The Effect of FAmily-CEntered (FACE®) Pediatric Advanced Care Planning Intervention on Family Anxiety: A Randomized Controlled Clinical Trial for Adolescents With HIV and Their Families. (November 2020)

• Record Type: Journal Article
• Authors: Lin, Christopher J.; Cheng, Yao I.; Garvie, Patricia A.; D'Angelo, Lawrence J.; Wang, Jichuan; Lyon, Maureen E.
• Is Part Of: Journal of family nursing. Volume 26:Number 4(2020:Nov.)
• Page Start: 315
• Page End: 326
• Publication Date: 2020-11
• Subjects: pediatrics -- family intervention -- advance care planning -- HIV; Family nursing -- Periodicals; Nursing -- Periodicals; 610.73
• DOI: 10.1177/1074840720964093
• Languages: English
• ISSNs: 1074-8407

Abstract

Clinicians fear pediatric advance care planning (pACP) for adolescents is too distressing for families. Multisite longitudinal randomized controlled trial of adolescents with HIV tested the effect of FAmily-CEntered (FACE ® ) pACP intervention on families' anxiety and depression. One hundred five adolescent/family dyads were randomized to FACE ® ( n = 54 dyads) or control ( n = 51 dyads). Families were 90% African American, 37% HIV-positive, and 22% less than high school educated. Families reported lower anxiety 3 months post-FACE ® intervention than control (β = −4.71, 95% confidence interval [CI] = [−8.20, −1.23], p = .008). Male family members were less anxious than female family members (β = −4.55, 95% CI = [−6.96, −2.138], p ≤ .001). Family members living with HIV reported greater depressive symptoms than HIV-uninfected families (β = 3.32, 95% CI = [0.254, 6.38], p = .034). Clinicians can be assured this structured, facilitated FACE ® pACP model minimized family anxiety without increasing depressive symptoms. Adolescent/family dyads should be invited to have access to, and provision of, evidence-based pACP as part of patient-centered/family-supported care in the HIV continuum of care.