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Shared Decision Making to Improve Palliative Care in the Nursing Home
NA trial testing Web Conferencing in Pain in 40 participants. Completed in 31 March 2018.
| Lead sponsor | Washington University School of Medicine |
|---|---|
| Phase | NA |
| Status | Completed |
| Study type | INTERVENTIONAL |
| Allocation | randomized |
| Design | parallel |
| Masking | none |
| Primary purpose | supportive care |
| Enrollment | 40 |
| Start date | 1 September 2016 |
| Primary completion | 31 March 2018 |
| Estimated completion | 31 March 2018 |
| Sites | 1 location across United States |
Washington University School of Medicine
65 and older, any sex, with Pain. Patients with the condition only — healthy volunteers not accepted.
Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.
9 questions that indicate depression- taken at 30 days-Scale is 0-27 with higher values representing more depression. Measure collected every 30 days. Analysis is a comparison of means between the last measure taken and the baseline scores- with an overall average then computed.
| Group | Value | 95% CI |
|---|---|---|
| Intervention | .74 | ± 1.19 |
| Control | 3.38 | ± 3.5 |
Family members will report which of their responsibilities are perceived as burdensome. Response options for each item range from 0-4, and total scores range from 0-88, with higher scores indicating greater self-reported burden. Total score computed with an average score response.
| Group | Value | 95% CI |
|---|---|---|
| Intervention | 3.16 | ± 2.63 |
| Control | 4.25 | ± 4.93 |
7 questions that measure family member anxiety. It has 7 items and is scored 0-21 with a higher number representing greater anxiety. A total score is computed.
| Group | Value | 95% CI |
|---|---|---|
| Intervention | .63 | ± .96 |
| Control | 2.06 | ± 2.72 |
4 questions pertaining to family quality of life. There are 4 items each scored 0-9 with a total score of 0 to 36 and higher scores representing poorer quality of life.
| Group | Value | 95% CI |
|---|---|---|
| Intervention | 33.79 | ± 4.21 |
| Control | 32.06 | ± 7.89 |
Twenty-eight percent of Americans over the age of 65 die in a nursing home. Research has found the quality of care of end-of-life care in nursing homes to have many challenges. It has also been documented that family members, especially those living at a distance, want to be involved in the care of their resident and family support can be beneficial to residents. Family members' involvement in decision-making in the nursing home setting improves outcomes for residents with life-limiting illnesses. Shared decision-making (SDM) is a process wherein a healthcare choice is jointly made by a healthcare provider and a resident or resident's proxy, often a family member. This proposal seeks to facilitate SDM among family members, residents with life-limiting illnesses (who are not enrolled in hospice), and the nursing home care team. The overall research question (RQ) asks: To what extent are outcomes for family member and residents with life limiting illnesses associated with SDM via web-conferencing in the nursing home? The overall hypothesis (H) is that SDM among family members, residents (when possible), and skilled nursing home staff via web-conferencing will improve outcomes for family members and residents with life-limiting illnesses. This is an exploratory mixed methods randomized clinical trial pilot to test the effect of shared decision making using web-based conferencing on the depression and burden of family members and the pain of nursing home residents.
3 peer-reviewed publications reference this trial (live from Europe PMC):
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