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Bakitas M et al. - Compared with participants receiving usual oncology care, those receiving a nurse-led, palliative care–focused intervention provided concurrently with oncology care had higher scores for quality of life and mood, but did not have improvements in symptom intensity scores or reduced days in the hospital or ICU or emergency department visits.
Methods- Study to determine the effect of a nursing-led intervention on quality of life, symptom intensity, mood, and resource use in pts with advanced cancer
- Randomized controlled trial conducted from Nov 2003 through May 2008; 322 pts with advanced cancer
- A multicomponent, psychoeducational intervention:
- Project ENABLE- Educate, Nurture, Advise, Before Life Ends
- Conducted by advanced practice nurses
- Consisted of 4 weekly educational sessions and monthly f/u sessions until death or study completion
- Main Outcome Measures:
- QoL- measured by the Functional Assessment of Chronic Illness Therapy for Palliative Care
- Symptom intensity- measured by the Edmonton Symptom Assessment Scale
- Mood- measured by the Center for Epidemiological Studies Depression Scale
- assessed at baseline, 1 mo, and every 3 mo until death or study completion
- Intensity of service measured as:
- Number of days in the hospital and in ICU, and
- Number of emergency department visits recorded in the electronic medical record
- assessed at baseline, 1 mo, and every 3 mo until death or study completion
- 322 pts with cancer of GI tract, lung, genitourinary tract and breast were randomized
- Estimated treatment effects for all participants were a mean of 4.6 for quality of life, -27.8 for symptom intensity, and -1.8 for depressed mood
- Estimated treatment effects in participants who died during the study were a mean 8.6 for quality of life, -24.2 for symptom intensity, and -2.7 for depressed mood
- Intensity of service did not differ between the 2 groups
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