Evidence map›Paper›PMID 30853552›Full record

ArticleJournal of pain and symptom management2019

A Tool to Assess Patient and Surrogate Knowledge About the POLST (Physician Orders for Life-Sustaining Treatment) Program.

Susan E Hickman, Alexia M Torke, Greg A Sachs, Rebecca L Sudore, Anne L Myers, Qing Tang, Giorgos Bakoyannis, Bernard J Hammes

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of pain and symptom management, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. An Integrative Review of the State of POLST Science: What Do We Know and Where Do We Go?Journal of the American Medical Directors Association · 2024
    Review
  5. Article
  6. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Susan E HickmanIndiana University School of Nursing, Department of Community & Health Systems, Indianapolis, Indiana, USA; IUPUI Research in Palliative and End-of-Life Communication and Training (RESPECT) Signature Center, Indianapolis, Indiana, USA. Electronic address: hickman@iu.edu.
Alexia M TorkeIUPUI Research in Palliative and End-of-Life Communication and Training (RESPECT) Signature Center, Indianapolis, Indiana, USA; Indiana University School of Medicine, Department of General Internal Medicine & Geriatrics, Indianapolis, Indiana, USA; Regenstrief Institute, Indianapolis, Indiana, USA.
Greg A SachsIUPUI Research in Palliative and End-of-Life Communication and Training (RESPECT) Signature Center, Indianapolis, Indiana, USA; Indiana University School of Medicine, Department of General Internal Medicine & Geriatrics, Indianapolis, Indiana, USA; Regenstrief Institute, Indianapolis, Indiana, USA.
Rebecca L SudoreUniversity of California San Francisco School of Medicine, San Francisco, California, USA; San Francisco Veterans Affairs Health Care System, San Francisco, California, USA.
Anne L MyersIndiana University School of Nursing, Department of Community & Health Systems, Indianapolis, Indiana, USA.
Qing TangIndiana University Fairbanks School of Public Health and School of Medicine, Department of Biostatistics, Indianapolis, Indiana, USA.
Giorgos BakoyannisIndiana University Fairbanks School of Public Health and School of Medicine, Department of Biostatistics, Indianapolis, Indiana, USA.
Bernard J HammesRespecting Choices, A Division of C-TAC Innovations, La Crosse, Wisconsin, USA.

Funding

The Quality of POLST Decisions in the Nursing Facility SettingR01NR015255 · NINR · INDIANA UNIVERSITY INDIANAPOLIS · PI HICKMAN, SUSAN E · 2015 to 2018
$2.3M
Mentoring Researchers in Advance Care Planning for Underrepresented Older Adults at Risk for Alzheimer’s Disease and Related Dementias and Their CaregiversK24AG054415 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI REBECCA L SUDORE · 2017 to 2026
$1.7M
NIA NIH HHS K24 AG054415NINR NIH HHS R01 NR015255
6 · The paper itself

Abstract

contextIt is especially important that patients are well informed when making high-stakes, preference-sensitive decisions like those on the Physician Orders for Life-Sustaining Treatment (POLST) form. However, there is currently no way to easily evaluate whether patients understand key concepts when making these important decisions.

objectivesTo develop a POLST knowledge survey.

methodsExpert (n = 62) ratings of key POLST facts were used to select items for a POLST knowledge survey. The survey was administered to nursing facility residents (n = 97) and surrogate decision-makers (n = 112). A subset (n = 135) were re-administered the survey after a standardized advance care planning discussion to assess the scale's responsiveness to change.

resultsThe 19-item survey demonstrated adequate reliability (α = 0.72.). Residents' scores (x = 11.4, standard deviation 3.3) were significantly lower than surrogate scores (x = 14.7, standard deviation 2.5) (P < 0.001). Scores for both groups increased significantly after administration of a standardized advance care planning discussion (P < 0.001). Although being a surrogate, age, race, education, cognitive functioning, and health literacy were significantly associated with higher POLST Knowledge Survey scores in univariate analyses, only being a surrogate (P < 0.001) and being white (P = 0.028) remained significantly associated with higher scores in multivariate analyses.

conclusionThe 19-item POLST Knowledge Survey demonstrated adequate reliability and responsiveness to change. Findings suggest the survey could be used to identify knowledge deficits and provide targeted education to ensure adequate understanding of key clinical decisions when completing POLST.

Indexed as

Advance Care PlanningHealth Knowledge, Attitudes, PracticePatientsAdolescentAdultAgedAged, 80 and overClinical Decision-MakingFemaleHealth LiteracyHumansMaleMiddle AgedNursing HomesPalliative CarePatient Education as Topicadvance care planningnursing homepalliative carePhysician Orders for Life-Sustaining Treatment

Identifiers

PMID30853552
PMCPMC6857935

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.