In congruence with the mission of NINR to promote and improve the health of individuals, families, communities, and populations and in response to the 11 additional institutes supporting the solicitation of proposals to address pain management (PA-07-282) this proposal seeks to test an intervention which will improve the perceptions of pain management by caregivers of hospice patients, resulting in improved pain control for those facing terminal illness. Following encouraging pilot testing the intervention has been named ACTIVE (Assessing Caregivers for Team Intervention through Video Encounters). This project proposes to strengthen hospice care for patients by enabling patient/family participation in hospice interdisciplinary teams through use of a commercially available video technologies. This randomized controlled trial will definitively test the effect of caregiver/patient participation in hospice interdisciplinary team meetings on the caregiver's perception of pain and the effect of changes in perception on reported patient pain. The study aims to 1) test the effectiveness of the ACTIVE intervention, specifically focusing on the changes in caregiver perceptions of pain, the effectiveness of caregiver assessment to identify individuals who will most benefit from the ACTIVE intervention, and the effect of changes in perception on severity of pain reported by the patient, 2) evaluate the cost and benefits and, 3) evaluate the potential for translation of the ACTIVE intervention into routine hospice care. The theoretical model modified from Saltz and Schaefer advocate the assessment of the organizational context, team process, team structure, and outcomes as a foundation for the intervention. This proposal randomizes 544 hospice caregivers into two groups (standard care and intervention) and uses qualitative and quantitative methods in parallel and equal status. The qualitative design includes observations of team meetings, record reviews, and interviews with staff and family members. The quantitative component uses standardized instruments to measure the outcomes of participation. If successful, the ACTIVE intervention can be easily translated into other settings, holding potential to improve pain management for all suffering chronic and terminal pain.

Public Health Relevance

In congruence with the mission of NINR to promote and improve the health of individuals, families, communities, and populations and in response to the 11 additional institutes supporting the solicitation of proposals to address pain management (PA-07-282) this proposal seeks to test an intervention which will improve the perceptions of pain management by caregivers of hospice patients, resulting in improved pain control for those facing terminal illness. The ACTIVE intervention uses low cost commercially available video technology to enable caregiver/patient participation in hospice interdisciplinary care plan meetings.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Research Project (R01)
Project #
5R01NR011472-04
Application #
8487258
Study Section
Nursing Science: Adults and Older Adults Study Section (NSAA)
Program Officer
Aziz, Noreen M
Project Start
2010-09-15
Project End
2014-06-30
Budget Start
2013-07-01
Budget End
2014-06-30
Support Year
4
Fiscal Year
2013
Total Cost
$438,599
Indirect Cost
$127,016
Name
University of Missouri-Columbia
Department
Family Medicine
Type
Schools of Medicine
DUNS #
153890272
City
Columbia
State
MO
Country
United States
Zip Code
65211
Wittenberg-Lyles, Elaine; Washington, Karla; Oliver, Debra Parker et al. (2015) "It is the 'starting over' part that is so hard": Using an online group to support hospice bereavement. Palliat Support Care 13:351-7
Washington, Karla T; Demiris, George; Pike, Kenneth C et al. (2015) Anxiety among informal hospice caregivers: an exploratory study. Palliat Support Care 13:567-73
Albright, David L; Kruse, Robin L; Oliver, Debra Parker et al. (2014) Testing the factorial validity of scores from the caregiver pain medicine questionnaire. J Pain Symptom Manage 48:99-109
Oliver, Debra Parker; Washington, Karla; Kruse, Robin L et al. (2014) Hospice family members' perceptions of and experiences with end-of-life care in the nursing home. J Am Med Dir Assoc 15:744-50
Wittenberg-Lyles, Elaine; Parker Oliver, Debra; Demiris, George et al. (2014) YouTube as a tool for pain management with informal caregivers of cancer patients: a systematic review. J Pain Symptom Manage 48:1200-10
Gage, L Ashley; Washington, Karla; Oliver, Debra Parker et al. (2014) Family Members' Experience With Hospice in Nursing Homes. Am J Hosp Palliat Care :
Wittenberg-Lyles, Elaine; Kruse, Robin L; Oliver, Debra Parker et al. (2014) Exploring the collective hospice caregiving experience. J Palliat Med 17:50-5
Washington, Karla T; Wittenberg-Lyles, Elaine; Parker Oliver, Debra et al. (2013) Application of the VALUE communication principles in ACTIVE hospice team meetings. J Palliat Med 16:60-6
Kruse, Robin L; Parker Oliver, Debra; Wittenberg-Lyles, Elaine et al. (2013) Conducting the ACTIVE randomized trial in hospice care: keys to success. Clin Trials 10:160-9
Oliver, Debra Parker; Wittenberg-Lyles, Elaine; Washington, Karla et al. (2013) Hospice caregivers' experiences with pain management: "I'm not a doctor, and I don't know if I helped her go faster or slower". J Pain Symptom Manage 46:846-58

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