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Website launched to help patients prepare for complex medical decisions
Date:1/4/2013

ing that go beyond completing an advance directive form. These include successful surrogate selection and communication with the surrogate, determination of the surrogate's role, and communication with family and doctors.

The website's audio-visual interface is tailored to typically underserved populations (including users with low health or computer literacy and/or visual or hearing impairment) and aims to incorporate a patient-centered, comprehensive and manageable approach.

The PREPARE website is written at a fifth-grade reading level, and includes voice-overs of all text, closed-captioning for the hearing impaired, and large font for the visually impaired. In preliminary pilot testing, older adults from diverse backgrounds rated PREPARE a nine out of a 10- point-scale for ease of use, according to Sudore.

"We wanted to make the website free and easy-to-use by everyone," she said. "We made sure to take advice given to us by patients and surrogates. The site doesn't merely ask people to do advance care planning, but actually shows people, through videos and a step-by-step process, how to actually have the conversation and make informed medical decisions."

The study included 69 English and Spanish-speaking patients and surrogate decision makers who reported having to make serious medical decisions for themselves or loved ones. The mean age of patients was 78 years and 61 percent were non-white. The mean age of the surrogate decision makers was 57 years, and 91 percent were non-white.

Qualitative analysis revealed that advance directives were not enough to prepare patients and surrogates for medical decision making. Many participants stated that solely focusing on treatments, such as mechanical ventilation, was not sufficient to help with the "many decisions" with which they were facing.


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Contact: Leland Kim
leland.kim@ucsf.edu
415-502-6397
University of California - San Francisco
Source:Eurekalert  

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