Fidelity is fundamental: intervention predictors in advance care plans in terminal cancer.

摘要: Objectives Assessing whether interventions are implemented as intended (fidelity) is critical to establishing efficacy in clinical research yet rarely applied advance care planning (ACP) interventions. We aimed develop and implement a fidelity audit tool for an ACP intervention. Methods developed assessing: (A) content; (B) quality (general communication, eliciting EOL preferences prognostic communication); (C) family/caregiver involvement. audited (double-coded) 55 audio-recordings of discussions delivered advanced cancer patients caregivers, within trial. Results Fidelity content was high: mean=9.38/11 but lower the general communication (mean=12.47/20), discussion patient (mean=4.67/7), prognosis (mean=3.9/6) involvement (mean=2.67/4). Older age caregiver religiosity were associated with higher fidelity. Higher trial primary outcome family report wishes being discussed met. Conclusions content, not quality, intervention strong. Communication skills training interventionists. Adherence older religious carers, factors that may influence acceptance death readiness undertake ACP, making easier. Trial registration number ACTRN12613001288718.