The Liverpool Care Pathway for cancer patients dying in hospital medical wards: A before–after cluster phase II trial of outcomes reported by family members
Background: Hospital is the most common place of cancer death but concerns regarding the quality of end-of-life care remain. Aim: Preliminary assessment of the effectiveness of the Liverpool Care Pathway on the quality of end-of-life care provided to adult cancer patients during their last week of l...
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| Veröffentlicht in: | Palliative medicine 2014-01, Vol.28 (1), p.10-17 |
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| creator | Costantini, Massimo Pellegrini, Fabio Di Leo, Silvia Beccaro, Monica Rossi, Carla Flego, Guia Romoli, Vittoria Giannotti, Michela Morone, Paola Ivaldi, Giovanni P Cavallo, Laura Fusco, Flavio Higginson, Irene J |
| description | Background:
Hospital is the most common place of cancer death but concerns regarding the quality of end-of-life care remain.
Aim:
Preliminary assessment of the effectiveness of the Liverpool Care Pathway on the quality of end-of-life care provided to adult cancer patients during their last week of life in hospital.
Design:
Uncontrolled before–after intervention cluster trial.
Settings/participants:
The trial was performed within four hospital wards participating in the pilot implementation of the Italian version of the Liverpool Care Pathway programme. All cancer patients who died in the hospital wards 2–4 months before and after the implementation of the Italian version of Liverpool Care Pathway were identified. A total of 2 months after the patient’s death, bereaved family members were interviewed using the Toolkit After-Death Family Interview (seven 0–100 scales assessing the quality of end-of-life care) and the Italian version of the Views of Informal Carers - Evaluation of Services (VOICES) (three items assessing pain, breathlessness and nausea-vomiting).
Results:
An interview was obtained for 79 family members, 46 (73.0%) before and 33 (68.8%) after implementation of the Italian version of Liverpool Care Pathway. Following Italian version of Liverpool Care Pathway implementation, there was a significant improvement in the mean scores of four Toolkit scales: respect, kindness and dignity (+16.8; 95% confidence interval = 3.6–30.0; p = 0.015); family emotional support (+20.9; 95% confidence interval = 9.6–32.3; p < 0.001); family self-efficacy (+14.3; 95% confidence interval = 0.3–28.2; p = 0.049) and coordination of care (+14.3; 95% confidence interval = 4.2–24.3; p = 0.007). No significant improvement in symptom’ control was observed.
Conclusions:
These results provide the first robust data collected from family members of a preliminary clinically significant improvement, in some aspects, of quality of care after the implementation of the Italian version of Liverpool Care Pathway programme. The poor effect for symptom control suggests areas for further innovation and development. |
| doi_str_mv | 10.1177/0269216313487569 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1541978988</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_0269216313487569</sage_id><sourcerecordid>1490750534</sourcerecordid><originalsourceid>FETCH-LOGICAL-c497t-c91f44c6d6cb4130b385ce24d10053cf3bd007c423bcb0dc7738c86c49a2ffd83</originalsourceid><addsrcrecordid>eNqNks2KFDEUhYMoTju6dyUBN25K81dJxd3QONrQoIsR3BVJ6tZ0hqpKmaRm6J3v4H4ezicxTY8iA6Krs7jfOZfLPQg9p-Q1pUq9IUxqRiWnXDSqlvoBWlGhVEU4-fIQrQ7j6jA_QU9SuiKEciLFY3TCuKxZI8gK3V7sAG_9NcQ5hAGvTQT8yeTdjdnjPkTszOQg4tlkD1NOuNv76RL7Ce9Cmn02Ax6h867ojYldeovPsIVihB_fvps-F6sblnTQeWcS4M0G5-gLHnocluzCCAlHmEPM0GFblprRD_uSOlqI6Sl61JshwbM7PUWfz99drD9U24_vN-uzbeWEVrlymvZCONlJZ0U50vKmdsBERwmpueu57QhRTjBunSWdU4o3rpHFbFjfdw0_Ra-OuXMMXxdIuR19cjAMZoKwpJbWgmrV6OZ_UFKzmmkp_40KTVTBuSjoy3voVVjiVG4ulCJaKqHqQpEj5WJIKULfztGPJu5bStpDI9r7jSiWF3fBiy2v-m34VYECVEcgmUv4Y-vfAn8Cw1y_JQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1470967475</pqid></control><display><type>article</type><title>The Liverpool Care Pathway for cancer patients dying in hospital medical wards: A before–after cluster phase II trial of outcomes reported by family members</title><source>MEDLINE</source><source>Applied Social Sciences Index & Abstracts (ASSIA)</source><source>SAGE Journals Online</source><creator>Costantini, Massimo ; Pellegrini, Fabio ; Di Leo, Silvia ; Beccaro, Monica ; Rossi, Carla ; Flego, Guia ; Romoli, Vittoria ; Giannotti, Michela ; Morone, Paola ; Ivaldi, Giovanni P ; Cavallo, Laura ; Fusco, Flavio ; Higginson, Irene J</creator><creatorcontrib>Costantini, Massimo ; Pellegrini, Fabio ; Di Leo, Silvia ; Beccaro, Monica ; Rossi, Carla ; Flego, Guia ; Romoli, Vittoria ; Giannotti, Michela ; Morone, Paola ; Ivaldi, Giovanni P ; Cavallo, Laura ; Fusco, Flavio ; Higginson, Irene J</creatorcontrib><description>Background:
Hospital is the most common place of cancer death but concerns regarding the quality of end-of-life care remain.
Aim:
Preliminary assessment of the effectiveness of the Liverpool Care Pathway on the quality of end-of-life care provided to adult cancer patients during their last week of life in hospital.
Design:
Uncontrolled before–after intervention cluster trial.
Settings/participants:
The trial was performed within four hospital wards participating in the pilot implementation of the Italian version of the Liverpool Care Pathway programme. All cancer patients who died in the hospital wards 2–4 months before and after the implementation of the Italian version of Liverpool Care Pathway were identified. A total of 2 months after the patient’s death, bereaved family members were interviewed using the Toolkit After-Death Family Interview (seven 0–100 scales assessing the quality of end-of-life care) and the Italian version of the Views of Informal Carers - Evaluation of Services (VOICES) (three items assessing pain, breathlessness and nausea-vomiting).
Results:
An interview was obtained for 79 family members, 46 (73.0%) before and 33 (68.8%) after implementation of the Italian version of Liverpool Care Pathway. Following Italian version of Liverpool Care Pathway implementation, there was a significant improvement in the mean scores of four Toolkit scales: respect, kindness and dignity (+16.8; 95% confidence interval = 3.6–30.0; p = 0.015); family emotional support (+20.9; 95% confidence interval = 9.6–32.3; p < 0.001); family self-efficacy (+14.3; 95% confidence interval = 0.3–28.2; p = 0.049) and coordination of care (+14.3; 95% confidence interval = 4.2–24.3; p = 0.007). No significant improvement in symptom’ control was observed.
Conclusions:
These results provide the first robust data collected from family members of a preliminary clinically significant improvement, in some aspects, of quality of care after the implementation of the Italian version of Liverpool Care Pathway programme. The poor effect for symptom control suggests areas for further innovation and development.</description><identifier>ISSN: 0269-2163</identifier><identifier>EISSN: 1477-030X</identifier><identifier>DOI: 10.1177/0269216313487569</identifier><identifier>PMID: 23652840</identifier><identifier>CODEN: PAMDE2</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Advance Care Planning - standards ; Advance Care Planning - statistics & numerical data ; Aged ; Cancer ; Chronic Disease - mortality ; Chronic Disease - therapy ; Cluster Analysis ; Communication ; Confidence intervals ; Critical Pathways ; Family - psychology ; Family physicians ; Female ; Hospital Units - standards ; Hospital Units - statistics & numerical data ; Hospitals ; Humans ; Interviews as Topic ; Italian version ; Italy ; Male ; Medicine ; Neoplasms - mortality ; Neoplasms - therapy ; Outcome and Process Assessment (Health Care) - methods ; Outcome and Process Assessment (Health Care) - standards ; Palliative Care ; Patients ; Pilot Projects ; Program Evaluation ; Quality improvement ; Quality of care ; Relatives ; Respiratory diseases ; Terminal Care - psychology ; Terminal Care - standards ; Terminal Care - statistics & numerical data ; Treatment Outcome</subject><ispartof>Palliative medicine, 2014-01, Vol.28 (1), p.10-17</ispartof><rights>The Author(s) 2013</rights><rights>SAGE Publications © Jan 2014</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c497t-c91f44c6d6cb4130b385ce24d10053cf3bd007c423bcb0dc7738c86c49a2ffd83</citedby><cites>FETCH-LOGICAL-c497t-c91f44c6d6cb4130b385ce24d10053cf3bd007c423bcb0dc7738c86c49a2ffd83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0269216313487569$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0269216313487569$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,12837,21810,27915,27916,30990,30991,43612,43613</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23652840$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Costantini, Massimo</creatorcontrib><creatorcontrib>Pellegrini, Fabio</creatorcontrib><creatorcontrib>Di Leo, Silvia</creatorcontrib><creatorcontrib>Beccaro, Monica</creatorcontrib><creatorcontrib>Rossi, Carla</creatorcontrib><creatorcontrib>Flego, Guia</creatorcontrib><creatorcontrib>Romoli, Vittoria</creatorcontrib><creatorcontrib>Giannotti, Michela</creatorcontrib><creatorcontrib>Morone, Paola</creatorcontrib><creatorcontrib>Ivaldi, Giovanni P</creatorcontrib><creatorcontrib>Cavallo, Laura</creatorcontrib><creatorcontrib>Fusco, Flavio</creatorcontrib><creatorcontrib>Higginson, Irene J</creatorcontrib><title>The Liverpool Care Pathway for cancer patients dying in hospital medical wards: A before–after cluster phase II trial of outcomes reported by family members</title><title>Palliative medicine</title><addtitle>Palliat Med</addtitle><description>Background:
Hospital is the most common place of cancer death but concerns regarding the quality of end-of-life care remain.
Aim:
Preliminary assessment of the effectiveness of the Liverpool Care Pathway on the quality of end-of-life care provided to adult cancer patients during their last week of life in hospital.
Design:
Uncontrolled before–after intervention cluster trial.
Settings/participants:
The trial was performed within four hospital wards participating in the pilot implementation of the Italian version of the Liverpool Care Pathway programme. All cancer patients who died in the hospital wards 2–4 months before and after the implementation of the Italian version of Liverpool Care Pathway were identified. A total of 2 months after the patient’s death, bereaved family members were interviewed using the Toolkit After-Death Family Interview (seven 0–100 scales assessing the quality of end-of-life care) and the Italian version of the Views of Informal Carers - Evaluation of Services (VOICES) (three items assessing pain, breathlessness and nausea-vomiting).
Results:
An interview was obtained for 79 family members, 46 (73.0%) before and 33 (68.8%) after implementation of the Italian version of Liverpool Care Pathway. Following Italian version of Liverpool Care Pathway implementation, there was a significant improvement in the mean scores of four Toolkit scales: respect, kindness and dignity (+16.8; 95% confidence interval = 3.6–30.0; p = 0.015); family emotional support (+20.9; 95% confidence interval = 9.6–32.3; p < 0.001); family self-efficacy (+14.3; 95% confidence interval = 0.3–28.2; p = 0.049) and coordination of care (+14.3; 95% confidence interval = 4.2–24.3; p = 0.007). No significant improvement in symptom’ control was observed.
Conclusions:
These results provide the first robust data collected from family members of a preliminary clinically significant improvement, in some aspects, of quality of care after the implementation of the Italian version of Liverpool Care Pathway programme. The poor effect for symptom control suggests areas for further innovation and development.</description><subject>Advance Care Planning - standards</subject><subject>Advance Care Planning - statistics & numerical data</subject><subject>Aged</subject><subject>Cancer</subject><subject>Chronic Disease - mortality</subject><subject>Chronic Disease - therapy</subject><subject>Cluster Analysis</subject><subject>Communication</subject><subject>Confidence intervals</subject><subject>Critical Pathways</subject><subject>Family - psychology</subject><subject>Family physicians</subject><subject>Female</subject><subject>Hospital Units - standards</subject><subject>Hospital Units - statistics & numerical data</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Interviews as Topic</subject><subject>Italian version</subject><subject>Italy</subject><subject>Male</subject><subject>Medicine</subject><subject>Neoplasms - mortality</subject><subject>Neoplasms - therapy</subject><subject>Outcome and Process Assessment (Health Care) - methods</subject><subject>Outcome and Process Assessment (Health Care) - standards</subject><subject>Palliative Care</subject><subject>Patients</subject><subject>Pilot Projects</subject><subject>Program Evaluation</subject><subject>Quality improvement</subject><subject>Quality of care</subject><subject>Relatives</subject><subject>Respiratory diseases</subject><subject>Terminal Care - psychology</subject><subject>Terminal Care - standards</subject><subject>Terminal Care - statistics & numerical data</subject><subject>Treatment Outcome</subject><issn>0269-2163</issn><issn>1477-030X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNks2KFDEUhYMoTju6dyUBN25K81dJxd3QONrQoIsR3BVJ6tZ0hqpKmaRm6J3v4H4ezicxTY8iA6Krs7jfOZfLPQg9p-Q1pUq9IUxqRiWnXDSqlvoBWlGhVEU4-fIQrQ7j6jA_QU9SuiKEciLFY3TCuKxZI8gK3V7sAG_9NcQ5hAGvTQT8yeTdjdnjPkTszOQg4tlkD1NOuNv76RL7Ce9Cmn02Ax6h867ojYldeovPsIVihB_fvps-F6sblnTQeWcS4M0G5-gLHnocluzCCAlHmEPM0GFblprRD_uSOlqI6Sl61JshwbM7PUWfz99drD9U24_vN-uzbeWEVrlymvZCONlJZ0U50vKmdsBERwmpueu57QhRTjBunSWdU4o3rpHFbFjfdw0_Ra-OuXMMXxdIuR19cjAMZoKwpJbWgmrV6OZ_UFKzmmkp_40KTVTBuSjoy3voVVjiVG4ulCJaKqHqQpEj5WJIKULfztGPJu5bStpDI9r7jSiWF3fBiy2v-m34VYECVEcgmUv4Y-vfAn8Cw1y_JQ</recordid><startdate>20140101</startdate><enddate>20140101</enddate><creator>Costantini, Massimo</creator><creator>Pellegrini, Fabio</creator><creator>Di Leo, Silvia</creator><creator>Beccaro, Monica</creator><creator>Rossi, Carla</creator><creator>Flego, Guia</creator><creator>Romoli, Vittoria</creator><creator>Giannotti, Michela</creator><creator>Morone, Paola</creator><creator>Ivaldi, Giovanni P</creator><creator>Cavallo, Laura</creator><creator>Fusco, Flavio</creator><creator>Higginson, Irene J</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7QJ</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AN0</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HEHIP</scope><scope>K6X</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20140101</creationdate><title>The Liverpool Care Pathway for cancer patients dying in hospital medical wards: A before–after cluster phase II trial of outcomes reported by family members</title><author>Costantini, Massimo ; Pellegrini, Fabio ; Di Leo, Silvia ; Beccaro, Monica ; Rossi, Carla ; Flego, Guia ; Romoli, Vittoria ; Giannotti, Michela ; Morone, Paola ; Ivaldi, Giovanni P ; Cavallo, Laura ; Fusco, Flavio ; Higginson, Irene J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c497t-c91f44c6d6cb4130b385ce24d10053cf3bd007c423bcb0dc7738c86c49a2ffd83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Advance Care Planning - standards</topic><topic>Advance Care Planning - statistics & numerical data</topic><topic>Aged</topic><topic>Cancer</topic><topic>Chronic Disease - mortality</topic><topic>Chronic Disease - therapy</topic><topic>Cluster Analysis</topic><topic>Communication</topic><topic>Confidence intervals</topic><topic>Critical Pathways</topic><topic>Family - psychology</topic><topic>Family physicians</topic><topic>Female</topic><topic>Hospital Units - standards</topic><topic>Hospital Units - statistics & numerical data</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Interviews as Topic</topic><topic>Italian version</topic><topic>Italy</topic><topic>Male</topic><topic>Medicine</topic><topic>Neoplasms - mortality</topic><topic>Neoplasms - therapy</topic><topic>Outcome and Process Assessment (Health Care) - methods</topic><topic>Outcome and Process Assessment (Health Care) - standards</topic><topic>Palliative Care</topic><topic>Patients</topic><topic>Pilot Projects</topic><topic>Program Evaluation</topic><topic>Quality improvement</topic><topic>Quality of care</topic><topic>Relatives</topic><topic>Respiratory diseases</topic><topic>Terminal Care - psychology</topic><topic>Terminal Care - standards</topic><topic>Terminal Care - statistics & numerical data</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Costantini, Massimo</creatorcontrib><creatorcontrib>Pellegrini, Fabio</creatorcontrib><creatorcontrib>Di Leo, Silvia</creatorcontrib><creatorcontrib>Beccaro, Monica</creatorcontrib><creatorcontrib>Rossi, Carla</creatorcontrib><creatorcontrib>Flego, Guia</creatorcontrib><creatorcontrib>Romoli, Vittoria</creatorcontrib><creatorcontrib>Giannotti, Michela</creatorcontrib><creatorcontrib>Morone, Paola</creatorcontrib><creatorcontrib>Ivaldi, Giovanni P</creatorcontrib><creatorcontrib>Cavallo, Laura</creatorcontrib><creatorcontrib>Fusco, Flavio</creatorcontrib><creatorcontrib>Higginson, Irene J</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>British Nursing Database</collection><collection>British Nursing Index</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Sociology Collection</collection><collection>British Nursing Index</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Psychology Journals</collection><collection>Sociology Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Palliative medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Costantini, Massimo</au><au>Pellegrini, Fabio</au><au>Di Leo, Silvia</au><au>Beccaro, Monica</au><au>Rossi, Carla</au><au>Flego, Guia</au><au>Romoli, Vittoria</au><au>Giannotti, Michela</au><au>Morone, Paola</au><au>Ivaldi, Giovanni P</au><au>Cavallo, Laura</au><au>Fusco, Flavio</au><au>Higginson, Irene J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Liverpool Care Pathway for cancer patients dying in hospital medical wards: A before–after cluster phase II trial of outcomes reported by family members</atitle><jtitle>Palliative medicine</jtitle><addtitle>Palliat Med</addtitle><date>2014-01-01</date><risdate>2014</risdate><volume>28</volume><issue>1</issue><spage>10</spage><epage>17</epage><pages>10-17</pages><issn>0269-2163</issn><eissn>1477-030X</eissn><coden>PAMDE2</coden><abstract>Background:
Hospital is the most common place of cancer death but concerns regarding the quality of end-of-life care remain.
Aim:
Preliminary assessment of the effectiveness of the Liverpool Care Pathway on the quality of end-of-life care provided to adult cancer patients during their last week of life in hospital.
Design:
Uncontrolled before–after intervention cluster trial.
Settings/participants:
The trial was performed within four hospital wards participating in the pilot implementation of the Italian version of the Liverpool Care Pathway programme. All cancer patients who died in the hospital wards 2–4 months before and after the implementation of the Italian version of Liverpool Care Pathway were identified. A total of 2 months after the patient’s death, bereaved family members were interviewed using the Toolkit After-Death Family Interview (seven 0–100 scales assessing the quality of end-of-life care) and the Italian version of the Views of Informal Carers - Evaluation of Services (VOICES) (three items assessing pain, breathlessness and nausea-vomiting).
Results:
An interview was obtained for 79 family members, 46 (73.0%) before and 33 (68.8%) after implementation of the Italian version of Liverpool Care Pathway. Following Italian version of Liverpool Care Pathway implementation, there was a significant improvement in the mean scores of four Toolkit scales: respect, kindness and dignity (+16.8; 95% confidence interval = 3.6–30.0; p = 0.015); family emotional support (+20.9; 95% confidence interval = 9.6–32.3; p < 0.001); family self-efficacy (+14.3; 95% confidence interval = 0.3–28.2; p = 0.049) and coordination of care (+14.3; 95% confidence interval = 4.2–24.3; p = 0.007). No significant improvement in symptom’ control was observed.
Conclusions:
These results provide the first robust data collected from family members of a preliminary clinically significant improvement, in some aspects, of quality of care after the implementation of the Italian version of Liverpool Care Pathway programme. The poor effect for symptom control suggests areas for further innovation and development.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>23652840</pmid><doi>10.1177/0269216313487569</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0269-2163 |
| ispartof | Palliative medicine, 2014-01, Vol.28 (1), p.10-17 |
| issn | 0269-2163 1477-030X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1541978988 |
| source | MEDLINE; Applied Social Sciences Index & Abstracts (ASSIA); SAGE Journals Online |
| subjects | Advance Care Planning - standards Advance Care Planning - statistics & numerical data Aged Cancer Chronic Disease - mortality Chronic Disease - therapy Cluster Analysis Communication Confidence intervals Critical Pathways Family - psychology Family physicians Female Hospital Units - standards Hospital Units - statistics & numerical data Hospitals Humans Interviews as Topic Italian version Italy Male Medicine Neoplasms - mortality Neoplasms - therapy Outcome and Process Assessment (Health Care) - methods Outcome and Process Assessment (Health Care) - standards Palliative Care Patients Pilot Projects Program Evaluation Quality improvement Quality of care Relatives Respiratory diseases Terminal Care - psychology Terminal Care - standards Terminal Care - statistics & numerical data Treatment Outcome |
| title | The Liverpool Care Pathway for cancer patients dying in hospital medical wards: A before–after cluster phase II trial of outcomes reported by family members |
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