title: Study protocol for 'we DECide': implementation of advance care planning for nursing home residents with dementia.
abstract: OBJECTIVE
  To evaluate the effects of 'we DECide', an educational intervention for nursing home staff on shared decision-making in the context of advance care planning for residents with dementia.
  
  
  BACKGROUND
  Advance care planning (preparing care choices for when persons no longer have decision-making capacity) is of utmost importance for nursing home residents with dementia, but is mostly not realized for this group. Advance care planning consists of discussing care choices and making decisions and corresponds to shared decision-making (the involvement of persons and their families in care and treatment decisions).
  
  
  METHODS
  This quasi-experimental pre-test-post-test study is conducted in 19 nursing homes (Belgium). Participants are nursing home staff.
  
  
  METHODS
  'We DECide' focuses on three crucial moments for discussing advance care planning: the time of admission, crisis situations and everyday conversations. The 'ACP-audit' assesses participants' views on the organization of advance care planning (organizational level), the 'OPTION scale' evaluates the degree of shared decision-making in individual conversations (clinical level) and the 'IFC-SDM Questionnaire' assesses participants' views on Importance, Frequency and Competence of realizing shared decision-making (clinical level). (Project funded: July 2010).
  
  
  CONCLUSIONS
  The study hypothesis is that 'we DECide' results in a higher realization of shared decision-making in individual conversations on advance care planning. A better implementation of advance care planning will lead to a higher quality of end-of-life care and more person-centred care. We believe our study will be of interest to researchers and to professional nursing home caregivers and policy-makers.
authors.affiliation: KU Leuven, LUCAS, Centre for Care Research and Consultancy, Belgium.
authors.forename: Sophie
authors.initials: S
authors.lastname: Ampe
authors.forename: Aline
authors.initials: A
authors.lastname: Sevenants
authors.forename: Evelien
authors.initials: E
authors.lastname: Coppens
authors.forename: Nele
authors.initials: N
authors.lastname: Spruytte
authors.forename: Tinne
authors.initials: T
authors.lastname: Smets
authors.forename: Anja
authors.initials: A
authors.lastname: Declercq
authors.forename: Chantal
authors.initials: C
authors.lastname: van Audenhove
mesh_terms: D032722:Advance Care Planning; D001530:Belgium; D002985:Clinical Protocols; D003657:Decision Making; D003704:Dementia / Q000451:nursing*; D006801:Humans
keywords: advance care planning; care choices; dementia; education; end of life; nursing; residential facilities; shared decision-making