Do preparation and life completion discussions improve functioning and quality of life in seriously ill patients? Pilot randomized control trial

Significant palliative care intervention has focused on physical pain and symptom control; yet less empirical evidence supports efforts to address the psychosocial and spiritual dimensions of experience. To evaluate the impact of an intervention (Outlook) that promotes discussions of end-of-life pre...

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Veröffentlicht in:Journal of palliative medicine 2008-11, Vol.11 (9), p.1234-1240
Hauptverfasser: Steinhauser, Karen E, Alexander, Stewart C, Byock, Ira R, George, Linda K, Olsen, Maren K, Tulsky, James A
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container_end_page 1240
container_issue 9
container_start_page 1234
container_title Journal of palliative medicine
container_volume 11
creator Steinhauser, Karen E
Alexander, Stewart C
Byock, Ira R
George, Linda K
Olsen, Maren K
Tulsky, James A
description Significant palliative care intervention has focused on physical pain and symptom control; yet less empirical evidence supports efforts to address the psychosocial and spiritual dimensions of experience. To evaluate the impact of an intervention (Outlook) that promotes discussions of end-of-life preparation and completion on health outcomes in dying persons, including pain and symptoms, physical function, emotional function (anxiety and depression), spiritual well-being, and quality of life at the end of life. A three-arm pilot randomized control trial. Subjects were recruited from inpatient and outpatient hospital, palliative care, and hospice settings. Intervention subjects met with a facilitator three times and discussed issues related to life review, forgiveness, and heritage and legacy. Attention control subjects met with a facilitator three times and listened to a nonguided relaxation CD. True control subjects received no intervention. Preoutcomes and postoutcomes included the Memorial Symptom Assessment Scale, QUAL-E, Rosow-Breslau ADL Scale, Profile of Mood States anxiety sub-scale, the CESD short version, and the Daily Spiritual Experience Scale. Eighty-two hospice eligible patients enrolled in the study; 38 were women, 35 were African American. Participants' primary diagnoses included cancer (48), heart disease (5) lung disease (10), and other (19) Ages ranged from 28-96. Participants in the active discussion intervention showed improvements in functional status, anxiety, depression, and preparation for end of life. The Outlook intervention was acceptable to patients from a variety of educational and ethnic backgrounds and offers a brief, manualized, intervention for emotional and spiritual concerns.
doi_str_mv 10.1089/jpm.2008.0078
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source MEDLINE; Alma/SFX Local Collection
subjects Activities of Daily Living
Adult
Aged
Aged, 80 and over
Female
Humans
Interviews as Topic
Male
Middle Aged
North Carolina
Palliative Care - methods
Quality of Life - psychology
Severity of Illness Index
Spirituality
Terminal Care - psychology
title Do preparation and life completion discussions improve functioning and quality of life in seriously ill patients? Pilot randomized control trial
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