Study of a Family-Supported Advance Care Planning Program in Adult Palliative Care Patients and Their Families to Improve End-of-Life Decision Making and Communication

What this Trial Is About

Researchers are evaluating the effectiveness of a structured, family-supported, patient-centred advance care planning ACP program for adult palliative care patients and their family members. This randomized controlled trial aims to determine if the ACP-Family intervention improves end-of-life decision making and psychological outcomes compared to usual palliative care. The study also explores whether the type of hospital setting influences the interventions effectiveness. Participants will be randomly assigned to one of two groups the ACP-Family group or the usual care group ACP-UC. The ACP-Family intervention involves two face-to-face sessions lasting 45 to 60 minutes each, delivered within one month by a trained ACP facilitator. These sessions cover five key elements of advance care planning, including understanding illness, values and beliefs, possible future health conditions, advance directives, and the role of a substituted decision maker. If patients are discharged before completing the sessions, treatment continues at home. The usual care group receives standard palliative care available at the hospital. During the study, researchers will assess participants at 6 and 12 months to measure the accuracy of family members predictions of patients treatment preferences, new ACP documentation, whether patients end-of-life care preferences were respected, patients decisional conflict, quality of communication, and family members decision-making confidence and mental health. All discussion sessions in the ACP group will be recorded for quality assurance. The total participation duration includes follow-ups at 6 and 12 months to monitor these outcomes and satisfaction with the intervention.

ACP-Family Programme for Palliative Care Patients and Their Family Member