Indiana University-Purdue University Indianapolis (IUPUI) / Heart failure is a terminal disease with an unpredictable trajectory. Family
members of patients with heart failure are often called upon to make decisions about
treatment and end of life care, sometimes with little guidance as to the patients’ wishes.
Advance care planning (ACP) is an ongoing process by which patients make decisions
about their future healthcare. Only about one-third of patients with heart failure have
participated in ACP, which is a similar percentage to the overall population. Despite
increased focus on ACP and interventions to improve it, the rates of ACP in the
population remain relatively unchanged. There is a need to develop interventions that are
targeted based on patient engagement in the process rather than the existing broad-based
interventions.
The purpose of this dissertation study is to examine the relationship between the
American Heart Association stage of heart failure and readiness to engage in advance
care planning. The study consisted of mailed surveys that consisted of demographic
questionnaires and the Advance Care Planning Engagement Survey. Engagement was
analyzed in relation to heart failure stage, heart failure class, comorbidities, perception of
health status, recent hospitalizations, making healthcare decisions for others, and
demographic variables. The results demonstrated that although there was no significant
association between heart failure stage or class and engagement in advance care planning,
there were significant associations between medical comorbidities and advance care
planning engagement. Other significantly associated participant characteristics included age, gender, education, ethnicity, and income. Findings suggest that people with multiple
comorbid conditions will be more likely to be ready to engage in ACP than those with
fewer health conditions. The results from this study will contribute to the development of
strategies to improve advance care planning that are targeted based on engagement level.
| Identifer | oai:union.ndltd.org:IUPUI/oai:scholarworks.iupui.edu:1805/20660 |
| Date | 08 1900 |
| Creators | Catalano, Lori A. |
| Contributors | Hickman, Susan, Von Ah, Diane, Torke, Alexia, Weaver, Michael |
| Source Sets | Indiana University-Purdue University Indianapolis |
| Language | en_US |
| Detected Language | English |
| Type | Dissertation |
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