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Improving hospice outcomes through systematic assessment: a clinical trial
Susan C McMillan1, Brent J Small, William E Haley
1College 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
Cancer Nursing
|October 2, 2010
Summary
Systematic depression assessment improved hospice patient mood. While overall quality of life improved for all patients, the intervention specifically targeted patient depression, highlighting its importance in palliative care.
Area of Science:
- Palliative Care Research
- Health Services Research
- Clinical Outcomes Assessment
Background:
- Systematic assessment is crucial in palliative care.
- Hospice settings often lack adequate documentation of systematic assessments.
- Standardized tools can improve patient-caregiver dyad outcomes.
Purpose of the Study:
- To evaluate the effectiveness of systematic feedback from standardized assessment tools.
- To compare outcomes in hospice patient-caregiver dyads receiving feedback versus usual care.
- To identify improvements in hospice care through data-driven interventions.
Main Methods:
- Randomized controlled trial with 709 hospice home care patients and their caregivers.
- Interdisciplinary teams (IDTs) assigned to experimental or control groups.
- Standardized assessments administered at admission and post-IDT meetings; experimental group received feedback.
Main Results:
- Significant improvement in patient depression scores in the intervention group (P < .001).
- All patients showed improved quality of life (P < .001), irrespective of the intervention.
- No significant differences observed in symptom distress, spiritual needs, or caregiver outcomes.
Conclusions:
- Systematic assessment of depression is beneficial and needed in hospice care.
- Standard hospice care positively impacted quality of life, potentially limiting observed intervention effects.
- Further focus on caregiver needs may be warranted in hospice interventions.
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