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Several lines of evidence suggest that high-risk patients on chronic dialysis are not prepared adequately for end-of-life decision making. In this study, U.S. researchers randomized 210 chronic dialysis patients (mean age, 62) with predicted 1-year mortality of at least 30% to receive an advance care planning intervention plus usual care or usual care alone. The intervention began with an 80-minute structured session (conducted by a trained nurse) that addressed cognitive, emotional, and spiritual aspects of end-of-life decision making; both patients and their designated surrogates participated in the sessions, which concluded with completion of a goals-of-care document. Two weeks later, the document was reviewed in another session.
On quest…