Watching a Video Changes Perceptions of End-of-Life Care

A very simple study examined the effect of an informational video on perceptions of end-of-life care. The study enrolled 50 patients with malignant glioma and randomly assigned them to receive verbal information about end-of-life care options or to receive the verbal information and watch a video that illustrated three levels of medical care: cardiopulmonary resuscitation [CPR] and ventilation, basic care (hospitalization, no CPR), and comfort care (symptom management only). The primary study outcome was patients' preferences for end-of-life care. Patients’ decision making and comfort level with the video were also examined.

After receiving the verbal description of end-of-life care options, 25.9% indicated that they preferred aggressive care (CPR and ventilation), 51.9% preferred basic care, and 22.2% preferred comfort care. Among patients who also viewed the video, none preferred aggressive care, 4.4% preferred basic care, 91.3% preferred comfort care, and 4.4% were uncertain. This finding was statistically significant. The majority of patients that watched the video, 82.6%, reported feeling very comfortable while watching.

Compared to patients who only heard a verbal description of end-of-life options, patients who viewed the video were more likely to prefer comfort care and avoid CPR, and were more certain of their end-of-life decision making. It may be that seeing what healthcare providers are talking about is more meaningful that simply hearing about them. This study’s findings suggest that healthcare providers need to consider how information is provided to patients and reconsider the phrase “a picture is worth a thousand words.”