Format

Send to

Choose Destination
See comment in PubMed Commons below
Cancer Nurs. 2011 Mar-Apr;34(2):89-97. doi: 10.1097/NCC.0b013e3181f70aee.

Improving hospice outcomes through systematic assessment: a clinical trial.

Author information

1
College of Nursing, Center for Hospice, Center for Hospice, Palliative Care and End of Life Studies at USF, University of South Florida, Tampa, Florida 33612, USA. smcmilla@health.usf.edu

Abstract

BACKGROUND:

Systematic assessment is vital to palliative care, but documentation confirming completion of systematic assessment in hospice settings is often inadequate or absent.

OBJECTIVE:

The objective of the study was to determine the efficacy of systematic feedback from standardized assessment tools for hospice patient-caregiver dyads in improving hospice outcomes compared with the usual clinical practice.

INTERVENTIONS/METHODS:

The sample of patients (n = 709) newly admitted to hospice home care in 2 hospices had designated family caregivers. The interdisciplinary teams (IDTs) caring for these dyads were randomly assigned to either experimental (n = 338) or control (n = 371) conditions. Data were collected from both groups of dyads using standardized assessments on admission and 1 week after each of the first 2 IDT meetings in which these dyads were discussed. The experimental intervention consisted of reporting data from the standardized assessments to the IDTs.

RESULTS:

Results showed improved patient depression (P < .001) as a result of the intervention and improvement in both groups in patients' quality of life (P < .001). No other patient outcomes (symptom distress, spiritual needs) or caregiver outcomes (depression, support, spiritual needs) were significantly different.

CONCLUSIONS:

Assessment of depression added to usual care probably had an effect because it is not normally a focus of hospice staff. Hospice care was so good during the study that overall quality of life improved as a result of standard care and left little room for improvement in other variables.

IMPLICATIONS FOR PRACTICE:

Systematic assessment of depression is needed in hospice patients. No caregiver variables changed, which may indicate a need for a focus on caregivers.

PMID:
20885302
PMCID:
PMC3036771
DOI:
10.1097/NCC.0b013e3181f70aee
[Indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Wolters Kluwer Icon for PubMed Central
    Loading ...
    Support Center