Unspecified Adult Solid Tumor, Protocol Specific Clinical Trial
Official title:
The Pilot Palliative ARNP (Advanced Registered Nurse Practitioner) Liaison Program (The PAL Program): Improving Communication Between Patients, Oncologists, and Hospice, Promoting Timely Hospice Referrals and Bringing Education and Research Efforts to Hospice and Palliative Care
RATIONALE: Gathering information about patients with terminal metastatic cancer may help
doctors learn more about the effectiveness of a nurse practitioner hospice program. It is not
yet known whether a nurse practitioner program helps increase patients' length of stay in
hospice.
PURPOSE: This randomized research study is evaluating a nurse practitioner hospice program
for patients with terminal metastatic cancer and their families or caregivers.
OBJECTIVES:
Primary
- To assess the effect of the palliative advanced registered nurse practitioner liaison
program (PAL) on length of patient's enrollment in hospice care.
Secondary
- To evaluate the impact of the PAL program on patient's knowledge about hospice services.
- To evaluate the impact of the PAL program on patient and family or caregiver's
psychological stress during palliative treatments.
OUTLINE: Patients are randomized to 1 of 2 arms.
- Arm I (advanced registered nurse practitioner [ARNP] intervention): Patients and their
families or caregiver receive information from an ARNP about terminal cancer, resources
available for supportive care, and the benefits of palliative care. After transition to
hospice, patients receive pain and palliative medicine, psychology, social services,
chaplaincy, and patient support group intervention arranged by the ARNP. Patients
complete the Patient Questionnaire about overall quality of life and mental, emotional,
and physical well being at baseline and at 3 weeks after intervention or at time of
enrollment in hospice. Patients and their families or caregivers are contacted by the
ARNP weekly.
- Arm II (no ARNP intervention): Patients and their families or caregivers complete the
same Patient Questionnaire, administered by a clinical research assistant (CRA), as in
Arm I. Patients and their families or caregivers receive no ARNP intervention. After
transition to hospice, patients receive routine hospice care.
Patients participate in this study for a duration of 21 days while in hospice care. At the
completion of the study, patients in both arms complete questionnaires about pain management,
social, emotional, and spiritual and mental well-being. Patients' families or caregivers
complete the Caregiver Questionnaire and the Hospice Family Satisfaction Survey 3 weeks after
patient's death.
;
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