly assigned (1:1) to receive a 4‐week patient‐centred self‐administered acupressure intervention or health education. Fatigue (primary outcome) and secondary outcomes (sleep quality, pain, fatigue–sleep disturbance–pain symptom cluster severity, anxiety, depression and quality of life) were measured by questionnaires and actigraphy. Results: Twenty‐four participants (80%) completed the study. Adherence to self‐administered acupressure practice was satisfactory, with all retained participants attending all sessions and 90.9% practising acupressure daily. All completers rated the class as very enjoyable or quite enjoyable. Fatigue, pain, symptom cluster severity, anxiety, depression and quality of life appeared to improve from baseline to post‐intervention in the intervention group. Among these outcomes, only the between‐group difference in anxiety post‐intervention was significant. The group × time interaction effect was nonsignificant for all outcomes. Conclusions: Patient‐centred self‐administered acupressure appears to be feasible and acceptable among advanced cancer patients. A fully powered trial is warranted to confirm the intervention effect. [ABSTRACT FROM AUTHOR]

Published
2022
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49. sj-pdf-2-cre-10.1177_02692155211043267 – Supplemental material for The effectiveness of pre- and post-operative rehabilitation for lung cancer: A systematic review and meta-analysis on postoperative pulmonary complications and length of hospital stay

Author

Xu, Xinyi, Cheung, Denise Shuk Ting, Smith, Robert, Lai, Agnes Yuen Kwan, and Lin, Chia-Chin

Subjects
FOS: Clinical medicine, 110604 Sports Medicine, FOS: Health sciences, 110904 Neurology and Neuromuscular Diseases, 110314 Orthopaedics
Abstract

Supplemental material, sj-pdf-2-cre-10.1177_02692155211043267 for The effectiveness of pre- and post-operative rehabilitation for lung cancer: A systematic review and meta-analysis on postoperative pulmonary complications and length of hospital stay by Xinyi Xu, Denise Shuk Ting Cheung, Robert Smith, Agnes Yuen Kwan Lai and Chia-Chin Lin in Clinical Rehabilitation

Published
2021
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50. sj-docx-1-ict-10.1177_15347354211033352 – Supplemental material for Feasibility of Aerobic Exercise and Tai-Chi Interventions in Advanced Lung Cancer Patients: A Randomized Controlled Trial

Author

Cheung, Denise Shuk Ting, Takemura, Naomi, Lam, Tai Chung, Ho, James Chung Man, Deng, Wen, Smith, Robert, Yan, Yinxia, Lee, Anne Wing Mui, and Lin, Chia Chin

Subjects
111708 Health and Community Services, FOS: Clinical medicine, 111702 Aged Health Care, FOS: Health sciences, 110306 Endocrinology, 111299 Oncology and Carcinogenesis not elsewhere classified
Abstract

Supplemental material, sj-docx-1-ict-10.1177_15347354211033352 for Feasibility of Aerobic Exercise and Tai-Chi Interventions in Advanced Lung Cancer Patients: A Randomized Controlled Trial by Denise Shuk Ting Cheung, Naomi Takemura, Tai Chung Lam, James Chung Man Ho, Wen Deng, Robert Smith, Yinxia Yan, Anne Wing Mui Lee and Chia Chin Lin in Integrative Cancer Therapies

Published
2021
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