title: Impact of advance directive videotape on patient comprehension and treatment preferences.
abstract: OBJECTIVE
  To examine the effects of an advance directive videotape on patient comprehension of advance directive concepts and preferences for resuscitation.
  
  
  METHODS
  Pilot study, randomized cohort trial.
  
  
  METHODS
  Extended Care and Rehabilitation Center, Veterans Affairs Medical Center, Durham, NC.
  
  
  METHODS
  Thirty-six residents of the center; mean age, 69 years.
  
  
  METHODS
  Sixteen subjects observed an advance directive videotape, and 20 subjects observed a health-relative videotape. All subjects received written material and counseling on advance directives.
  
  
  METHODS
  Structured interviews were conducted at three time points relative to the educational program (pretest, posttest, delayed posttest), measuring comprehension of two advance directive concepts (living will and cardiopulmonary resuscitation) and resuscitation preferences based on hypothetical clinical vignettes. Mean comprehension and mean resuscitation preference scores were derived for each time point.
  
  
  RESULTS
  The mean comprehension score improved an average of 1.6 points for all subjects from pretest to delayed posttest (P < .001); however, score changes were not significantly different between the two video groups (P = .39). Mean resuscitation preference scores were stable over time, and there were no significant score differences between the two video groups.
  
  
  CONCLUSIONS
  The advance directive videotape did not significantly affect resuscitation preferences or comprehension of selected advance directive concepts.
authors.affiliation: Department of Geriatric Research, Durham Veterans Affairs Medical Center, NC, USA.
authors.forename: E A
authors.initials: EA
authors.lastname: Siegert
authors.forename: E C
authors.initials: EC
authors.lastname: Clipp
authors.forename: P
authors.initials: P
authors.lastname: Mulhausen
authors.forename: G
authors.initials: G
authors.lastname: Kochersberger
mesh_terms: D016223:Advance Directives; D000368:Aged; D032882:Comprehension; D035061:Control Groups; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009735:Nursing Homes; D010353:Patient Education as Topic; D010358:Patient Participation / Q000523:psychology*; D010865:Pilot Projects; D013664:Teaching Materials; D014743:Videotape Recording