Motivational Interviewing to Enhance Advance Care Planning for Older Adults and Caregivers After Emergency Visits
NCT ID: NCT06090240
Last Updated: 2025-06-29
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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RECRUITING
NA
376 participants
INTERVENTIONAL
2023-10-20
2025-07-31
Brief Summary
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Compared to participants in the control group who will only receive a self-education booklet, participants in the intervention group will receive a motivational interview educational intervention to see the effectiveness of an MI-based ACP intervention implemented within six months following an emergency room visit regarding the completion of AD for older adults.
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Detailed Description
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Population: The target group will be dyads comprising older adults who have had ER visits within the previous six months and their family caregivers.
Intervention: An MI-based ACP intervention our team developed.
Main study aim: To investigate the effectiveness of an MI-based ACP intervention implemented within six months following an emergency room visit on completion of AD for older adults compared to a self-education group.
Study method: Investigators will recruit eligible participants from two largest public hospitals, including the geriatric outpatient clinic of Queen Mary Hospital (IRB Ref: UW23-402) and the accident \& emergency department of Queen Elizabeth Hospital (IRB Ref: KC/KE-23-0058/ER-1). A parallel RCT (allocation ratio= 1:1) with a post-trial qualitative study will be adopted and three follow-up time points at 3-, 6- and 12-month post-intervention. Participants in the intervention group will receive a motivational interview educational intervention, while participants in the comparison group will receive the pictorial ACP educational booklet for self-learning only. Completion of AD and health service utilization will be assessed at three follow-up time points. In addition, a post-intervention interview, regarding stakeholders' views on the relevance, effectiveness, and experience of the intervention., will be conducted.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
OTHER
SINGLE
Study Groups
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Motivational Interview
Older adult-family member dyads in this arm will receive an MI-based education intervention our team developed.
MI-based ACP intervention
Motivational Interviewing on Advance Care Planning Intervention: Dyads of older adults and family caregivers will receive three MI-based ACP counselling sessions: (1) a preparatory session, (2) motivation session, and (3) planning session. The preparatory session will take 10-15 minutes, and the following two sessions in weeks 2 and 3 will last 30-45 minutes each. Before each session, the nurse interventionist will first assess the dyad's readiness to engage in ACP based on the state of change algorithm. Participants who have never thought about ACP will be in the pre-contemplation state, those who are willing to discuss EOL care and preferences to be in the contemplation state, those ready to talk about EOL planning to be in the preparation state, and those in the action state have a confirmed action plan on signing up their ADs. Readiness-based ACP goals will be established, and state-matched MI counseling will be customized for each participant.
Self-learning
Older adult-family member dyads in this arm will receive a self-learning ACP educational material developed by the Hong Kong Hospital Authority.
No interventions assigned to this group
Interventions
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MI-based ACP intervention
Motivational Interviewing on Advance Care Planning Intervention: Dyads of older adults and family caregivers will receive three MI-based ACP counselling sessions: (1) a preparatory session, (2) motivation session, and (3) planning session. The preparatory session will take 10-15 minutes, and the following two sessions in weeks 2 and 3 will last 30-45 minutes each. Before each session, the nurse interventionist will first assess the dyad's readiness to engage in ACP based on the state of change algorithm. Participants who have never thought about ACP will be in the pre-contemplation state, those who are willing to discuss EOL care and preferences to be in the contemplation state, those ready to talk about EOL planning to be in the preparation state, and those in the action state have a confirmed action plan on signing up their ADs. Readiness-based ACP goals will be established, and state-matched MI counseling will be customized for each participant.
Eligibility Criteria
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Inclusion Criteria
* At least one episode of ER visit in the last six months
* Has a family caregiver to be present during the intervention
* Able to communicate in Chinese
* Aged 18 or above
* Immediate or extended family member or friend nominated by an eligible older adult participant as primary caregiver
* Able to communicate in Chinese
Exclusion Criteria
* Moderate to severe cognitive impairment or diagnosis of dementia, as identified in health records
* Communication problems (e.g., deafness or aphasia)
For family caregivers:
* Moderate to severe cognitive impairment
* Communication problems (e.g., deafness or aphasia)
ALL
Yes
Sponsors
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The University of Hong Kong
OTHER
Responsible Party
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Principal Investigators
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Chia-Chin LIN, PhD,FAAN,RN
Role: PRINCIPAL_INVESTIGATOR
University of Hong Kong, School of Nursing
Locations
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University of Hong Kong, School of Nursing
Hong Kong, , Hong Kong
Countries
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Central Contacts
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Facility Contacts
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Other Identifiers
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IRB-2023-150, HKWC-2023-342
Identifier Type: -
Identifier Source: org_study_id
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