Group Visit Participants’ Changes and Experiences Related to ACP Readiness
| Survey Data | Interview Data (n = 15) | ||||
|---|---|---|---|---|---|
| ACP Readiness Questions | Baseline Mean (n = 110) | 6 Months Mean (n = 100) | % change | Description of findings | Supporting Quotes |
| How ready are you to sign official papers naming a medical decision maker to make medical decisions for you? | 4.49 | 4.80 | 7% (p-value: 0.046) | Intervention participants described being ready to name decision makers. Participants used the intervention as an opportunity to update or confirm previous choices, while those without existing documentation reported assigning decision makers afterwards. | “All of my kids are very responsible people, but the one that I had chosen lives in [another state] and she has her own business that really needs her pretty tied down. I thought that's not very practical to have to expect her to come to Denver to take care of all of these things if I fall into bad health or upon my death and so forth. I ended up changing it to a daughter that lives here.” (Intervention, Participant 27)) |
| How ready are you to talk to your decision maker about the kind of medical care you would want if you were very sick or near the end of life? | 4.65 | 4.74 | 2% (p-value: 0.59) | Participants reported having brief discussions with their decision makers. They did not involve decision makers in discussions about preferences. Rather, they informed them of their responsibility as decision maker once they had completed ACP documentation. | “We had one big talk and now it's their responsibility. I've given them everything I can. Carrying them anymore as adult children is useless and it really—it isn't my job. I've done my part and I have had expert input and so my point is, well, this is up to you now. I took care of all my business so you can take care of me. That's it.” (Intervention, Participant 21) |
| How ready are you to talk to your doctor about the kind of medical care you would want if you were very sick or near the end of life? | 3.47 | 3.99 | 15% (p-value: 0.039) | Participants reported feeling ready to discuss ACP with their doctor and that the primary purpose of doing so was to get their documents on record at the locations where they are likely to receive care. However, participants were unlikely to initiate a conversation about ACP during clinic visits focused on more pressing health concerns. | “We had a brief conversation on it. I appreciate [my doctor's] view and his thoughts on all of this. Other than that, we didn't get into any of the particulars. He made certain that he made copies and gave me back what I gave to him. He put it in my medical chart. He acknowledged what I had written… it was a positive acceptance of what I had prepared.” (Intervention, Participant 45) |
| How ready are you to sign official papers putting your wishes in writing about the kind of medical care you would want if you were very sick or near the end of life? | 4.24 | 4.69 | 11% (p-value: 0.015) | Group visits helped patients confirm, revise, and expand existing ACP documentation. Patients reported an improvement in both quantity and quality of ACP documentation. | “We sharpened a few statements to be a little more precise with respect to some of the discussions we had there in the group, which I think made for a better document” (Intervention, Participant 45) |
| Overall ACP engagement scores: | 4.21 | 4.56 | 8% (p-value: 0.021) | ||