This project is aimed at testing outcomes, and identifying predictors, for a goal attainment protocol and family intervention manual for guiding nurse-led interdisciplinary teams in identifying, clarifying, and helping to set in motion the completion of life tasks that a terminally ill patient deems important, but which remain undone. Examples of such tasks might be: wrapping up finances, reconnecting with a cut-off family member, making a videotape for descendants, or providing a vacation for a caretaker. The patient population will consist of 300 terminally ill cancer patients, age 62 years and older, and their families. Al1 will be patients of the Hospice of Louisville. The basic design has 2 phases. In Phase 1 ten social workers will be trained on Life Tasks Protocols/manual and twenty primary nurses will be trained to score a terminal restlessness instrument. This phase will involve the first 100 patients/families. Phase 2 will involve application of the protocols/manual and procedures for an additional 200 cases in order to gather outcome data for testing the hypotheses. Secondary aims of the research include: (1) development of basic norms for this patient group regarding the domains within which the life tasks fall (e.g., determining the prevalence of tasks dealing with cut-off relatives, financial concerns, and funeral preferences); (2) providing the field with a number of refined measures for application both in clinical settings and in future studies; and (3) more precisely defining a clinical pathway for multidisciplinary hospice teams to apply when dealing with such issues. From the above, and within the context of a correlational study, the following general hypotheses will be tested: (1) both patient and family member satisfaction will be positively correlated with the average level of goals attained; (2) patient and family member level of satisfaction will be positively correlated with the number of """"""""significant others"""""""" actually involved in the goal attainment process; (3) the need for bereavement services will decrease in relation to greater level of both goal attainment per se, and patient-family satisfaction with the goal attainment process; and (4) the incidence of terminal restlessness will be significantly lower among those patients with higher levels of goal attainment and higher satisfaction with the goal attainment process.
| Ransom, Sean; Sacco, William P; Weitzner, Michael A et al. (2006) Interpersonal factors predict increased desire for hastened death in late-stage cancer patients. Ann Behav Med 31:63-9 |
