PDF(Pubmed)
Abstract：
Legal representatives take a major role in healthcare decisions with and for people with dementia, but only a minority has a qualification in this field. The aim was to evaluate the efficacy of the PRODECIDE education program for legal representatives. In a prospective randomized controlled trial, legal representatives (volunteers and professionals, representing at least one person with dementia) were allocated (1:1 computer-generated block randomization) to the intervention (PRODECIDE education program) and control (standard care) groups. The primary outcome measure was knowledge, operationalized as the understanding of decision-making processes and in setting realistic expectations. Only data entry and analyses were blinded. A process evaluation in a mixed methods design was performed. We enrolled 218 legal representatives, and 216 were included in the primary analysis (intervention n = 109, control n = 107). The percentage of correct answers in the knowledge test post intervention was 69.0% in the intervention and 43.4% in the control group (difference 25.6%; CI 95%, 21.3 to 29.8; p < 0.001). In the comparison of professional and voluntary representatives, professionals had 13.6% (CI 95%, 8.0 to 19.2; p < 0.001) more correct answers. The PRODECIDE education program can improve the knowledge of legal representatives, an important prerequisite for evidence-based, informed decision-making.
摘要：
法律代表在痴呆症患者的医疗保健决策中发挥重要作用，但是只有少数人有这个领域的资格。目的是评估PRODECIDE法律代表教育计划的有效性。在一项前瞻性随机对照试验中，法定代表人(志愿者和专业人士，代表至少一个痴呆症患者)被分配(1:1计算机生成的区组随机化)到干预(PRODECIDE教育计划)和对照组(标准护理).主要结果指标是知识，作为对决策过程的理解和设定现实的期望。只有数据输入和分析是盲目的。在混合方法设计中进行了过程评估。我们招募了218名法定代表人，216例纳入主要分析(干预n=109,对照n=107).干预后知识测试中正确答案的百分比在干预中为69.0％，在对照组中为43.4％（差异25.6％；CI95％，21.3至29.8；p<0.001）。在专业代表和志愿代表的比较中，专业人士占13.6%(CI95%，8.0至19.2；p<0.001）更正确的答案。PRODECIDE教育计划可以提高法定代表人的知识，以证据为基础的重要前提，明智的决策。
