title: Randomized controlled trial of SPIRIT: an effective approach to preparing African-American dialysis patients and families for end of life.
abstract: This randomized controlled trial tested an intervention, Sharing Patients' Illness Representations to Increase Trust (SPIRIT), designed to enhance communication regarding end-of-life care between African Americans with end-stage renal disease (ESRD) and their chosen surrogate decision makers (N = 58 dyads). We used surveys and semi-structured interviews to determine the feasibility, acceptability, and preliminary effects of SPIRIT on patient and surrogate outcomes at 1 week and 3 months post-intervention. We also evaluated patients' deaths and surrogates' end-of-life decision making to assess surrogates' perceptions of benefits and limitations of the SPIRIT while facing end-of-life decisions. We found that SPIRIT promoted communication between patients and their surrogates and was effective and well received by the participants.
authors.affiliation: School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7460, USA.
authors.forename: Mi-Kyung
authors.initials: MK
authors.lastname: Song
authors.forename: Sandra E
authors.initials: SE
authors.lastname: Ward
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Happ
authors.forename: Beth
authors.initials: B
authors.lastname: Piraino
authors.forename: Heidi S
authors.initials: HS
authors.lastname: Donovan
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Shields
authors.forename: Mary C
authors.initials: MC
authors.lastname: Connolly
mesh_terms: D032722:Advance Care Planning / Q000458:organization & administration*; D001741:Black or African American / Q000193:education / Q000208:ethnology; D000368:Aged; D001294:Attitude to Health / Q000208:ethnology; D003142:Communication; D003220:Conflict, Psychological; D003657:Decision Making; D005190:Family / Q000208:ethnology; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000208:ethnology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009730:Nursing Assessment; D015403:Nursing Evaluation Research; D015404:Nursing Methodology Research; D010353:Patient Education as Topic / Q000458:organization & administration*; D019727:Proxy / Q000523:psychology*; D036301:Qualitative Research; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000523:psychology; D035502:Trust