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Richard O Schamp, MD, Department of Community and Family Medicine, Saint Louis University, Donco Building, 1402 Grand Avenue, St. Louis, MO 63104, John T Chibnall, PhD, Department of Psychiatry, Saint Louis University, David Wohl Memorial Institute, 1221 South Grand Blvd, St. Louis, MO 63104, and Leigh E Tenkku, MPH, Community and Family Medicine, Saint Louis University, 1420 Grand Avenue, Donco Building, St. Louis, MO 63104, 314-977-8481, tenkku@slu.edu.
Procedure-oriented healthcare directives are complex for patients to understand. A process was established to document healthcare wishes for present and advance directives allowing for general values to be expressed as pathway choices (longevity vs. function vs. palliation). We further hypothesized that attention to end-of-life beliefs and values would assist patients (and proxies) in expressing present and advance care pathway choices that best match their beliefs and values. The purpose of this pilot study was to examine the reliability and validity of a Beliefs and Values Questionnaire (BVQ), including its relationships to healthcare wishes. The BVQ is a 70-item inventory measuring domains of end-of-life beliefs and values. The statements reflect patient-focused, family-centered medical and social care in the Program for All-inclusive Care of the Elderly (PACE), scored by a 5-point Likert-type scale. The inventory was administered to 29 patients and 31 proxies. Preliminary analyses revealed alpha coefficients ranging from death comfort (0.80) to quality of life (0.49). For patients, higher scores in the domains: personal control, burden concern, and suffering avoidance predicted greater likelihood of choosing a palliative pathway for the advance directive. For proxies, higher scores on domains: death comfort and quality of life predicted greater likelihood of choosing a palliative pathway for the advance directive. These results indicate that beliefs and values can be assessed and that these correlate with choices for present and advance directives. The BVQ needs further refinement, but shows promise in providing information to guide providers and patients regarding values-based healthcare choices for end-of-life.
Learning Objectives: At the conclusion of the session, the learner will be able to
Keywords: End-of-Life Care, Decision-Making
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.