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1. The long-term intercorrelation between post-burn pain, anxiety, and depression: a post hoc analysis of the “RE-ENERGIZE” double-blind, randomized, multicenter placebo-controlled trial

Author

Panayi, Adriana C., Heyland, Daren K., Stoppe, Christian, Jeschke, Marc G., Didzun, Oliver, Matar, Dany, Tapking, Christian, Palackic, Alen, Bliesener, Björn, Harhaus, Leila, Knoedler, Samuel, Haug, Valentin, Bigdeli, Amir K., Kneser, Ulrich, Orgill, Dennis P., and Hundeshagen, Gabriel

Published
2024
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5. The effect of a selenium-based anti-inflammatory strategy on postoperative functional recovery in high-risk cardiac surgery patients - A nested sub-study of the sustain CSX trial

Author

Ott, Sascha, Lee, Zheng-Yii, Müller-Wirtz, Lukas M., Cangut, Busra, Roessler, Julian, Patterson, William, Thomas, Christian M., Bekele, Biniam M., Windpassinger, Marita, Lobdell, Kevin, Grant, Michael C., Arora, Rakesh C., Engelman, Daniel T., Fremes, Stephen, Velten, Markus, O'Brien, Benjamin, Ruetzler, Kurt, Heyland, Daren K., and Stoppe, Christian

Published
2024
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7. The effect of high-dose selenium on mortality and postoperative organ dysfunction in post-cardiotomy cardiogenic shock patients supported with mechanical circulatory support – A post-hoc analysis of the SUSTAIN CSX trial

Author

Ott, Sascha, Dresen, Ellen, Lee, Zheng Yii, Müller-Wirtz, Lukas M., Procopiuc, Livia, Ekrami, Elyad, Pitts, Leonard, Hellner, Nicolas, Catena, Daniel, Duerr, Georg Daniel, Wittmann, Maria, Waeschle, Reiner M., Elke, Gunnar, O'Brien, Benjamin, Heyland, Daren K., and Stoppe, Christian

Published
2024
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8. How Prepared Are People for Their Future? Findings from the 'Preparedness for the Future' Survey

Author

Heyland, Daren K., Pope, J. Paige, Jiang, Xuran, and Day, Andrew G.

Abstract

Objective: People are living longer than ever before. Many arrive at a later stage of life in poor health and with inadequate financial and social resources. The purpose of this paper is to describe people's general state of preparedness for their future as older persons, identify specific attitudes towards ageing and key characteristics that portend a lesser degree of preparedness, and identify the issues that need greater emphasis. Design: Cross-sectional survey. Setting: 502 adult participants enlisted on an online polling panel in Canada. Methods: Demographics, attitudes towards the future self and ageing and the responses to the 'Preparedness for the Future Questionnaire' (Prep-FQ) were analysed. Descriptive statistics were used to highlight overall and domain scores (possible score 0-100). Regression models were used to link key demographic characteristics and attitudes to a lower Prep FQ score. Results: The average age of participants was 54.1 years old (range 30-91). The majority (97%) felt it was important to think about themselves as an older person, yet less than 25% of people regularly spent time thinking about what it would be like for them as an older person. The average score on the Prep FQ was 61.6 (range 25-99). Items with the lowest scores were related to advance serious illness planning (medical care, funeral and legacy planning). Factors associated with a higher Prep FQ score included being female, having more education, thinking about when they are older and feeling positive about themselves as an older person. Conclusion: Helping people think and plan ahead more for healthy ageing may help some people move forward with confidence in creating a long, high-quality life and high-quality death. Helping 'at-risk' people plan for serious illness in advance is a high-priority target for improving people's general state of preparedness for the future.

Published
2022
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11. The impact of higher protein dosing on outcomes in critically ill patients with acute kidney injury: a post hoc analysis of the EFFORT protein trial

Author

Stoppe, Christian, Patel, Jayshil J., Zarbock, Alex, Lee, Zheng-Yii, Rice, Todd W., Mafrici, Bruno, Wehner, Rebecca, Chan, Man Hung Manuel, Lai, Peter Chi Keung, MacEachern, Kristen, Myrianthefs, Pavlos, Tsigou, Evdoxia, Ortiz-Reyes, Luis, Jiang, Xuran, Day, Andrew G., Hasan, M. Shahnaz, Meybohm, Patrick, Ke, Lu, and Heyland, Daren K.

Published
2023
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12. The Clinical Frailty Scale for mortality prediction of old acutely admitted intensive care patients: a meta-analysis of individual patient-level data

Author

Bruno, Raphael Romano, Wernly, Bernhard, Bagshaw, Sean M., van den Boogaard, Mark, Darvall, Jai N., De Geer, Lina, de Gopegui Miguelena, Pablo Ruiz, Heyland, Daren K., Hewitt, David, Hope, Aluko A., Langlais, Emilie, Le Maguet, Pascale, Montgomery, Carmel L., Papageorgiou, Dimitrios, Seguin, Philippe, Geense, Wytske W., Silva-Obregón, J. Alberto, Wolff, Georg, Polzin, Amin, Dannenberg, Lisa, Kelm, Malte, Flaatten, Hans, Beil, Michael, Franz, Marcus, Sviri, Sigal, Leaver, Susannah, Guidet, Bertrand, Boumendil, Ariane, and Jung, Christian

Published
2023
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15. The authors reply

Author

Angriman, Federico, Muttalib, Fiona, Lamontagne, François, Adhikari, Neill K. J., Chassé, Michaël, Aslanian, Pierre, Bélisle, Sylvain, Cailhier, Jean-François, Martin Carrier, François, Charbonney, Emmanuel, Denault, André, Girard, Martin, Guimond, Jean-Gilles, Halwagi, Antoine, Hébert, Paul, Kolan, Christophe, Ouellet, Caroline, Robillard, Nicholas, Benettaib, Fatna, Boumahni, Dounia, Lebrasseur, Martine, Salamé, Maya, Cantin, Marie-Ève, Archambault, Patrick, Drouin, Christine, Duquet-Deblois, Estel, Noël-Hunter, Monia, Dubé, Jean-Nicolas, Bériault, Marie-Josée, Chacon, Marco, Claveau, David, Naud, Jean-François, Rodrigue, Élise, Tapss, Danielle, Toupin, Guylaine, Ting Wang, Han, Brosseau, Marc, Laufer, Brian, Marquis, François, Toupin, Francis, Tassy, Danaë, Cheung, Vincent, Toun, Sam-Ang, Lamontagne, François, D’Aragon, Frédérick, Bérard, Dominique, Grondin-Beaudoin, Brian, Leclair, Marc-André, Lesur, Olivier, Mayette, Michaël, Poulin, Yannick, Quiroz Martinez, Hector, St-Arnaud, Charles, Carbonneau, Elaine, Bélisle, Julie, Bouchard, Marie-Pier, Côté, Line, Ladouceur, Marylène, Marchand, Joannie, Naisby, Alexandra, Robert-Petit, Louise, Thibault, Marie-Ève, Charbonney, Emmanuel, Albert, Martin, Bernard, Francis, Cavayas, Alexandros, Serri, Karim, Williamson, David, Williams, Virginie, Lainer Palacios, Julia, Lauzier, François, Francoeur, Charles, Leblanc, Guillaume, St-Onge, Maude, Turgeon, Alexis, Bellemare, David, Boulanger, Marie-Claude, Cloutier, Eve, Guilbault, Gabrielle, Thibeault, Frédérique, Belley-Côté, Emilie, Fox-Robichaud, Alison, Meade, Maureen, Whitlock, Richard, Hand, Lori, Hayward, Leah, Mullen, Courtney, Savija, Nevena, Lellouche, François, Simon, Mathieu, Tung Sia, Ying, Lizotte, Patricia, Rochwerg, Bram, Millen, Tina, Maslove, David, Gordon Boyd, J., Drover, John, Muscedere, John, Sibley, Stephanie, Boyd, Tracy, Hunt, Miranda, Mele, Tina, Bentall, Tracey, ElKhatib, Chadia, Shahin, Jason, Khwaja, Kosar, Campisi, Josie, Alam, Norine, Rahgoshai, Raham, Mehta, Sangeeta, Detsky, Michael, Shah, Sumesh, Kohli, Sonny, Cui, Fulan, Khera, Vikas, McConachie, David, Rehsia, Sachdeep, Bharti, Dalisha, Perez, Adic, James Kutsogiannis, Demetrios, Chowdhury, Raiyan, Davidow, Jon, Johnston, Curtis, Kim, Michael, Macala, Kimberley, Marcushamer, Sam, Markland, Darren, Matheson, Doug, Parker, Arabesque, Paton-Gay, Damian, Hewer, Tayne, Thompson, Patrica, Cook, Deborah, Al-Hazzani, Waleed, Duan, Erick, Ligori, Tania, Soth, Mark, Clarke, France, Copland, Mary, Matic, Karlo, Adhikari, Neill KJ, Amaral, Andre, Cuthbertson, Brian H, Fowler, Robert A, Piquette, Dominique, Scales, Damon C, Tillmann, Bourke, Wunsch, Hannah, Marinoff, Nicole, Kamra, Maneesha, Kaur, Navjot, Murali, Deeptha, Sabananthan, Thivya, Sugumaran, Thuva, Seely, Andrew, English, Shane, Meggison, Hilary, Microys, Sherissa, Millington, Scott, Sarti, Aimee, Haines, Jessica, Miezitis, Sydney, Porteous, Rebecca, Watpool, Irene, Del Sorbo, Lorenzo, Fan, Eddy, Granton, John, Abdelhady, Hesham, Romagnuolo, Tina, Rewa, Oleksa, Bagshaw, Sean, Meier, Michael, Sligl, Wendy, Baig, Nadia, Wood, Gordon, Ovakim, Daniel, Auld, Fiona, Carney, Gayle, Parfett, Deborah, Leblanc, Rémi, Poirier, Matthieu, Theriault, Theophile, Williston, Maryse, Caissie Collette, Jackie, Carriere, Melanie, Daigle, Melissa, Gaudet, Bernise, Morin, Karine, Ouellette-Bernier, Lola, Poitras, Julie, Robichaud, Melanie, Rockburn, Joanne, Mekontso Dessap, Armand, Arrestier, Romain, Bagate, François, Bendib, Ines, Benelli, Brice, Berti, Enora, Bertier, Astrid, Cavaleiro, Pedro, de Prost, Nicolas, Gendreau, Segolene, Hartman, Otto, Haudebourg, Anne-Fleur, Lopinto, Julien, Masi, Paul, Michaud, Gaël, Razazi, Keyvan, Tuffet, Samuel, Alves, Aline, Nait Chabane, Luiza, Ouali, Fariza, Ouedraogo, Rachida, Annane, Djillali, Abdeladim, Lilia, Bounab, Rania, Heming, Nicholas, Maxime, Virginie, Moine, Pierre, Bossard, Isabelle, Jourdier, Segolene, Mahiou, Siline, Tessa, Hayette, McGuinness, Shay, Ball, Jonathan, Hennessy, Immanuel, Hogan, Maurice, Butler, Magdalena, Cowdrey, Keri-Anne, Gilder, Eileen, Parke, Rachael, Ryan, Samantha, Woollett, Melissa, Van Der Poll, Andrew, Benson-Cooper, Kerry, Chen, Jonathan, Freeman, Kirk, Harley, David, Harvey, Dave, Hourigan, Craig, Julian, Kylie, Lo, Stephen, McArthur, Colin, Miller, Stuart, Pointer, Chris, Anthony Smith, Rex, Tincknell, Laura, McConnochie, Rachael, Simmonds, Catherine, Shaw, Geoffrey, Betteridge, Toby, Burke, Brandon, Closey, David, Crombie, Rosalind, Davidson, Neil, Henderson, Louise, Henderson, Seton, Hitchings, Louise, Knight, David, Quigley, Christine, Ritzema Carter, Jay, Roberts, Jessica, Townend, Katherine, Doyle, Tara, Mehrtens, Jan, Morgan, Stacey, Morris, Anna, Van Der Heyden, Kymbalee, Twardowski, Pawel, Dvoracek, Martin, Renner, Markus, Silverman, David, Smith, Myles, Monica Stephens, Katherine, Albert Waibel, Hansjörg, Wiebe, Stefan, Woolley, Mark, Eden, Amie, France, Dawn, Buehner, Ulrike, Erin Williams, Katallah Kramer, Browne, Troy, Callender, Owen, Chen, Jonathan, Farrell, Susanne, Higson, Vicky, Jackson, David, Keet, Owen, Goodson, Jennifer, Martynoga, Robert, Byrne, Kelly, Butler, Amelia, Trask, Kara, Mans, Gay, Termaat, Jonathan, Young, Paul, Barnes, Colin, Barry, Ben, Grayson, Kim, Moore, James, Psirides, Alex, Sturland, Shawn, Tietjens, Kate, Ure, Bob, Walker, Laurence, Wright, Jason, Aguilar-Dano, April, Delaney, Kirsha, Lawrence, Cassie, Lesona, Mildred, Millington, Alexandra, Navarra, Leanlove, Olatunji, Shaanti, Sol Cruz, Raulle, Sol Cruz, Rhoze, Young, Chelsea, Day, Andrew, Cook, Deborah J, Guyatt, Gordon H, Sprague, Sheila, Cohen, Dian, Heyland, Daren K, Lamontagne, François, Masse, Marie-Hélène, Ménard, Julie, Adhikari, Neill KJ, Pinto, Ruxandra, Kanji, Salmaan, Battista, Marie-Claude, Annane, Djillali, Tirupakuzhi Vijayaraghavan, Bharath Kumar, McGuinness, Shay, Parke, Rachael, and Arabi, Yaseen

Published
2023
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16. Effect of an Interactive Website to Engage Patients in Advance Care Planning in Outpatient Settings

Author

Howard, Michelle, Robinson, Carole A, McKenzie, Michael, Fyles, Gillian, Sudore, Rebecca L, Andersen, Elizabeth, Arora, Neha, Barwich, Doris, Bernard, Carrie, Elston, Dawn, Heyland, Rebecca, Klein, Doug, McFee, Erin, Mroz, Lawrence, Slaven, Marissa, Tan, Amy, and Heyland, Daren K

Subjects
Health Services and Systems, Health Sciences, Clinical Research, Cancer, Prevention, Aging, Behavioral and Social Science, Health Services, Advance Care Planning, Aged, Aged, 80 and over, Canada, Controlled Before-After Studies, Decision Making, Female, Health Knowledge, Attitudes, Practice, Humans, Internet, Male, Middle Aged, Outpatients, Patient Participation, Primary Health Care, Prospective Studies, Surveys and Questionnaires, advance care planning, end of life care, decision making, decision support techniques, behavior, prospective studies, patient engagement, primary care, oncology, Medical and Health Sciences, Studies in Human Society, General & Internal Medicine, Biomedical and clinical sciences, Health sciences, Human society
Abstract

PurposeOnline programs may help to engage patients in advance care planning in outpatient settings. We sought to implement an online advance care planning program, PREPARE (Prepare for Your Care; http://www.prepareforyourcare.org), at home and evaluate the changes in advance care planning engagement among patients attending outpatient clinics.MethodsWe undertook a prospective before-and-after study in 15 primary care clinics and 2 outpatient cancer centers in Canada. Patients were aged 50 years or older (primary care) or 18 years or older (cancer care) and free of cognitive impairment. They used the PREPARE website over 6 weeks, with reminders sent at 2 or 4 weeks. We used the 55-item Advance Care Planning Engagement Survey, which measures behavior change processes (knowledge, contemplation, self-efficacy, readiness) on 5-point scales and actions relating to substitute decision makers, quality of life, flexibility for the decision maker, and asking doctors questions on an overall scale from 0 to 21; higher scores indicate greater engagement.ResultsIn total, 315 patients were screened and 172 enrolled, of whom 75% completed the study (mean age = 65.6 years, 51% female, 35% had cancer). The mean behavior change process score was 2.9 (SD 0.8) at baseline and 3.5 (SD 0.8) at follow-up (mean change = 0.6; 95% CI, 0.49-0.73); the mean action measure score was 4.0 (SD 4.9) at baseline and 5.2 (SD 5.4) at follow-up (mean change = 1.2; 95% CI, 0.54-1.77). The effect size was moderate (0.75) for the former and small (0.23) for the latter. Findings were similar in both primary care and cancer care populations.ConclusionsImplementation of the online PREPARE program in primary care and cancer care clinics increased advance care planning engagement among patients.

Published
2020

17. Brief English and Spanish Survey Detects Change in Response to Advance Care Planning Interventions.

Author

Shi, Ying, Barnes, Deborah E, Boscardin, John, You, John J, Heyland, Daren K, Volow, Aiesha M, Howard, Michelle, and Sudore, Rebecca L

Subjects
Humans, Language, Psychometrics, Advance Directives, Socioeconomic Factors, Adult, Aged, Middle Aged, Patient Participation, Advance Care Planning, Female, Male, Surveys and Questionnaires, Ethnicity, Advance care planning, psychometrics, surveys and questionnaires, Clinical Trials and Supportive Activities, Clinical Research, Medical and Health Sciences, Anesthesiology
Abstract

ContextThe validated 82-item Advance Care Planning (ACP) Engagement Survey measures a broad range of ACP behaviors but is long.ObjectivesDetermine whether shorter survey versions (55-item, 34-item, 15-item, 9-item, and 4-item versions) can detect similar change in response to two well-validated ACP interventions and provide practical effect size information.MethodsWe assessed ACP engagement for 986 English- and Spanish-speaking adults in a randomized trial of PREPARE vs. an advance directive-only study arms. The survey was administered at baseline, one week, three months, six months, and 12 months. We calculated mean change scores from baseline to follow-up time points by study arm, intraclass correlation coefficients of change scores between the 82-item survey with shorter versions, and within-group and between-group effect sizes of the mean change scores.ResultsShorter survey versions were able to detect within-group and between-group changes at all time points. Within-group intraclass correlations of the 82-item to shorter versions were high (0.78-0.97), and the amount of between-group differences was comparable using all survey versions. Twelve-month within-group effect sizes ranged narrowly from 0.76 to 1.05 for different survey versions in the PREPARE arm and from 0.44 to 0.64 for the advance directive-only version. Between-group effect sizes ranged narrowly from 0.24 to 0.30 for different survey versions. Results were similar when stratified by English and Spanish speakers.ConclusionShorter versions of the ACP Engagement Survey were able to detect within-group and between-group changes comparable with the 82-item version and can be useful for efficiently and effectively measuring ACP engagement in research and clinical settings.

Published
2019

18. The effect of higher protein dosing in critically ill patients with high nutritional risk (EFFORT Protein): an international, multicentre, pragmatic, registry-based randomised trial

Author

Heyland, Daren K, Patel, Jayshil, Compher, Charlene, Rice, Todd W, Bear, Danielle E, Lee, Zheng-Yii, González, Victoria C, O'Reilly, Kevin, Regala, Racquel, Wedemire, Courtney, Ibarra-Estrada, Miguel, Stoppe, Christian, Ortiz-Reyes, Luis, Jiang, Xuran, and Day, Andrew G

Published
2023
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19. High-Dose IV Hydroxocobalamin (Vitamin B12) in Septic Shock: A Double-Blind, Allocation-Concealed, Placebo-Controlled Single-Center Pilot Randomized Controlled Trial (The Intravenous Hydroxocobalamin in Septic Shock Trial)

Author

Patel, Jayshil J., Willoughby, Rodney, Peterson, Jennifer, Carver, Thomas, Zelten, James, Markiewicz, Adrienne, Spiegelhoff, Kaitlin, Hipp, Lauren A., Canales, Bethany, Szabo, Aniko, Heyland, Daren K., Stoppe, Christian, Zielonka, Jacek, and Freed, Julie K.

Published
2023
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21. IV Vitamin C in Adults With Sepsis: A Bayesian Reanalysis of a Randomized Controlled Trial*

Author

Angriman, Federico, Muttalib, Fiona, Lamontagne, François, Adhikari, Neill K. J., Chassé, Michaël, Aslanian, Pierre, Bélisle, Sylvain, Cailhier, Jean-François, Carrier, François Martin, Charbonney, Emmanuel, Denault, André, Girard, Martin, Guimond, Jean-Gilles, Halwagi, Antoine, Hébert, Paul, Kolan, Christophe, Ouellet, Caroline, Robillard, Nicholas, Benettaib, Fatna, Boumahni, Dounia, Lebrasseur, Martine, Salamé, Maya, Cantin, Marie-Ève, Archambault, Patrick, Drouin, Christine, Dubé, Jean-Nicolas, Bériault, Marie-Josée, Chacon, Marco, Claveau, David, Naud, Jean-François, Rodrigue, Élise, Ting Wang, Han, Brosseau, Marc, Laufer, Brian, Marquis, François, Toupin, Francis, Lamontagne, François, D’Aragon, Frédérick, Bérard, Dominique, Grondin-Beaudoin, Brian, Leclair, Marc-André, Lesur, Olivier, Mayette, Michaël, Poulin, Yannick, Quiroz Martinez, Hector, St-Arnaud, Charles, Charbonney, Emmanuel, Albert, Martin, Bernard, Francis, Cavayas, Alexandros, Serri, Karim, Williamson, David, Duquet-Deblois, Estel, Noël-Hunter, Monia, Tapss, Danielle, Toupin, Guylaine, Tassy, Danaë, Cheung, Vincent, Toun, Sam-Ang, Carbonneau, Elaine, Bélisle, Julie, Bouchard, Marie-Pier, Côté, Line, Ladouceur, Marylène, Marchand, Joannie, Naisby, Alexandra, Robert-Petit, Louise, Thibault, Marie-Ève, Williams, Virginie, Lainer Palacios, Julia, Charbonney, Emmanuel, Albert, Martin, Bernard, Francis, Cavayas, Alexandros, Serri, Karim, Williamson, David, Lauzier, François, Francoeur, Charles, Leblanc, Guillaume, St-Onge, Maude, Turgeon, Alexis, Belley-Côté, Emilie, Fox-Robichaud, Alison, Meade, Maureen, Whitlock, Richard, Lellouche, François, Simon, Mathieu, Tung Sia, Ying, Rochwerg, Bram, Maslove, David, Gordon Boyd, J., Drover, John, Muscedere, John, Sibley, Stephanie, Mele, Tina, Shahin, Jason, Khwaja, Kosar, Mehta, Sangeeta, Detsky, Michael, Kohli, Sonny, Cui, Fulan, Khera, Vikas, McConachie, David, Rehsia, Sachdeep, James Kutsogiannis, Demetrios, Chowdhury, Raiyan, Davidow, Jon, Johnston, Curtis, Kim, Michael, Macala, Kimberley, Marcushamer, Sam, Markland, Darren, Matheson, Doug, Parker, Arabesque, Paton-Gay, Damian, Cook, Deborah, Al-Hazzani, Waleed, Duan, Erick, Ligori, Tania, Soth, Mark, Adhikari, Neill KJ, Amaral, Andre, Cuthbertson, Brian H, Fowler, Robert A, Piquette, Dominique, Scales, Damon C, Tillmann, Bourke, Wunsch, Hannah, Seely, Andrew, English, Shane, Meggison, Hilary, Microys, Sherissa, Millington, Scott, Sarti, Aimee, Del Sorbo, Lorenzo, Fan, Eddy, Granton, John, Rewa, Oleksa, Bagshaw, Sean, Meier, Michael, Sligl, Wendy, Wood, Gordon, Ovakim, Daniel, Leblanc, Rémi, Poirier, Matthieu, Theriault, Theophile, Williston, Maryse, Bellemare, David, Boulanger, Marie-Claude, Cloutier, Eve, Guilbault, Gabrielle, Thibeault, Frédérique, Hand, Lori, Hayward, Leah, Mullen, Courtney, Savija, Nevena, Lizotte, Patricia, Millen, Tina, Boyd, Tracy, Hunt, Miranda, Bentall, Tracey, ElKhatib, Chadia, Campisi, Josie, Alam, Norine, Rahgoshai, Raham, Shah, Sumesh, Bharti, Dalisha, Perez, Adic, Hewer, Tayne, Thompson, Patrica, Clarke, France, Copland, Mary, Matic, Karlo, Marinoff, Nicole, Kamra, Maneesha, Kaur, Navjot, Murali, Deeptha, Sabananthan, Thivya, Sugumaran, Thuva, Haines, Jessica, Miezitis, Sydney, Porteous, Rebecca, Watpool, Irene, Abdelhady, Hesham, Romagnuolo, Tina, Baig, Nadia, Auld, Fiona, Carney, Gayle, Parfett, Deborah, Caissie Collette, Jackie, Carriere, Melanie, Daigle, Melissa, Gaudet, Bernise, Morin, Karine, Ouellette-Bernier, Lola, Poitras, Julie, Robichaud, Melanie, Rockburn, Joanne, Mekontso Dessap, Armand, Arrestier, Romain, Bagate, François, Bendib, Ines, Benelli, Brice, Berti, Enora, Bertier, Astrid, Cavaleiro, Pedro, de Prost, Nicolas, Gendreau, Segolene, Hartman, Otto, Haudebourg, Anne-Fleur, Lopinto, Julien, Masi, Paul, Michaud, Gaël, Razazi, Keyvan, Tuffet, Samuel, Annane, Djillali, Abdeladim, Lilia, Bounab, Rania, Heming, Nicholas, Maxime, Virginie, Moine, Pierre, Alves, Aline, Nait Chabane, Luiza, Ouali, Fariza, Ouedraogo, Rachida, Bossard, Isabelle, Jourdier, Segolene, Mahiou, Siline, Tessa, Hayette, McGuinness, Shay, Ball, Jonathan, Hennessy, Immanuel, Hogan, Maurice, Van Der Poll, Andrew, Benson-Cooper, Kerry, Chen, Jonathan, Freeman, Kirk, Harley, David, Harvey, Dave, Hourigan, Craig, Julian, Kylie, Lo, Stephen, McArthur, Colin, Miller, Stuart, Pointer, Chris, Anthony Smith, Rex, Tincknell, Laura, Shaw, Geoffrey, Betteridge, Toby, Burke, Brandon, Closey, David, Crombie, Rosalind, Davidson, Neil, Henderson, Louise, Henderson, Seton, Hitchings, Louise, Knight, David, Quigley, Christine, Ritzema Carter, Jay, Roberts, Jessica, Townend, Katherine, Twardowski, Pawel, Dvoracek, Martin, Renner, Markus, Silverman, David, Smith, Myles, Monica Stephens, Katherine, Albert Waibel, Hansjörg, Wiebe, Stefan, Woolley, Mark, Buehner, Ulrike, Kramer, Katallah, Browne, Troy, Callender, Owen, Chen, Jonathan, Farrell, Susanne, Higson, Vicky, Jackson, David, Keet, Owen, Martynoga, Robert, Byrne, Kelly, Young, Paul, Barnes, Colin, Barry, Ben, Grayson, Kim, Moore, James, Psirides, Alex, Sturland, Shawn, Tietjens, Kate, Ure, Bob, Walker, Laurence, Wright, Jason, Butler, Magdalena, Cowdrey, Keri-Anne, Gilder, Eileen, Parke, Rachael, Ryan, Samantha, Woollett, Melissa, McConnochie, Rachael, Simmonds, Catherine, Doyle, Tara, Mehrtens, Jan, Morgan, Stacey, Morris, Anna, Van Der Heyden, Kymbalee, Eden, Amie, France, Dawn, Williams, Erin, Goodson, Jennifer, Butler, Amelia, Trask, Kara, Mans, Gay, Termaat, Jonathan, Aguilar-Dano, April, Delaney, Kirsha, Lawrence, Cassie, Lesona, Mildred, Millington, Alexandra, Navarra, Leanlove, Olatunji, Shaanti, Cruz, Raulle Sol, Cruz, Rhoze Sol, Young, Chelsea, Day, Andrew, Cook, Deborah J, Guyatt, Gordon H, Sprague, Sheila, Cohen, Dian, Heyland, Daren K, Lamontagne, François, Masse, Marie-Hélène, Ménard, Julie, Adhikari, Neill KJ, Pinto, Ruxandra, Kanji, Salmaan, Battista, Marie-Claude, Annane, Djillali, Vijayaraghavan, Bharath Kumar Tirupakuzhi, McGuinness, Shay, Parke, Rachael, and Arabi, Yaseen

Published
2023
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23. Adaptation and Preliminary Validation of the Advance Care Planning Engagement Survey for Surrogate Decision Makers

Author

Van Scoy, Lauren J, Day, Andrew G, Howard, Michelle, Sudore, Rebecca, and Heyland, Daren K

Subjects
Health Services and Systems, Biomedical and Clinical Sciences, Health Sciences, Clinical Research, Good Health and Well Being, Advance Care Planning, Caregivers, Chronic Disease, Decision Making, Factor Analysis, Statistical, Female, Humans, Male, Middle Aged, Patient Participation, Preliminary Data, Prospective Studies, Proxy, Psychometrics, Surveys and Questionnaires, Advance care planning, psychometrics, surveys and questionnaires, terminal care, caregivers, decision making, Medical and Health Sciences, Anesthesiology, Biomedical and clinical sciences, Health sciences
Abstract

CONTEXT:Although measures that assess patient engagement in the advance care planning (ACP) process exist, there are no validated tools to assess surrogate decision makers' (SDMs') role in ACP. OBJECTIVES:The objective of this study was to adapt and begin to validate a patient-oriented questionnaire for use with SDMs of patients with chronic illness. METHODS:Questions from the 55-item patient-oriented ACP engagement survey were adapted for SDMs and assessed for face validity. The resultant 47-item questionnaire was administered to 65 SDMs of patients with chronic illness. Responses were assessed and items were flagged for removal based on item redundancy, nonresponses, and ceiling effects. A preliminary exploratory factor analysis was performed, internal consistency was assessed, and domains were constructed based on findings. RESULTS:The 47-item questionnaire was administered to 65 participants (mean age 51.8; 81% female; 96% Caucasian). Seventeen items were removed owing to redundancy (r > 0.80), and 13 items lacking face validity were removed. In a preliminary exploratory factor analysis of the resultant 17-item questionnaire, a three-factor solution was deemed most statistically and conceptually sound. Items were organized into domains: 1) serving as an SDM (seven items); 2) contemplation (four items); 3) readiness (six items). Internal consistency for each domain was high (Cronbach alpha 0.90-0.91). CONCLUSION:The 17-item ACP engagement survey for SDMs (ACP-17-SDM) is a conceptually sound and reliable questionnaire adaptation of the original ACP engagement survey. This questionnaire may be used by researchers in parallel with the patient-oriented ACP engagement survey to more fully understand the impact of ACP interventions on SDMs. Larger studies are needed to more closely examine construct validity.

Published
2019

30. Using Normalisation Process Theory to explore an interprofessional approach to Goals of Care: a qualitative study of stakeholders' perspectives.

Author

Plaisance, Ariane, Heyland, Daren K, Laflamme, Brigitte, Morin, Michèle, Pageau, Félix, Girard, Ariane, and LeBlanc, Annie

Subjects
*MEDICAL protocols, *CROSS-sectional method, *NURSES, *INTERPROFESSIONAL relations, *RESEARCH funding, *QUALITATIVE research, *SOCIAL workers, *SELF-efficacy, *INTERVIEWING, *SOCIAL theory, *DESCRIPTIVE statistics, *UNCERTAINTY, *DECISION making in clinical medicine, *ATTITUDE (Psychology), *STAKEHOLDER analysis, *ADVANCE directives (Medical care)
Abstract

Goals of Care (GOC) is a longitudinal, multi-setting, and interprofessional practise aiming to guide the use of life-sustaining therapies. We documented the perspectives of different stakeholders regarding their roles in GOC intervention and explored the possibility of implementing an interprofessional approach in a healthcare and social services institution. We interviewed nurses, social workers, and relatives of deceased persons and analyzed the results using an analytical framework based on the 16 mechanisms of the Normalization Process Theory. We identified barriers to implementing a sustainable interprofessional approach to GOC, such as the lack of designated leaders responsible for supporting the day-to-day provision of this rather complex intervention, the difficulty of access to physicians in two of the three care settings under study, and the lack of a robust informational system. We also demonstrated that the GOC intervention is postponed until there is no uncertainty to deal with, i.e., at the end of life. Our study adds to an emerging body of literature criticising the concept of making advance medical directives itself. We advocated for the promotion of tools that would enable lay people to select and empower a supportive decision maker to better represent them in serious illness decision making. [ABSTRACT FROM AUTHOR]

Published
2024
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32. Outcomes That Define Successful Advance Care Planning: A Delphi Panel Consensus

Author

Sudore, Rebecca L, Heyland, Daren K, Lum, Hillary D, Rietjens, Judith AC, Korfage, Ida J, Ritchie, Christine S, Hanson, Laura C, Meier, Diane E, Pantilat, Steven Z, Lorenz, Karl, Howard, Michelle, Green, Michael J, Simon, Jessica E, Feuz, Mariko A, and You, John J

Subjects
Good Health and Well Being, Advance Care Planning, Delphi Technique, Humans, Outcome Assessment, Health Care, Advance care planning, consensus, Delphi technique, outcome measures, Medical and Health Sciences, Anesthesiology
Abstract

ContextStandardized outcomes that define successful advance care planning (ACP) are lacking.ObjectiveThe objective of this study was to create an Organizing Framework of ACP outcome constructs and rate the importance of these outcomes.MethodsThis study convened a Delphi panel consisting of 52 multidisciplinary, international ACP experts including clinicians, researchers, and policy leaders from four countries. We conducted literature reviews and solicited attendee input from five international ACP conferences to identify initial ACP outcome constructs. In five Delphi rounds, we asked panelists to rate patient-centered outcomes on a seven-point "not-at-all" to "extremely important" scale. We calculated means and analyzed panelists' input to finalize an Organizing Framework and outcome rankings.ResultsOrganizing Framework outcome domains included process (e.g., attitudes), actions (e.g., discussions), quality of care (e.g., satisfaction), and health care (e.g., utilization). The top five outcomes included 1) care consistent with goals, mean 6.71 (±SD 0.04); 2) surrogate designation, 6.55 (0.45); 3) surrogate documentation, 6.50 (0.11); 4) discussions with surrogates, 6.40 (0.19); and 5) documents and recorded wishes are accessible when needed 6.27 (0.11). Advance directive documentation was ranked 10th, 6.01 (0.21). Panelists raised caution about whether "care consistent with goals" can be reliably measured.ConclusionA large, multidisciplinary Delphi panel developed an Organizing Framework and rated the importance of ACP outcome constructs. Top rated outcomes should be used to evaluate the success of ACP initiatives. More research is needed to create reliable and valid measurement tools for the highest rated outcomes, particularly "care consistent with goals."

Published
2018

33. Improving partnerships with family members of ICU patients: study protocol for a randomized controlled trial

Author

Heyland, Daren K, Davidson, Judy, Skrobik, Yoanna, des Ordons, Amanda Roze, Van Scoy, Lauren J, Day, Andrew G, Vandall-Walker, Virginia, and Marshall, Andrea P

Subjects
Patient and family engagement, Randomized trial, Nutrition, End of life, decision-making, Supportive care, Critical care
Abstract

BackgroundOver the last decade, health care delivery has shifted to partnering with patients and their families to improve health and quality of care, and to lower costs. Partnering with family members (FMs) of critically ill patients who lack capacity is particularly important for improving experiences and outcomes for both patients and FMs. How best to apply such partnering strategies, however, is yet unknown. The IMPACT trial will evaluate two interventions that enable partnerships with families of critically ill patients, each in a distinct content area, but similar in that they empower and support FMs.MethodsThis multi-center, open-label, randomized, phase II clinical trial aims to randomize 150 older, long-stay ICU patients and their families into one of three groups (50 in each group): (1) The OPTimal nutrition by Informing and Capacitating FMs of best practices (OPTICs) group, a multi-faceted intervention to engage and empower FMs to advocate for, and audit, best nutritional practices for their critically ill FMs, (2) A web-based decision-support intervention called the ICU Workbook (The Canadian Researchers at the End of Life Network (CARENET) ICU Workbook; https://www.myicuguide.ca/. Accessed 3 Feb 2017.) to support families in shared decision-making process regarding goals of medical treatments, and (3) Usual care. The main outcomes for this trial include nutritional adequacy in hospital and hand-grip strength prior to hospital discharge; satisfaction with decision-making; decision conflict; and degree of shared decision-making.DiscussionWith the goal of improving the functional recovery of nutritionally high-risk older patients and the quality of care at the end of life for these patients and their FMs in the ICU, we have proposed two novel family capacitation strategies. We hope that the nutrition and decision-support interventions implemented and evaluated in our study will contribute to the evidentiary basis for best family partnered care pathways focused on optimizing the quality of ICU care for patients with life-threatening illness and their families.Trial registrationClinical trials.gov, ID: NCT02920086. Registered on 30 September 2016. Protocol version dated 11 October 2016.

Published
2018

38. Definition and recommendations for advance care planning: an international consensus supported by the European Association for Palliative Care

Author

Rietjens, Judith AC, Sudore, Rebecca L, Connolly, Michael, van Delden, Johannes J, Drickamer, Margaret A, Droger, Mirjam, van der Heide, Agnes, Heyland, Daren K, Houttekier, Dirk, Janssen, Daisy JA, Orsi, Luciano, Payne, Sheila, Seymour, Jane, Jox, Ralf J, Korfage, Ida J, and Care, European Association for Palliative

Subjects
Biomedical and Clinical Sciences, Oncology and Carcinogenesis, Good Health and Well Being, Advance Care Planning, Attitude of Health Personnel, Consensus, Delphi Technique, Humans, Palliative Care, European Association for Palliative Care, Oncology & Carcinogenesis, Oncology and carcinogenesis
Abstract

Advance care planning (ACP) is increasingly implemented in oncology and beyond, but a definition of ACP and recommendations concerning its use are lacking. We used a formal Delphi consensus process to help develop a definition of ACP and provide recommendations for its application. Of the 109 experts (82 from Europe, 16 from North America, and 11 from Australia) who rated the ACP definitions and its 41 recommendations, agreement for each definition or recommendation was between 68-100%. ACP was defined as the ability to enable individuals to define goals and preferences for future medical treatment and care, to discuss these goals and preferences with family and health-care providers, and to record and review these preferences if appropriate. Recommendations included the adaptation of ACP based on the readiness of the individual; targeting ACP content as the individual's health condition worsens; and, using trained non-physician facilitators to support the ACP process. We present a list of outcome measures to enable the pooling and comparison of results of ACP studies. We believe that our recommendations can provide guidance for clinical practice, ACP policy, and research.

Published
2017

39. Defining Advance Care Planning for Adults: A Consensus Definition From a Multidisciplinary Delphi Panel

Author

Sudore, Rebecca L, Lum, Hillary D, You, John J, Hanson, Laura C, Meier, Diane E, Pantilat, Steven Z, Matlock, Daniel D, Rietjens, Judith AC, Korfage, Ida J, Ritchie, Christine S, Kutner, Jean S, Teno, Joan M, Thomas, Judy, McMahan, Ryan D, and Heyland, Daren K

Subjects
Clinical Research, Good Health and Well Being, Adult, Advance Care Planning, Chronic Disease, Decision Making, Delphi Technique, Female, Humans, Interdisciplinary Research, Internationality, Male, Practice Guidelines as Topic, Terminology as Topic, Advance care planning, consensus, Delphi technique, policy making, Medical and Health Sciences, Anesthesiology
Abstract

ContextDespite increasing interest in advance care planning (ACP) and previous ACP descriptions, a consensus definition does not yet exist to guide clinical, research, and policy initiatives.ObjectiveThe aim of this study was to develop a consensus definition of ACP for adults.MethodsWe convened a Delphi panel of multidisciplinary, international ACP experts consisting of 52 clinicians, researchers, and policy leaders from four countries and a patient/surrogate advisory committee. We conducted 10 rounds using a modified Delphi method and qualitatively analyzed panelists' input. Panelists identified several themes lacking consensus and iteratively discussed and developed a final consensus definition.ResultsPanelists identified several tensions concerning ACP concepts such as whether the definition should focus on conversations vs. written advance directives; patients' values vs. treatment preferences; current shared decision making vs. future medical decisions; and who should be included in the process. The panel achieved a final consensus one-sentence definition and accompanying goals statement: "Advance care planning is a process that supports adults at any age or stage of health in understanding and sharing their personal values, life goals, and preferences regarding future medical care. The goal of advance care planning is to help ensure that people receive medical care that is consistent with their values, goals and preferences during serious and chronic illness." The panel also described strategies to best support adults in ACP.ConclusionsA multidisciplinary Delphi panel developed a consensus definition for ACP for adults that can be used to inform implementation and measurement of ACP clinical, research, and policy initiatives.

Published
2017

40. Measuring Advance Care Planning: Optimizing the Advance Care Planning Engagement Survey.

Author

Sudore, Rebecca L, Heyland, Daren K, Barnes, Deborah E, Howard, Michelle, Fassbender, Konrad, Robinson, Carole A, Boscardin, John, and You, John J

Subjects
Humans, Factor Analysis, Statistical, Cross-Sectional Studies, Reproducibility of Results, Psychometrics, Aged, Middle Aged, Patient Participation, Advance Care Planning, Canada, United States, Female, Male, Surveys and Questionnaires, Advance care planning, psychometrics, surveys and questionnaires, Factor Analysis, Statistical, Anesthesiology, Medical and Health Sciences
Abstract

ContextA validated 82-item Advance Care Planning (ACP) Engagement Survey measures a broad range of behaviors. However, concise surveys are needed.ObjectivesThe objective of this study was to validate shorter versions of the survey.MethodsThe survey included 57 process (e.g., readiness) and 25 action items (e.g., discussions). For item reduction, we systematically eliminated questions based on face validity, item nonresponse, redundancy, ceiling effects, and factor analysis. We assessed internal consistency (Cronbach's alpha) and construct validity with cross-sectional correlations and the ability of the progressively shorter survey versions to detect change one week after exposure to an ACP intervention (Pearson correlation coefficients).ResultsFive hundred one participants (four Canadian and three US sites) were included in item reduction (mean age 69 years [±10], 41% nonwhite). Because of high correlations between readiness and action items, all action items were removed. Because of high correlations and ceiling effects, two process items were removed. Successive factor analysis then created 55-, 34-, 15-, nine-, and four-item versions; 664 participants (from three US ACP clinical trials) were included in validity analysis (age 65 years [±8], 72% nonwhite, 34% Spanish speaking). Cronbach's alphas were high for all versions (four items 0.84-55 items 0.97). Compared with the original survey, cross-sectional correlations were high (four items 0.85; 55 items 0.97) as were delta correlations (four items 0.68; 55 items 0.93).ConclusionShorter versions of the ACP Engagement Survey are valid, internally consistent, and able to detect change across a broad range of ACP behaviors for English and Spanish speakers. Shorter ACP surveys can efficiently measure broad ACP behaviors in research and clinical settings.

Published
2017

44. Measuring engagement in advance care planning: a cross-sectional multicentre feasibility study

Author

Howard, Michelle, Bonham, Aaron J, Heyland, Daren K, Sudore, Rebecca, Fassbender, Konrad, Robinson, Carole A, McKenzie, Michael, Elston, Dawn, You, John J, Ilan, Roy, Brenner, Ingrid, Fyles, Gillian, Slaven, Marissa, Mantle, Carol, Swinton, Marilyn, and Douglas, Maureen

Subjects
Health Services and Systems, Biomedical and Clinical Sciences, Nursing, Health Sciences, Clinical Research, Aging, Health Services, Good Health and Well Being, Adult, Advance Care Planning, Aged, Aged, 80 and over, Canada, Chronic Disease, Cross-Sectional Studies, Decision Making, Feasibility Studies, Female, Health Knowledge, Attitudes, Practice, Humans, Male, Middle Aged, Patient Acceptance of Health Care, Patient Participation, Surveys and Questionnaires, advance care planning, communication, survey, measurement, Clinical Sciences, Public Health and Health Services, Other Medical and Health Sciences, Biomedical and clinical sciences, Health sciences, Psychology
Abstract

ObjectivesTo assess the feasibility, acceptability and clinical sensibility of a novel survey, the advance care planning (ACP) Engagement Survey, in various healthcare settings.SettingA target sample of 50 patients from each of primary care, hospital, cancer care and dialysis care settings.ParticipantsA convenience sample of patients without cognitive impairment who could speak and read English was recruited. Patients 50 and older were eligible in primary care; patients 80 and older or 55 and older with clinical markers of advanced chronic disease were recruited in hospital; patients aged 19 and older were recruited in cancer and renal dialysis centres.OutcomesWe assessed feasibility, acceptability and clinical sensibility of the ACP Engagement Survey using a 6-point scale. The ACP Engagement Survey measures ACP processes (knowledge, contemplation, self-efficacy and readiness) on 5-point Likert scales and actions (yes/no).Results196 patients (38-96 years old, 50.5% women) participated. Mean (±SD) time to administer was 48.8±19.6 min. Mean acceptability scores ranged from 3.2±1.3 in hospital to 4.7±0.9 in primary care, and mean relevance ranged from 3.5±1.0 in hospital to 4.9±0.9 in dialysis centres (p

Published
2016

45. A Comparison of High and Usual Protein Dosing in Critically Ill Patients With Obesity: A Post Hoc Analysis of an International, Pragmatic, Single-Blinded, Randomized Clinical Trial*

Author

Tweel, Lauren E., primary, Compher, Charlene, additional, Bear, Danielle E., additional, Gutierrez-Castrellon, Pedro, additional, Leaver, Susannah K., additional, MacEachern, Kristen, additional, Ortiz-Reyes, Luis, additional, Pooja, Lakhani, additional, León, Angélica, additional, Wedemire, Courtney, additional, Lee, Zheng Yii, additional, Day, Andrew G., additional, and Heyland, Daren K., additional

Published
2023
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