Evaluation of an Intervention Designed to Enhance the Quality of Decision Support Provided to Patients Making Decisions About End-of-life Place of Care

NCT00614003 | Completed Phase 2

• 1 other identifier: H-01-07-09
• Study Type: interventional
• Target: 90
• Locations: 1 country
• Sites: 5

Brief Summary

Most dying cancer patients would prefer a home death yet die in an institution. Patients can experience uncertainty when weighing practical considerations, concern for others, and their personal ratings about the desirability and undesirability of various outcomes related to different locations of care. Health professionals, trained in decision support, can help patients to make decisions that are informed by both relevant information and what outcomes are most valued by patients. Therefore, I will study if an educational intervention can help nurses and case managers to strengthen their skills and confidence in providing patient decision support around place of end of life care. Project Description: Using a two step approach I will study if the quality of providers decision support can be improved with an education. In step one nurses and care coordinators will be interviewed to identify factors that make it easier or more difficult to provide patient decision support. This information will be used to develop an education program. In step two, nurses and care coordinator volunteers will be assigned by a flip of a coin to either receive the decision support education or not. Before and after the education program the quality of the decision support participants provide will be measured and compared. As well, participants receiving the education program will be asked about their satisfaction with the education program.

Conditions

Palliative Care

Keywords

decisional conflict;; decision quality;; place of end of life care;; provider education

Outcome Measures

Primary Outcomes (1)

• Decision support quality audit using simulated patients measured by the validated and reliable Decision Support Analysis Tool

  6 month

Secondary Outcomes (1)

• Knowledge of place of care determinants and decision support concepts; self perceived quality of decision support provision in clinical practice and behavior intention survey; acceptability and utility of intervention components

  6 months

Study Arms (1)

1

EXPERIMENTAL

decision support

Behavioral: Decision support skills building Intervention

Interventions

Decision support skills building Intervention BEHAVIORAL

Decision support skills

1

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Nurses and case coordinators who:
• are members of a regulated health profession
• care for palliative cancer patients, and/or
• cancer patients with advanced disease, and
• work at least 4 shifts per month,
• in a clinical area where end of life care discussions are likely to be undertaken, and
• are proficient in written and spoken English.

Sponsors & Collaborators

• Ottawa Hospital Research Institute: lead

Study Sites (5)

St. Elizabeths Health Care Agency

Kingston, Ontario, Canada

Location

Ottawa Carefor Nursing Services

Ottawa, Ontario, Canada

Location

SCOHS Regional Palliative Care Community Services

Ottawa, Ontario, Canada

Location

The Ottawa Hospital

Ottawa, Ontario, Canada

Location

Community Care Access Center's (CCAC)

Toronto, Ontario, Canada

Location

Related Publications (1)

• Murray MA, O'Connor A, Stacey D, Wilson KG. Efficacy of a training intervention on the quality of practitioners' decision support for patients deciding about place of care at the end of life: A randomized control trial: Study protocol. BMC Palliat Care. 2008 Apr 30;7:4. doi: 10.1186/1472-684X-7-4.

  PMID: 18447916 DERIVED

Study Officials

• Annette O'Connor, MD

  Ottawa Hospital Research Institute

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: January 18, 2008
• First Posted: February 13, 2008
• Study Start: April 1, 2007
• Primary Completion: June 1, 2008
• Study Completion: June 1, 2008
• Last Updated: May 25, 2015

Record last verified: 2015-05

Locations

CA (5)