This study will demonstrate whether an end-of-life preparation and completion intervention reducesanxiety, depression, pain and other symptoms and improves functional status, spiritual well-being, andquality of life. If effective, the intervention offers a brief, inexpensive, and transportable non-physiciantreatment method for improving the experience of individuals in the latter stages of life-limiting illness. Effortsto improve end-of-care often focus on pain and symptom control, but few, if any, effective interventions existaddressing preparation arid completion. We designed an end-of-life preparation and completionintervention, based on the human development literature identifying life completion as a developmental taskand the robust evidence in health communication and clinical psychology that addresses the value ofexpressing emotions and stress on health outcomes.
Our specific aims are 1) evaluate the impact of anintervention that promotes discussions of end-of-life preparation and completion on health outcomes in dyingpersons, including pain and symptoms, physical-function, emotional function (anxiety and depression),spiritual well-being, and quality of life at the end of life and 2) evaluate the content of the such discussions,examining task variation associated with gender, ethnicity, socio-economic status, quality of communicationwith family, spirituality, and stage of illness to improve understanding of the need for tailored interventioncontent based on demographics or location in the trajectory of illness. We propose a randomized control trialto evaluate the intervention. 140 patients with advanced cancer, CHF, or COPD will be randomly assignedinto one of two intervention groups and complete a brief battery of pre-test measures. Subjects in the firstgroup ('treatment') will meet with a facilitator three times for a period of forty-five minutes each. In the firstsession, subjects will be asked to discuss issues related to life review. A week later, participants will beasked to speak in more depth about issues such as regret, forgiveness and things left undone. In the finalsession, a week hence, subjects will focus on heritage and legacy. The subjects in the second group('attention control') will meet with a facilitator three times for a period of forty-five minutes each and be askedto listen to a non-guided relaxation CD. One week and two weeks later, participants in all groups will receivepost-test measures administered by a blinded interviewer.
| Bailey Jr, Donald E; Hendrix, Cristina C; Steinhauser, Karen E et al. (2017) Randomized trial of an uncertainty self-management telephone intervention for patients awaiting liver transplant. Patient Educ Couns 100:509-517 |
| Hendrix, Cristina C; Bailey Jr, Donald E; Steinhauser, Karen E et al. (2016) Effects of enhanced caregiver training program on cancer caregiver's self-efficacy, preparedness, and psychological well-being. Support Care Cancer 24:327-36 |
| Bailey Jr, Donald E; Steinhauser, Karen; Hendrix, Cristina et al. (2011) Pairing Self-Management with Palliative Care: Intervening in Life-Limiting Illness. J Nurs Healthc Chronic Illn 3:1-3 |
