Nurse Practitioner Hospice Program for Patients With Terminal Metastatic Cancer and Their Families or Caregivers
Condition: Hematopoietic/Lymphoid Cancer; Unspecified Adult Solid Tumor, Protocol Specific
Study type: Interventional
Phase: Early Phase 1

Summary: 
      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.
    

Detailed description: 
      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.
    

Intervention name(s): counseling intervention; questionnaire administration; survey administration; end-of-life treatment/management; psychosocial assessment and care
Intervention type(s): Other; Other; Other; Procedure; Procedure
Intervention model: Single Group Assignment
Primary purpose: Other
Keywords: unspecified adult solid tumor, protocol specific; hematopoietic/lymphoid cancer