Purpose Of Review: This review describes the advances in trial methodology and presents new methodologies to meet some of the challenges of conducting trials in a palliative care setting. To describe why this review is timely and relevant.
Recent Findings: This review discusses the process required to conduct trials of complex interventions described by the Britain's Medical Research Council. It discusses the importance of feasibility trials and the quantitative research inherent in these trials. It describes the design alternatives to the classic randomized controlled trials (RCTs), including cluster randomization, step wedge and fast-track randomization, and n-of-1 trial design. The strengths and weaknesses of each are described.
Summary: An understanding of the limitations of RCTs is important. It is important that clinicians and researchers understand the need for alternative trial design and how and when to use them.
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http://dx.doi.org/10.1097/SPC.0b013e32835843d7 | DOI Listing |
Am J Hosp Palliat Care
January 2025
Department of Pediatrics, University of Chicago, Comer Children's Hospital, Chicago, IL, USA.
Pediatric neuro-oncology patients have one of the highest mortality rates among all children with cancer. Our study examines the potential relationship between palliative care consultation and intensity of in-hospital care and determines if racial and ethnic differences are associated with palliative care consultations during their terminal admission. Retrospective observational study using the Pediatric Health Information System (PHIS) database with data from U.
View Article and Find Full Text PDFAm J Hosp Palliat Care
January 2025
Division of Cancer Education, National Cancer Centre Singapore, Singapore.
Background: Palliative Care, Geriatrics and Emergency physicians are exposed to death, terminally ill patients and distress of patients and their families. As physicians bear witness to patients' suffering, they are vulnerable to the costs of caring-the emotional distress associated with providing compassionate and empathetic care to patients. If left unattended, this may culminate in burnout and compromise professional identity.
View Article and Find Full Text PDFEur J Cardiovasc Nurs
January 2025
Department of Nursing, Maastricht University Medical Centre, Maastricht, The Netherlands.
Many nurses and allied professionals (NAPs) lack the skills, knowledge and confidence to engage in conducting and implementing research. This statement describes the importance of NAPs' involvement in clinical research within the context of cardiovascular care. The existing gaps, barriers and enablers to NAPs involvement in research as a potential response to workforce issues in these professions as well as to contribute to excellence in patient care delivery and associated outcomes are identified.
View Article and Find Full Text PDFJAMA
January 2025
Division of General Internal Medicine and Geriatrics, Indiana University School of Medicine, Indianapolis.
Importance: Care management benefits community-dwelling patients with dementia, but studies include few patients with moderate to severe dementia or from racial and ethnic minority populations, lack palliative care, and seldom reduce health care utilization.
Objective: To determine whether integrated dementia palliative care reduces dementia symptoms, caregiver depression and distress, and emergency department (ED) visits and hospitalizations compared with usual care in moderate to severe dementia.
Design, Setting, And Participants: A randomized clinical trial of community-dwelling patients with moderate to severe dementia and their caregivers enrolled from March 2019 to December 2020 from 2 sites in central Indiana (2-year follow-up completed on January 7, 2023).
West J Nurs Res
January 2025
UT Health San Antonio, San Antonio, TX, USA.
Background: Provision of palliative care in acute care settings is significantly lacking despite evidence that early integration leads to better patient/family-related outcomes and improved healthcare cost and efficiency.
Objective: This study investigated influencing factors that affect the nature and frequency of palliative care practices of acute care nurses.
Methods: A descriptive, cross-sectional design was used to examine the effects of personal and environmental factors on nurses' palliative care practices in the acute care setting.
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