View clinical trials related to End of Life.
Filter by:Patient-centered medical care considers a patient's values and goals for their health and well-being. Healthcare providers use this information to formulate a medical care plan that is aligned with these expectations. This shared-decision making process should occur with every medical decision, but it is especially important whenever decisions about end-of-life care are being considered. Eliciting patient preferences about resuscitation and life-support treatments in the event of life-threatening illnesses are considered to be a standard of excellent and appropriate medical care. Unfortunately, these discussions don't happen consistently and even when they do occur, are rarely ideal. The consequences can be devastating, often resulting in the delivery of unwanted medical care that can be associated with significant physical and mental suffering among patients and their families. In response to this problem, the investigators developed a novel tool to help guide these difficult conversations between healthcare providers and patients. The investigators previously tested this tool in a small group of hospitalized patients who found it acceptable and helpful. In this larger study, the investigators will compare how effective this tool is compared to usual care in ensuring hospitalized patients have their treatment preferences identified, documented and result in end-of-life care that is consistent with their preferences.
This study was designed as a prospective randomized controlled study in order to evaluate the effect of end-of-life care awareness training to be given to intensive care nurses on the knowledge levels, attitudes, and behaviors of nurses. The study was conducted between May and July 2023 with 76 nurses working in the Anesthesia and Reanimation Intensive Care Unit, General Intensive Care Unit, and Cardiovascular Surgery Intensive Care Unit of Van Training and Research Hospital, who met the inclusion criteria. The hypotheses of this research: H1: End-of-life care awareness training increases the knowledge level of intensive care nurses about end-of-life care. H2: End-of-life care awareness training positively affects intensive care nurses' attitudes toward end-of-life care. H3: End-of-life care awareness training positively affects the behaviors of intensive care nurses towards end-of-life care. Nurses who completed their undergraduate education worked in intensive care for at least one year, actively continued their profession (no annual leave, report, etc.), and were willing and voluntary to participate in the study were included in the study. Nurses who had a palliative care nursing certificate, had received training on end-of-life care by participating in a training program such as ELNEC, and had not participated in the training program of the study for more than two sessions were not included in the study. At the beginning of the research, the pre-test forms/scales "Nurse Information Form", "End-of-Life Care Knowledge Test" and "Intensive Care Nurses' Attitudes and Behaviors Towards End-of-Life Care Scale" were administered to all nurses. After the pre-test application, the nurses were randomly included in the training and control groups. A randomization list generated by a computer-based random number sequence was used to determine which group the intensive care nurses would be in. - The "End-of-Life Care Education Program in Intensive Care" prepared by the researchers in line with the End-of-Life Nursing Education-Intensive Care program was applied to the intensive care nurses in the training group. The training program was implemented online for 45-60 minutes one day a week for 4 weeks. The same forms/scales were repeated 4 weeks after the training. - Intensive care nurses in the control group did not receive any intervention during the study. Similar to the training group, the same forms/scales were repeated 4 weeks after the training. After the study is completed, the same training program will be applied to the nurses in the control group.
The goal of this cluster based intervention trial is to evaluate the effect of a nurse-led patient education program on dry mouth in patients with a life-limiting condition or frailty. The Mouth Educational Program (MEP) is a nurse-led patient education program, in which trained nurses use current clinical, palliative dry mouth guidelines in a structured manner to discuss causes, consequences and interventions with the patients and to create an appropriate treatment plan. This intervention will be compared to a control group receiving care as usual. Therefore, the main question it aims to answer is: Does a nurse-led patient education program reduce dry mouth complaints in patients with a life-limiting condition or frailty? Participants will be asked to answer questionnaires and, when part of the intervention group, partake in the Mouth Educational Program (MEP).
The purpose of the study is to understand the feasibility of a resilience focused community of practice program that includes psilocybin-assisted therapy for End-of-Life Distress. The community of practice refers to a research informed group therapy process that runs over a 10-week period of time and includes one group administered psilocybin-assisted therapy session. Target population: The treatment team will treat a total of 64 patients who have: - a terminal diagnosis (experiencing end of life distress), - AND who are eligible for the RTT + Psilocybin-assisted Therapy Treatment program through the RTT Society.
The goal of this clinical trial is to evaluate the effectiveness of culturally specific end-of-life communication skills training (CST) among Chinese oncology nurses. The main question it aims to answer is: What is the effectiveness of culturally specific end-of-life CST among Chinese oncology nurses? Participants will receive an 8-week communication skills training. Researchers will compare the intervention group and the wait-list group to see if skills, self-efficacy, and outcome expectancy beliefs will be improved.
Nearly 25% of Americans die in intensive care units (ICUs). Most deaths in ICUs are expected and involve the removal of ventilator support, or palliative withdrawal of mechanical ventilation (WMV). Prior work by the Principal Investigator (PI) found that patient suffering can be common; with 30-59% of patients going through this process experiencing distress. Thus, experts and national organizations have called for evidence to inform guidelines for WMV. This research study will 1) develop and refine a Comfort Measures Only Time out (CMOT) intervention consisting of a structured time out with check-list protocol for the ICU team (nurse, physician, respiratory therapist) to improve the process of WMV. and 2) Pilot test the CMOT intervention in 4 ICUs (2 medical/2 surgical) among 40 WMV patients.
The aim of this research is to test the acceptability and feasibility of a shared decision making intervention and a patient decision aid to support patients with kidney failure, relatives, and health professionals in planning and deciding about end-of-life care together.
This study aims to evaluate psychological dimensions in patients and caregivers in the transition phase from active to palliative care.
For family caregivers of patients with advanced cancer, preparedness for caregiving is crucial for maintaining health and quality of life both during care and after the death of the patient. This project contributes to earlier research funded by the Swedish Cancer Society, about an intervention that was delivered by a multi-professional team and proved to be successful in promoting preparedness. However, such interventions are often costly and logistically challenging. In addition, the Covid-19 pandemic has further significantly raised the need for digital alternatives in healthcare. As a possible solution, an evidence-based intervention, narstaende.se, has been developed consisting of recorded videos of conversations between clinicians and family caregivers (actors), linked to informational texts and a moderated chat forum. The intervention was pilot tested during 2020 and 2021, exploring feasibility, content and family caregivers' experiences. As preliminary results are promising, the intervention is taken one step further and tested as a web-based intervention in a larger scale.
In the ICU, the vast majority of patients die following a life-sustaining therapies (LST) limitation decision. Most often, the patient is not able to express himself and has not made his wishes known beforehand, for example in the form of advance directives. The "relatives" are then the only recourse to state the patient's wishes, without any guarantee that they are aware of them. In France, the final decision is made by the physician (or the medical team) who is responsible for it. In this context, disagreements and even real legal conflicts on LST limitation decisions between relatives and physicians seem to be more and more frequent. To our knowledge, few data exist on the frequency of these disagreements over LST limitation decisions. The main objective of this study is to evaluate the frequency of disagreements between relatives and physicians over LST limitation decisions in adult intensive care.