دورية أكاديمية
Effect of the Serious Illness Care Program in Outpatient Oncology:A Cluster Randomized Clinical Trial
| العنوان: | Effect of the Serious Illness Care Program in Outpatient Oncology:A Cluster Randomized Clinical Trial |
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| المؤلفون: | Bernacki, Rachelle, Paladino, Joanna, Neville, Bridget, Hutchings, Mathilde, Kavanagh, Jane, Geerse, Olaf P., Lakin, Joshua, Sanders, Justin, Miller, Kate, Lipsitz, Stuart, Gawande, Atul, Block, Susan |
| المصدر: | Bernacki , R , Paladino , J , Neville , B , Hutchings , M , Kavanagh , J , Geerse , O P , Lakin , J , Sanders , J , Miller , K , Lipsitz , S , Gawande , A & Block , S 2019 , ' Effect of the Serious Illness Care Program in Outpatient Oncology : A Cluster Randomized Clinical Trial ' , Jama Internal Medicine , vol. 179 , no. 6 , pp. 751-759 . https://doi.org/10.1001/jamainternmed.2019.0077Test |
| سنة النشر: | 2019 |
| المجموعة: | University of Groningen research database |
| الوصف: | Importance High-quality conversations between clinicians and seriously ill patients about values and goals are associated with improved outcomes but occur infrequently. Objective To examine feasibility, acceptability, and effect of a communication quality-improvement intervention (Serious Illness Care Program) on patient outcomes. Design, Setting, and Participants A cluster randomized clinical trial of the Serious Illness Care Program in an outpatient oncology setting was conducted. Patients with advanced cancer (n = 278) and oncology clinicians (n = 91) participated between September 1, 2012, and June 30, 2016. Data analysis was performed from September 1, 2016, to December 27, 2018. All analyses were conducted based on intention to treat. Interventions Tools, training, and system changes. Main Outcomes and Measures The coprimary outcomes included goal-concordant care (Life Priorities) and peacefulness (Peace, Equanimity, and Acceptance in the Cancer Experience questionnaire) at the end of life. Secondary outcomes included therapeutic alliance (Human Connection Scale), anxiety (Generalized Anxiety Disorder 7 scale), depression (Patient Health Questionnaire 9), and survival. Uptake and effectiveness of clinician training, clinician use of the conversation tool, and conversation duration were evaluated. Results Data from 91 clinicians in 41 clusters (72.9% participation; intervention, n = 48; control, n = 43; 52 [57.1%] women) and 278 patients (45.8% participation; intervention, n = 134; control, n = 144; 148 [53.2%] women) were analyzed. Forty-seven clinicians (97.9%) rated the training as effective (mean [SD] score, 4.3 [0.7] of 5.0 possible); of 39 who received a reminder, 34 (87.2%) completed at least 1 conversation (median duration, 19 minutes; range, 5-70). Peacefulness, therapeutic alliance, anxiety, and depression did not differ at baseline. The coprimary outcomes were evaluated in 64 patients; no significant differences were found between the intervention and control groups. However, the trial ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | https://research.rug.nl/en/publications/7c36c67b-6583-4475-a97b-75852edd11cfTest |
| DOI: | 10.1001/jamainternmed.2019.0077 |
| الإتاحة: | https://doi.org/10.1001/jamainternmed.2019.0077Test https://hdl.handle.net/11370/7c36c67b-6583-4475-a97b-75852edd11cfTest https://research.rug.nl/en/publications/7c36c67b-6583-4475-a97b-75852edd11cfTest https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6547155Test |
| حقوق: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.C3D19EC1 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1001/jamainternmed.2019.0077 |
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