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P45 Physicians’ perceived acceptability of a question prompt list for dementia at the end of life
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  1. S Heck1,
  2. JT Van der Steen2,
  3. CM Juffermans3,
  4. YM Van der Linden3,
  5. MM Garvelink3,
  6. WP Achterberg3 and
  7. RTCM Koopmans3
  1. 1Leiden University, Leiden, Netherlands
  2. 2Leiden University Medical Centre, Leiden, Netherlands

Abstract

Background Question prompt lists can support communication between patients, relatives and professional caregivers. Examples of questions encourage to ask about topics that are relevant to patients and relatives, which may, for example, enhance participation in decision making and improve outcome. We developed a question prompt list about end of life for people with dementia and their relatives. Physicians’ endorsement of its use and perceived acceptability is essential for effective implementation.

Methods In 2018, we surveyed 65 physicians (elderly care physicians and general practitioners) to evaluate the list. The survey was based on decision aid evaluation methodology including a validated acceptability scale ranging 15–75 with scores of 45 and meaning the aid is acceptable. Subsequently, we interviewed those physicians with either very high or very low acceptability scores.

Results The mean acceptability score was 51, but the physicians differed substantially in their evaluations of acceptability (SD 11). One third (32%) felt unable to answer the questions in the question prompt list. The interviews indicated this was bothering for some, and we explored this using the quantitative data. With inability to answer all questions, acceptability was lower and more variable (46 SD 13 vs. 54 SD 8).

Conclusions When accompanied by physician guidance and training, the question prompt list may fill a gap in seeking ways to develop advance care planning specific to dementia. An improved version of the question prompt list will be tested as part of two innovative advance care planning interventions.

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