Evidence map›Paper›PMID 38060714›Full record

ArticleCureus2023

Feasibility of Nurse-Led Advance Care Planning Before Pre-cardiac Procedures: A Descriptive Study.

Kyoko Shigetomi, Eiji Hiraoka, Miho Takahashi, Tadanori Nabeshima, Yasuhiro Norisue, Kotaro Obunai, Joji Ito, Minoru Tabata

Open access · diamondAbstract read
In one paragraph

Article in Cureus, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.3field-weighted citation impact, top 36% of its field
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

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Review
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 at 4 institutions in 2 countries.

Kyoko ShigetomiDepartment of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, JPN.
Eiji HiraokaDepartment of Internal Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, JPN.
Miho TakahashiDepartment of Critical Care Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, JPN.
Tadanori NabeshimaDepartment of Critical Care Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, JPN.
Yasuhiro NorisueDepartment of Critical Care Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, JPN.
Kotaro ObunaiDepartment of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, JPN.
Joji ItoDepartment of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, JPN.
Minoru TabataDepartment of Cardiovascular Surgery, Juntendo University Graduate School of Medicine, Tokyo, JPN.
Juntendo University Urayasu Hospital · JPBay Medical Center · USChiba Cerebral and Cardiovascular Center · JPJuntendo University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background Shared decision-making is important for deciding whether to perform surgery, especially high-risk surgery, or end-of-life care in cases of serious complications after the surgery. In shared decision-making, surgeons should be aware of patients' values. Therefore, advance care planning (ACP) before the surgery is important. In Japan, the feasibility of ACP, particularly preoperative nurse-led ACP, is yet to be evaluated. Methodology This retrospective, single-center, descriptive study included all adult candidates for open-heart or thoracic aortic surgery and transcutaneous aortic valve implantation (TAVI) referred by their surgeon for a nurse-led preoperative ACP between April 1, 2020 and December 31, 2021. The nurse conducted semi-structured interviews with patients regarding goals of care, unacceptable conditions, undesired procedures, advance directives, and their surrogates and documented them. The content of these interviews and their influence on decision-making were retrospectively investigated. Results Sixty-four patients (median age, 82 years; Society of Thoracic Surgeons (STS) score, 7.9; EuroSCORE II, 4.2; JapanSCORE, 7.0) were included (open-heart or thoracic aortic surgery 24, TAVI 40). Among them, 63 (98.4%), 56 (87.5%), and 13 (20.3%) patients articulated their goals of care, unacceptable conditions, and undesired procedures. Only one (1.6%) had a written advance directive. Although all of the patients could designated their surrogate, only 11 (17.2%) had shared their values disclosed in the pre-procedure ACP communication with their surrogates. Two patients who planned to undergo open-heart surgery disclosed their wish not to undergo the surgery only to the nurses but could not tell their surgeon; thereafter, the surgery was canceled. Three patients died after the procedure; however, the patients' value disclosed in ACP was not used for the end-of-life decision. Conclusion Nurse-led ACP can be implemented before high-risk cardiac procedures. It may have an impact on the decision-making of surgery although the ACP content may not be utilized for the end-of-life discussion after the procedures between surgeons and the family member.

Indexed as

advance care planning (acp)goal of carehigh-risk cardiac surgerynurse-led acpshared decision-making

Identifiers

PMID38060714
PMCPMC10698293
OpenAlexW4388412760

What OpenQuestion holds

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LicenceCC BY
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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.