Impact of advance directive videotape on patient comprehension and treatment preferences
E. A. Siegert, E. C. Clipp, P. Mulhausen and G. Kochersberger
Department of Geriatric Research, Durham Veterans Affairs Medical Center, NC, USA.
OBJECTIVE: To examine the effects of an advance directive videotape on
patient comprehension of advance directive concepts and preferences for
resuscitation. DESIGN: Pilot study, randomized cohort trial. SETTING:
Extended Care and Rehabilitation Center, Veterans Affairs Medical Center,
Durham, NC. PARTICIPANTS: Thirty-six residents of the center; mean age, 69
years. INTERVENTIONS: Sixteen subjects observed an advance directive
videotape, and 20 subjects observed a health-relative videotape. All
subjects received written material and counseling on advance directives.
MEASUREMENT: Structured interviews were conducted at three time points
relative to the educational program (pretest, posttest, delayed posttest),
measuring comprehension of two advance directive concepts (living will and
cardiopulmonary resuscitation) and resuscitation preferences based on
hypothetical clinical vignettes. Mean comprehension and mean resuscitation
preference scores were derived for each time point. RESULTS: The mean
comprehension score improved an average of 1.6 points for all subjects from
pretest to delayed posttest (P < .001); however, score changes were not
significantly different between the two video groups (P = .39). Mean
resuscitation preference scores were stable over time, and there were no
significant score differences between the two video groups. CONCLUSION: The
advance directive videotape did not significantly affect resuscitation
preferences or comprehension of selected advance directive concepts.
