N/A
N=40
Shared Decision Making to Improve Palliative Care in the Nursing Home
Pain
Bottom Line
View on ClinicalTrials.gov: NCT02917603 ↗Enrolled (actual)
40
Serious AEs
0.0%
Results posted
Feb 2020
Primary outcome: Primary: Difference in Mean Patient Health Questionaire 9 Score From Baseline — .74; 3.38 units on a scale — p=<.009
Study Design & Population
- Study type
- Interventional
- Phase
- N/A
- Interventions
- Web Conferencing (Behavioral)
- Age
- Older Adult · 65+ yrs
- Sex
- All
- Sponsor
- Washington University School of Medicine
- Primary completion
- Mar 2018
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Difference in Mean Patient Health Questionaire 9 Score From Baseline |
.74; 3.38 | <.009 sig |
| SECONDARY Zarit Burden Interview |
3.16; 4.25 | <.21 |
| SECONDARY Generalized Anxiety- 7 |
.63; 2.06 | <.06 |
| SECONDARY Caregiver Quality of Life |
33.79; 32.06 | <.73 |
Summary
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.
Eligibility Criteria
Inclusion Criteria
- Residents: Residents of The Bluffs nursing home, Columbia Missouri, over the age of 65, have at least one family member who agrees to participate, and have a serious life limiting illness. Residents enrolled in hospice or admitted to post hospital short term nursing home stay are excluded from participation.
- Family Members: Identified family member by a resident or nursing home staff at The Bluffs, over the age of 18, without cognitive impairment, and with access to a computer, tablet, or smartphone device.
Exclusion Criteria
- Residents enrolled in hospice can not participate.
Data sourced from ClinicalTrials.gov (NCT02917603). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.