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C Barbieri

Publications and source records attributed to C Barbieri.

93 records · Page 6Linked to original sources
PubMedDate not supplied

Effects of advance care education in cardiovascular rehabilitation programs: a prospective randomized study.

PURPOSE: To determine the effect of advance care education provided to patients enrolled in cardiovascular rehabilitation (CVR) programs and assess patients' acceptance of the educational program. METHODS: In a multicenter, prospective, randomized study, the authors administered two questionnaires 6 months apart to 284 patients enrolled in 14 CVR programs in 11 states. An educational group (99 subjects) participated in educational programs related to advance care planning and received advance directive forms after completing the first questionnaires; 185 subjects served as controls. Primary outcomes were completion of patient-physician discussions of end-of-life issues and patient confidence that their end-of-life wishes were understood by their physicians. Secondary outcomes were completion of formal advance directives and patient acceptance of the educational program. RESULTS: Both the educational and control groups demonstrated a larger proportion of patients at the end of the study, compared with the amount at the beginning of the study, who had completed living wills, durable powers of attorney for healthcare, and discussions with their physicians about advance directives and life support care. These outcomes were not observed more commonly after the educational intervention. Neither groups gained confidence, however, that their physicians understood their end-of-life wishes. Only 8.6% of patients had a negative response to the educational program. CONCLUSIONS: Advance care education is well received by patients enrolled in CVR programs. Enrollment in CVR promotes advance care planning to a small but measurable degree CVR rehabilitation programs appear to be acceptable sites for advance care planning but further research is needed to develop effective educational interventions.

Adult↗
PubMedDate not supplied

Involvement of cardiovascular rehabilitation programs in advance directive education.

BACKGROUND: Cardiac rehabilitation programs represent opportunities to educate patients with cardiac disease about living wills and durable powers of attorney for health care. The extent of advance directive education that is currently provided in cardiac rehabilitation programs, however, is unknown. METHODS: A questionnaire was mailed to nonphysician directors of cardiac rehabilitation programs to determine the programs' involvement in educating enrollees about end-of-life issues and the directors' opinions regarding the appropriateness of such education in cardiac rehabilitation curricula. Data were presented as proportions with 95% confidence intervals (Cls). RESULTS: Of the 1013 cardiac rehabilitation program directors, 845 (83%) responded to the questionnaire, of which 48 stated they were no longer enrolling patients. Of the remaining 797 program directors (83%), 71% (95% CI, 67%-74%) informed patients of their prognosis, but only 18% (95% CI, 15%-20%) and 12% (95% CI, 9%-14%) asked patients if they had a living will or a durable power of attorney for health care, respectively. Only 9% (95% CI, 7%-11%) offered educational sessions on advance directives and 17% distributed advance directive informational material. Education about cardiopulmonary resuscitation was provided by 27% (95% CI, 23%-30%), but only 3% (95% CI, 2%-4%) provided information on do-not-resuscitate topics. Fifty percent (95% CI, 46%-53%) were in favor of including advance directive education and 49% (95% CI, 45%-52%) favored inclusion of do-not-resuscitate topics into curricula. CONCLUSIONS: Cardiac rehabilitation programs are potentially valuable but not widely used sites for educating patients with cardiac disease about advance directives.

Advance Care Planning↗