Abstract: Worry as a Mechanism to Motivate Information Seeking About Protective End-of-Life Communication Behaviors
Making known one’s end-of-life care (EOL) wishes via the processes of advance care planning (ACP) and advance directive (AD) completion is associated with a bevy of positive outcomes for patients. Such desirable outcomes include fewer ICU admissions, decreased rates of unnecessary intensive medical procedures, lower healthcare costs, greater patient-provider relationship satisfaction, increased quality of life, and more. Despite these benefits, fewer than 30% of patients in the United States engage in ACP or complete advance directives. These abysmally low numbers are most likely due to several causes, including low self-efficacy and subsequent low motivation to engage in the process. Several researchers have examined the persuasive power of using worry to motivate patients to engage in preventative health behaviors, such as cancer screening. This study sought to expand upon that body of literature by examining patient’s motivation to seek information related to ACP and AD after being exposed to stimuli intended to arouse differing levels of worry regarding bad EOL outcomes. Participants (n = 480) were randomly assigned to either the high worry (n = 163), low worry (n = 159), or control group (n = 158) and asked to complete a questionnaire examining beliefs and information seeking intention regarding ACP and AD completion. Additionally, to control for participants’ level of state worry, each participant completed the Penn State Worry Questionnaire, which was treated as a covariate in the final analysis. A repeated measures MANCOVA found a statistically significant increase for the worrying conditions on the participants’ intention to seek information about ACP and ADs from time 1 to time 2. However, those in the control groups did not show a statistically significant increase from time 1 to time 2. Results of the experiment indicated worry was associated with greater motivation to engage in information seeking about ACP and AD. We believe this study contributes to the literature on worry as a persuasive mechanism to motivate patients to engage in important preventative health behaviors.