Skip to main content
Mijn bibliotheek
Shop
Nieuws Boeken Tijdschriften E-learning Web-tv Video Audio
Tips voor Mijn BSL
UITGEBREID ZOEKEN
Inloggen
Top
Quality of Life Research
Gepubliceerd in: Quality of Life Research 3/2012

01-04-2012

Palliative care outcomes in surgical oncology patients with advanced malignancies: a mixed methods approach

Auteurs: Gwenyth R. Wallen, Karen Baker, Marilyn Stolar, Claiborne Miller-Davis, Nancy Ames, Jan Yates, Jacques Bolle, Donna Pereira, Diane St. Germain, Daniel Handel, Ann Berger

Gepubliceerd in: Quality of Life Research | Uitgave 3/2012

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail
    Link delen
publish
Publiceer nu

Abstract

Purpose

To prospectively compare outcomes and processes of hospital-based early palliative care with standard care in surgical oncology patients (N = 152).

Methods

A randomized, mixed methods, longitudinal study evaluated the effectiveness of a hospital-based Pain and Palliative Care Service (PPCS). Interviews were conducted presurgically and at follow-up visits up to 1 year. Primary outcome measures included the Gracely Pain Intensity and Unpleasantness Scales and the Symptom Distress Scale. Qualitative interviews assessed social support, satisfaction with care, and communication with providers. Survival analysis methods explored factors related to treatment crossover and study discontinuation. Models for repeated measures within subjects over time explored treatment and covariate effects on patient-reported pain and symptom distress.

Results

None of the estimated differences achieved statistical significance; however, for those who remained on study for 12 months, the PPCS group performed better than their standard of care counterparts. Patients identified consistent communication, emotional support, and pain and symptom management as positive contributions delivered by the PPCS.

Conclusions

It is unclear whether lower pain perceptions despite greater symptom distress were clinically meaningful; however, when coupled with the patients’ perceptions of their increased resources and alternatives for pain control, one begins to see the value of an integrated PPCS.
vorige artikel A mixed methods approach to adapting health-related quality of life measures for use in routine oncology clinical practice
volgende artikel Developing a model of participation post-stroke: a mixed-methods approach
Literatuur
1.
Arnold, B. L. (2011). Mapping hospice patients” perception and verbal communication of end-of-life needs: An exploratory mixed methods inquiry. BMC Palliative Care, 10(1), 1–10.PubMedCrossRef
2.
Bakitas, M., Lyons, K. D., Hegel, M. T., Balan, S., Brokaw, F. C., Seville, J., et al. (2009). Effects of a palliative care intervention on clinical outcomes in patients with advanced cancer: The project ENABLE II randomized controlled trial. Journal of the American Medical Association, 302(7), 741–749.PubMedCrossRef
3.
Barrera, M. (1986). Distinctions between social support concepts, measures, and models. American Journal of Community Psychology, 14(4), 413–445.CrossRef
4.
Carr, A. J., & Higginson, I. J. (2001). Measuring quality of life: Are quality of life measures patient centered? British Medical Journal, 322, 1357–1360.PubMedCrossRef
5.
Cleeland, C. S. (2001). Cross-cutting research issues: A research agenda for reducing distress of patients with cancer. In K. M. Foley & H. Gellband (Eds.), Improving palliative care for cancer (pp. 233–276). Washington, DC: National Academy Press.
6.
Creswell, J. W. (2009). Research design: Qualitative, quantitative, and mixed methods (3rd ed). Thousand Oaks, CA: Sage.
7.
Creswell, J. W., & Plano Clark, V. L. (2007). Designing and conducting mixed methods research. Thousand Oaks, CA: Sage.
8.
Creswell, J. W., & Zhang, W. (2009). The application of mixed methods designs to trauma research. Journal of Traumatic Stress, 22(6), 612–621.
9.
Del Bufalo, C., Morelli, A., Bassein, L., Fasano, L., Quarta, C. C., Pacilli, A. M., et al. (1995). Severity scores in respiratory intensive care: Apache ii predicted mortality better than saps ii. Respiratory Care, 40(10), 1042–1047.PubMed
10.
Devery, K., Lennie, I., & Cooney, N. (1999). Health outcomes for people who use palliative care services. Journal of Palliative Care, 15(2), 5–12.PubMed
11.
Gracely, R. H., Dubner, R., & McGrath, P. A. (1982). Fentanyl reduces the intensity of painful tooth pulp sensations: Controlling for detection of active drugs. Anesthesia and Analgesia, 61(9), 751–755.PubMedCrossRef
12.
Gracely, R. H., & Kwilosz, D. M. (1988). The descriptor differential scale: Applying psychophysical principles to clinical pain assessment. Pain, 35(3), 279–288.PubMedCrossRef
13.
Gracely, R. H., McGrath, P., & Dubner, R. (1978). Ratio scales of sensory and affective verbal pain descriptors. Pain, 5(1), 5–18.PubMedCrossRef
14.
Grande, G., & Todd, C. J. (2000). Why are trials in palliative care so difficult? Palliative Medicine, 14(1), 69–74.PubMedCrossRef
15.
Helgeson, V. S., & Cohen, S. (1996). Social support and adjustment to cancer: Reconciling descriptive, correlational, and intervention research. Health Psychology, 15(2), 135–148.PubMedCrossRef
16.
Higginson, I. J. (1999). Evidence based palliative care. There is some evidence-and there needs to be more. BMJ, 319(7208), 462–463.PubMedCrossRef
17.
Higginson, I. J., & Carr, A. J. (2001). Measuring quality of life: Using quality of life measures in the clinical setting. BMJ, 322(7297), 1297–1300.PubMedCrossRef
18.
Higginson, I. J., Finlay, I., Goodwin, D. M., Cook, A. M., Hood, K., Edwards, A. G., et al. (2002). Do hospital-based palliative teams improve care for patients or families at the end of life? Journal of Pain and Symptom Management, 23(2), 96–106.
19.
Hutchison, C. (1999). Social support: Factors to consider when designing studies that measure social support. Journal of Advanced Nursing, 29(6), 1520–1526.PubMedCrossRef
20.
Israel, B. A., & Schurman, S. J. (1990). Social support, control and the stress process. In K. Glanz, B. K. Rimer, & F. M. Lewis (Eds.), Health behavior and health education: Theory, research, and practice. San Francisco: Jossey-Bass.
21.
Jackson, B. S., Strauman, J., Frederickson, K., & Strauman, T. J. (1991). Long-term biopsychosocial effects of interleukin-2 therapy. Oncology Nursing Forum, 18, 683–690.PubMed
22.
Karim, K. (2000). Conducting research involving palliative patients. Nursing Standard, 15(2), 34–36.
23.
Knaus, W. A., Draper, E. A., Wagner, D. P., & Zimmerman, J. E. (1985). APACHE II: A severity of disease classification system. Critical Care Medicine, 13(10), 818–829.PubMedCrossRef
24.
Krueger, R. A. (1998). Analyzing & reporting focus groups. Thousand Oaks, CA: Sage Publications, Inc.
25.
Lesage, P., & Portenoy, R. K. (2001). Ethical challenges in the care of patients with serious illness. Pain Medicine, 2(2), 121–130.PubMedCrossRef
26.
Max, M. B., Lynch, S. A., Muir, J., Shoaf, S. E., Smoller, B., & Dubner, R. (1992). Effects of desipramine, amitriptyline, and fluoxetine on pain in diabetic neuropathy. New England Journal of Medicine, 326(19), 1250–1256.PubMedCrossRef
27.
Mazzocato, C., Sweeney, C., & Bruera, E. (2001). Clinical research in palliative care: Patient populations, symptoms, interventions and endpoints. Palliative Medicine, 15(2), 163–168.PubMedCrossRef
28.
McArthur, J. C., Yiannoutsos, C., Simpson, D. M., Adornato, B. T., Singer, E. J., Hollander, H., et al. (2000). A phase II trial of nerve growth factor for sensory neuropathy associated with hiv infection. Neurology, 54(5), 1080–1088.
29.
McCorkle, R., Cooley, M. E., & Shea, J. A. (1998). A user’s manual for the symptom distress scale. Philadelphia: University of Pennsylvania.
30.
31.
Morgan, D. L. (1998). Computerized analysis. In R. A. Krueger (Ed.), Analyzing & reporting focus groups. Thousand Oaks, CA: Sage Publications, Inc.
32.
O’Mara, A. M., Germain, D., Ferrell, B., & Bornemann, T. (2009). Challenges to and lessons learned from conducting palliative care research. Journal of Pain and Symptom Management, 37(3), 387–394.PubMedCrossRef
33.
Portenoy, R. K., Thaler, H. T., Kornblith, A. B., McCarthy L. J., Friedlander-Klar, H., Kiyasu, E., et al. (1994). The memorial symptom assessment scale: An instrument for the evaluation of symptom prevalence, characteristics and distress. European Journal of Cancer Part A: General Topics, 30(9), 1326–1336.
34.
Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385–401.CrossRef
35.
Sarna, L. (1998). Effectiveness of structured nursing assessment of symptom distress in advanced lung cancer. Oncology Nursing Forum, 25, 1041–1048.PubMed
36.
Sarna, L., Lindsey, A. M., Dean, H., Brecht, M. L., & McCorkle, R. (1993). Nutritional intake, weight change, symptom distress, and functional status over time in adults with lung cancer. Oncology Nursing Forum, 20, 481–489.PubMed
37.
Shaver, P. R., & Brennan, K. A. (1991). Measures of depression and loneliness. In J. P. Robinson, P. R. Shaver, & L. S. Wrightsman (Eds.), Measures of personality and social psychological attitudes. San Diego: Academic Press Inc.
38.
Standing Medical Advisory Committee, & Committee, Standing Nursing and Midwifery Advisory. (1992). The principles and provision of palliative care. London.
39.
Taylor, E. J. (1993). Factors associated with meaning in life among people with recurrent cancer. Onclology Nursing Forum, 20, 1399–1407.
40.
Ternel, J. S., Greer, J. A., Musilkansky, M. A., Gallagher, E. R., Admane, S., Jackson, V. A., et al. (2010). Early palliative care for patients with metastatic non-small-cell lung cancer. The New England Journal of Medicine, 363, 733–742.CrossRef
41.
Wallen, G. R., & Berger, A. (2004). Mixed methods: In search of truth in palliative care medicine. Journal of Palliative Medicine, 7(3), 403–404.PubMedCrossRef
42.
Wallen, G. R., Ulrich, C., & Grady, C. (2005). Learning about a “Good Death”: Ethical considerations in palliative care nursing research. DNA Reporter, 30(2), 8–9.
43.
Wills, T. A., & Shinar, O. (2000). Measuring perceived and received social support. In S. Cohen, L. G. Underwood, & B. H. Gottlieb (Eds.), Social support measurement and intervention: A guide for health and social scientists (pp. 86–135). New York: Oxford University Press.
Metagegevens
Titel
Palliative care outcomes in surgical oncology patients with advanced malignancies: a mixed methods approach
Auteurs
Gwenyth R. Wallen
Karen Baker
Marilyn Stolar
Claiborne Miller-Davis
Nancy Ames
Jan Yates
Jacques Bolle
Donna Pereira
Diane St. Germain
Daniel Handel
Ann Berger
Publicatiedatum
01-04-2012
Uitgeverij
Springer Netherlands
Gepubliceerd in
Quality of Life Research / Uitgave 3/2012
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-011-0065-7

Andere artikelen Uitgave 3/2012

Quality of Life Research 3/2012 Naar de uitgave

OriginalPaper

Applying mixed methods to pretest the Pressure Ulcer Quality of Life (PU-QOL) instrument

OriginalPaper

Neuro-QOL: quality of life item banks for adults with neurological disorders: item development and calibrations based upon clinical and general population testing

OriginalPaper

A mixed methods approach to adapting health-related quality of life measures for use in routine oncology clinical practice

OriginalPaper

Dyadic effects of fear of recurrence on the quality of life of cancer survivors and their caregivers

OriginalPaper

Correlates of quality of life in China rural–urban female migrate workers

Commentary

Best practices in mixed methods for quality of life research