Trial reportJournal of pain and symptom management2020
Surrogate Decision Maker Stress in Advance Care Planning Conversations: A Mixed-Methods Analysis From a Randomized Controlled Trial.
Trial report in Journal of pain and symptom management, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
What it found
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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.
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.
Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Preferences for life-sustaining treatments and advance directives among heart failure patients: a systematic review and meta-analysis.BMC cardiovascular disorders · 2026Pooled it
- Decision aids for people facing health treatment or screening decisions.The Cochrane database of systematic reviews · 2024Pooled it
- The Value of Advance Care Planning for Spokespersons of Patients With Advanced Illness.Journal of pain and symptom management · 2023Trial
- What Surrogates Understand (and Don't Understand) About Patients' Wishes After Engaging Advance Care Planning: A Qualitative Analysis.The American journal of hospice & palliative care · 2022Trial
- Multi Components in the Implementation of Advanced Care Planning for Patients with Cancer: A Scoping Review.Journal of caring sciences · 2025Review
- Advance Care Planning Initiatives in Critical Care Centers in Japan: A Case Report.Clinical case reports · 2025Article
- Measuring decision aid effectiveness for end-of-life care: A systematic review.PEC innovation · 2024Article
- Life-Stage and Contextual Factors of Advance Care Planning Among Older Adults With Limited Income.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2024Article
- Relationships Between Personality Traits and Perceived Stress in Surrogate Decision-Makers of Intensive Care Unit Patients.The American journal of hospice & palliative care · 2024Article
- Advanced directives' knowledge among Portuguese palliative patients and caregivers: do the sociodemographic factors influence it? A cross-sectional survey.BMC palliative care · 2023Article
- Intrinsic Traits Such as Personality and Decision-Making Style are Predictive of Stress in Surrogate Decision-Makers.The American journal of hospice & palliative care · 2023Article
- Using a self-directed workbook to support advance care planning with long term care home residents.BMC palliative care · 2021Article
- A Parallel Process of Staff-Family Distress in Long-Term Care: A Challenge to Collaboration.SAGE open nursingArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
Abstract
contextSpokespersons serving as surrogate decision makers for their loved ones report high levels of stress. Despite known benefits, advance care planning (ACP) conversations often do not occur. More information is needed to understand spokesperson stress during ACP.
objectivesTo explore if and how spokespersons perceive stress related to ACP conversations; compare factors related to stress; and assess whether ACP intervention impacted stress.
methodsSecondary and mixed-methods analysis with data transformation of semistructured interviews occurring during a 2 × 2 factorial (four armed) randomized controlled trial that compared standard online ACP to a comprehensive online ACP decision aid. Tools were completed by patients with advanced illness (n = 285) alone or with their spokesperson (n = 285). About 200 spokesperson interviews were purposively sampled from each of the four arms (50 per arm).
resultsACP conversations were reported as stressful by 54.41% (74 of 136) and nonstressful by 45.59% (62 of 136). Five themes impacting spokesperson stress were the nature of the relationship with their loved one; self-described personality and belief systems; knowledge and experience with illness and ACP conversations; attitude toward ACP conversations; and social support in caregiving and decision making. No significant differences in stress were associated with arm assignment.
conclusionIdentifying what factors impact spokesperson stress in ACP conversations can be used to help design ACP interventions to more appropriately address the needs and concerns of spokespersons.
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Registered trials
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