The PREPARE ME Theory: A Layman's Explanation
I cannot find any evidence of a "PREPARE ME theory" specifically attributed to Carmencita Abaquin in the medical literature provided or in established palliative care frameworks.
What the Evidence Actually Shows
The term "PREPARE" in patient care refers to a well-established advance care planning intervention, not a theory by Carmencita Abaquin. The PREPARE program is an evidence-based web-based tool designed to help patients engage in advance care planning through a structured process of behavior change and action 1.
The PREPARE Intervention Framework
PREPARE is a validated advance care planning program that guides patients through specific steps to prepare for end-of-life decision-making. It focuses on two main domains 1:
Behavior Change Processes
- Knowledge building about what advance care planning means 1
- Contemplation of personal values and preferences 1
- Self-efficacy development to have difficult conversations 1
- Readiness to take action on planning 1
Action Steps
- Identifying decision makers who will speak for you if you cannot 1
- Clarifying quality of life preferences and what matters most 1
- Providing flexibility for decision makers to adapt to changing circumstances 1
- Learning to ask clinicians questions about your care 1
How PREPARE Works in Practice
The PREPARE program achieved nearly 100% engagement in advance care planning discussions and documentation when combined with an easy-to-read advance directive. In a randomized trial, 99.5% of participants who used PREPARE engaged in both discussions and documentation, compared to 90-93% with an advance directive alone 1.
What Patients Actually Want When Preparing
Research shows patients prioritize knowing someone will make decisions for them, understanding what to expect physically, having financial affairs in order, and knowing their physician is comfortable discussing death. These preferences are consistent across patients, families, and healthcare providers 2.
Patients differ from physicians in wanting to plan funerals and know timing of death, but are less likely to want to discuss personal fears. This highlights the importance of individualized approaches to preparation 2.
The Broader Context: Stages of Change in Advance Care Planning
The evidence does reference Prochaska's Stages of Change theory as applied to advance care planning, which provides a framework for understanding patient readiness 3:
- Precontemplation: Patient sees no need; intervention focuses on education 3
- Contemplation: Patient sees need but has barriers; intervention removes obstacles 3
- Preparation: Patient is ready; intervention provides motivation 3
- Action: Patient completes directives; intervention ensures accuracy 3
- Maintenance: Ongoing review and updates as circumstances change 3
Important Distinction: Emotional Preparedness vs. Prognostic Awareness
Being emotionally prepared for death is distinct from understanding your prognosis. Research shows poor agreement between these two concepts, with different predictors for each 4. Healthcare professionals must address both emotional preparation and accurate understanding of prognosis separately 4.
Clinical Implications
Preparation for end-of-life involves practical tasks (advance directives), relational aspects (family preparation), and personal dimensions (emotional readiness). Better communication with healthcare providers is associated with improved preparation across all these domains 5.
A substantial minority of patients worry about their family's preparation to cope and fear being a burden. Thirty-one percent worry "quite a bit" or "completely" about their family's readiness, highlighting the need for family-inclusive preparation discussions 5.
If you are looking for information about a specific theory by Carmencita Abaquin, it may be published in sources not included in this medical evidence database, or it may be known by a different name in the literature.