title: Is it safe? Talking to teens with HIV/AIDS about death and dying: a 3-month evaluation of Family Centered Advance Care (FACE) planning - anxiety, depression, quality of life.
abstract: OBJECTIVE
  To determine the safety of engaging HIV-positive (HIV+) adolescents in a Family Centered Advance Care (FACE) planning intervention.
  
  
  METHODS
  We conducted a 2-armed, randomized controlled clinical trial in 2 hospital-based outpatient clinics from 2006-2008 with HIV+ adolescents and their surrogates (n = 76). Three 60-90 minutes sessions were conducted weekly. FACE intervention groups received: Lyon FCACP Survey(©), the Respecting Choices(®) interview, and completion of The Five Wishes(©). The Healthy Living Control (HLC) received: Developmental History, Healthy Tips, Future Planning (vocational, school or vocational rehabilitation). Three-month post-intervention outcomes were: completion of advance directive (Five Wishes(©)); psychological adjustment (Beck Depression, Anxiety Inventories); quality of life (PedsQL(™)); and HIV symptoms (General Health Self-Assessment).
  
  
  RESULTS
  Adolescents had a mean age, 16 years; 40% male; 92% African-American; 68% with perinatally acquired HIV, 29% had AIDS diagnosis. FACE participants completed advance directives more than controls, using time matched comparison (P < 0.001). Neither anxiety, nor depression, increased at clinically or statistically significant levels post-intervention. FACE adolescents maintained quality of life. FACE families perceived their adolescents as worsening in their school (P = 0.018) and emotional (P = 0.029) quality of life at 3 months, compared with controls.
  
  
  CONCLUSIONS
  Participating in advance care planning did not unduly distress HIV+ adolescents.
authors.affiliation: Children's National Medical Center and George Washington School of Medicine and Health Sciences, Washington, District of Columbia.
authors.forename: Maureen E
authors.initials: ME
authors.lastname: Lyon
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Garvie
authors.forename: Linda
authors.initials: L
authors.lastname: Briggs
authors.forename: Jianping
authors.initials: J
authors.lastname: He
authors.forename: Robert
authors.initials: R
authors.lastname: Malow
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: D'Angelo
authors.forename: Robert
authors.initials: R
authors.lastname: McCarter
references.citation: J Acquir Immune Defic Syndr Hum Retrovirol. 1995 Mar 1;8(3):273-8
references.pmid: 7859139
references.citation: J Am Geriatr Soc. 2002 Feb;50(2):378-81
references.pmid: 12028224
references.citation: J Natl Med Assoc. 2003 Mar;95(3):196-200
references.pmid: 12749679
references.citation: Ethn Dis. 1999 Winter;9(1):132-9
references.pmid: 10355482
references.citation: JAMA. 2000 Nov 15;284(19):2460-8
references.pmid: 11074775
references.citation: J Acquir Immune Defic Syndr. 2005 Apr 1;38(4):488-94
references.pmid: 15764966
references.citation: J Acquir Immune Defic Syndr. 2010 Jan;53(1):86-94
references.pmid: 20035164
references.citation: JAMA. 2009 Aug 19;302(7):741-9
references.pmid: 19690306
references.citation: J Palliat Med. 2005;8 Suppl 1:S95-102
references.pmid: 16499474
references.citation: J Abnorm Child Psychol. 1997 Jun;25(3):173-81
references.pmid: 9212370
references.citation: Am J Hosp Palliat Care. 2007 Dec-2008 Jan;24(6):515-21
references.pmid: 17601835
references.citation: Med Care. 2001 Aug;39(8):800-12
references.pmid: 11468499
references.citation: J Palliat Med. 2008 Dec;11(10):1309-13
references.pmid: 19115889
references.citation: Am J Med. 2000 Oct 15;109(6):469-75
references.pmid: 11042236
references.citation: J Am Geriatr Soc. 2002 Jan;50(1):182-90
references.pmid: 12028266
references.citation: Pediatrics. 1999 Apr;103(4 Pt 1):826-30
references.pmid: 10103317
references.citation: J Am Geriatr Soc. 2001 Oct;49(10):1346-52
references.pmid: 11890494
references.citation: MMWR Recomm Rep. 1992 Dec 18;41(RR-17):1-19
references.pmid: 1361652
references.citation: J Palliat Med. 2009 Jul;12(7):617-22
references.pmid: 19594346
references.citation: Arch Intern Med. 1993 May 24;153(10):1241-8
references.pmid: 8494476
references.citation: Oncol Nurs Forum. 2003 Jan-Feb;30(1):123-9
references.pmid: 12515990
references.citation: West J Nurs Res. 2007 Jun;29(4):448-65
references.pmid: 17538126
references.citation: J Palliat Med. 2005;8 Suppl 1:S70-8
references.pmid: 16499471
references.citation: Crit Care Med. 2003 May;31(5 Suppl):S373-8
references.pmid: 12771586
references.citation: Crit Care Med. 2003 May;31(5 Suppl):S394-9
references.pmid: 12771590
references.citation: HIV Med. 2010 Feb;11(2):143-51
references.pmid: 19751364
references.citation: AIDS Behav. 2008 May;12(3):374-83
references.pmid: 18330687
references.citation: J Palliat Med. 2005;8 Suppl 1:S58-69
references.pmid: 16499470
references.citation: Am J Med. 2000 Jan;108(1):14-9
references.pmid: 11059436
references.citation: Omega (Westport). 1995;31(4):263-73
references.pmid: 11660223
references.citation: J Palliat Med. 2004 Apr;7(2):335-40
references.pmid: 15130214
references.citation: Arch Intern Med. 1998 Dec 7-21;158(22):2493-7
references.pmid: 9855388
references.citation: Med Care. 1999 Feb;37(2):126-39
references.pmid: 10024117
references.citation: Pediatrics. 2009 Feb;123(2):e199-206
references.pmid: 19171571
references.citation: Crit Care Clin. 1993 Jan;9(1):125-36
references.pmid: 8422613
references.citation: Soc Sci Med. 1999 Jun;48(12):1779-89
references.pmid: 10405016
references.citation: Pediatrics. 2000 Aug;106(2 Pt 1):351-7
references.pmid: 10920167
references.citation: J Palliat Med. 2005;8 Suppl 1:S1-3
references.pmid: 16499457
references.citation: N Engl J Med. 2007 Feb 1;356(5):469-78
references.pmid: 17267907
references.citation: J Nurs Scholarsh. 2004;36(3):233-8
references.pmid: 15495492
references.citation: J Palliat Med. 2008 Apr;11(3):459-69
references.pmid: 18363489
references.citation: Curr HIV/AIDS Rep. 2007 Dec;4(4):173-80
references.pmid: 18366948
references.citation: Ambul Pediatr. 2003 Nov-Dec;3(6):329-41
references.pmid: 14616041
references.citation: Int J Palliat Nurs. 2001 Sep;7(9):427-34
references.pmid: 11832846
references.citation: J Palliat Med. 2009 Jan;12(1):71-6
references.pmid: 19284266
references.citation: J Palliat Med. 2009 Apr;12(4):363-72
references.pmid: 19327074
references.citation: J Adolesc Health. 2009 Feb;44(2):133-135
references.pmid: 19167661
references.citation: J Palliat Med. 2006 Aug;9(4):847-9
references.pmid: 16910797
references.citation: J Adolesc Health. 2004 Dec;35(6):529.e1-6
references.pmid: 15581537
references.citation: JAMA. 2005 Jul 20;294(3):359-65
references.pmid: 16030281
references.citation: AIDS. 2009 Sep 10;23(14):1859-65
references.pmid: 19584705
references.citation: Health Psychol. 2009 Jul;28(4):391-3
references.pmid: 19594261