Karin T. Kirchhoff|Bernard J. Hammes|Karen A. Kehl|Linda Briggs|Roger Brown
Effect of a Disease?Specific Planning Intervention on Surrogate Understanding of Patient Goals for Future Medical Treatment
objectives determine whether diseasespecific planning process improve surrogate understanding goals patients lifelimiting illnesses future medical treatments design multisite randomized controlled trial conducted january 1 2004 july 31 2007 setting six outpatient clinics large community university health systems three wisconsin cities participants competent englishspeaking adults aged 18 older chronic congestive heart failure chronic renal disease surrogate decisionmakers intervention trained health professionals conducted structured patientcentered interview intended promote informed decisionmaking result completion document clarifying goals patient regard four diseasespecific health outcome situations degree decisionmaking latitude granted surrogate measurements surrogate understanding patient goals care regard four expected diseasespecific outcomes situations degree surrogate latitude decisionmaking results three hundred thirteen patientsurrogate pairs completed study measured according kappa scores four situations degree latitude intervention group surrogates demonstrated significantly higher degree understanding patient goals control group surrogates intervention group kappa scores ranged 061 078 whereas control group kappa scores ranged 007 028 conclusion surrogates intervention group significantly better understanding patient goals preferences surrogates control group finding first step toward ensuring patient goals care known honored