title: Advance directive group education in a VA outpatient clinic.
abstract: Advance directive education is an important social work role in many medical settings. Despite its obvious benefit in terms of time-effectiveness, group education around advance directives has received little previous attention in the social work research literature. In a retrospective cohort (n = 13,913), we compared three education strategies in an attempt to evaluate their effectiveness on advance directive completion: (1) participation in a group session, (2) one or more individual sessions with a social worker, and (3) no advance directive education. Social work education of any kind resulted in an overall completion rate of 20% versus 2.1% in the non-intervention group. Group education was twice as effective as an individual social work session, and as effective as multiple sessions, but less time consuming. Our study confirmed previous findings that older patients are more likely to complete advance directives independent of education strategy. Participants in the group sessions were also older than the rest of the cohort, leading us to hypothesize about the particular appeal of group education to older patients. We conclude that group education is an effective as well as time- and cost-efficient social work tool for facilitating completion of advance medical directives, particularly among older patients.
authors.affiliation: Nursing Home Care Unit, VA Medical Center, 4150 Clement Street (111), San Francisco, CA 94121, USA. Dipko.Lisa_R@SanFrancisco.med.va.gov
authors.forename: Lisa R
authors.initials: LR
authors.lastname: Dipko
authors.forename: Karen
authors.initials: K
authors.lastname: Xavier
authors.forename: R Jeffrey
authors.initials: RJ
authors.lastname: Kohlwes
mesh_terms: D016223:Advance Directives; D000554:Ambulatory Care Facilities; D006126:Group Processes; D006282:Health Personnel / Q000193:education*; D006801:Humans; D010353:Patient Education as Topic / Q000458:organization & administration*; D012947:Social Work / Q000193:education*; D014481:United States; D014493:United States Department of Veterans Affairs