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首页> 外文期刊>The American journal of hospice & palliative medicine >Efficacy of Motivational Interviewing to Enhance Advance Directive Completion in Latinos With Chronic Illness: A Randomized Controlled Trial
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Efficacy of Motivational Interviewing to Enhance Advance Directive Completion in Latinos With Chronic Illness: A Randomized Controlled Trial

机译：诱导面试提高拉丁裔患者慢性疾病的预先指示完成的疗效：随机对照试验

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Background: End-of-life (EOL) care for Latinos with chronic illness is a critically important problem. Latinos with chronic illness suffer worse health outcomes and poorer quality of care due to various issues occurring in care delivery systems. Latinos are less likely than non-Hispanic whites to prepare an advance directive (AD) for health-care decision-making that impacts treatment decisions for when EOL is near. Advance care planning (ACP) interventions tailored specifically for Latinos have rarely been implemented. Objective: The primary aim examines whether a motivational interviewing (MI) intervention increased rates of AD documentation among older Latinos. The secondary aim was to examine whether MI improved communication with providers and family members. Methods: We pilot tested a randomized controlled trial with older Latinos >50 years with one or more chronic illnesses, including cancer. Participants were randomly assigned to usual care (UC) receiving ACP education alone versus treatment (TX), which received ACP education, plus MI counseling including interactive decisional support, emotional support, and barrier navigation. Results: Results of logistic regression indicate TX group participants were significantly more likely to document an AD than UC, however were less ready to talk with health-care providers or family members. Those reporting navigational barriers for talking about dying is difficult showed a significant negative relationship for AD completion even with significant intervention effects. Conclusion: When using MI to motivate individuals toward ACP EOL conversations other factors are important to consider. Further research is needed, especially among Latinos to understand best practices for ACP education and counseling for EOL care.
机译：背景：患有慢性疾病的拉丁美洲的生活结束（EOL）是一个批判性重要问题。由于护理系统中发生的各种问题，拉丁群患有慢性疾病的患者遭受更严重的健康结果和较差的护理。拉丁美洲人不太可能比非西班牙裔白人制定一个预先指令（AD），用于卫生保健决策，影响艾尔近期的治疗决策。专门针对拉美裔人定制的预先保育计划（ACP）干预措施很少得到实施。目的：主要目的探讨了令人驾驶面试（MI）干预是否增加了拉美裔人之间的广告文件率。二次目的是检查MI是否改善了与提供者和家庭成员的沟通。方法：我们试点测试了随机对照试验，较旧的拉丁苷> 50年，一种或多种慢性疾病，包括癌症。与会者被随机分配给普通护理（UC）接受ACP教育，接受ACP教育，加上MI咨询，包括互动决策支持，情感支持和障碍导航。结果：Logistic回归结果表明TX集团参与者明显更有可能记录广告，而不是UC，然而，不再与医疗保健提供者或家庭成员交谈。谈论死亡的报告导航障碍是困难的，即使具有明显的干预效果，AD完成也存在显着的负面关系。结论：使用MI激励个人对ACP EOL谈话的其他因素来考虑。需要进一步的研究，特别是在拉美裔之间了解ACP教育和咨询EOL Care的最佳实践。

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