Semester

Summer

Date of Graduation

2020

Document Type

Dissertation

Degree Type

PhD

College

Eberly College of Arts and Sciences

Department

Psychology

Committee Chair

Barry Edelstein

Committee Co-Chair

Alvin Moss

Committee Member

Christina Duncan

Committee Member

Kevin Larkin

Committee Member

Aaron Metzger

Abstract

The Physician Orders for Life Sustaining Treatment (POLST) allows patients to express preferences for end-of-life medical decisions. Although POLST forms are used throughout the United States, evidence is lacking about the quality of the decision-making process of individuals completing these forms. The use of a decision aid developed for the POLST could ensure that patients completing these forms are informed, confident, and certain of their treatment decisions. The purpose of the study was to develop and evaluate a video decision aid for the West Virginia POST. 64 English-speaking, community-dwelling adults (50+), with no evidence of cognitive impairment, were recruited to participate in the study. Participants were randomized to active control or intervention conditions. Participants were provided with a vignette that contained medical information for the purpose of making treatment decisions. Participants made decisions for each of the medical decisions contained in the WV POST and completed measures of knowledge, decisional conflict, and satisfaction at pre- and post-intervention. At post-intervention, participants in the intervention group were more generally more knowledgeable, less conflicted, and more satisfied with their decisions. There was no significant association between group and medical decision made for any of the four medical decisions in the WV POST. Results provide foundational support for the use of decision aids with multi-decision end-of-life care orders, such as POLST paradigm forms.

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