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- Title
Is Inpatient Hospice Care Clinically Effective? Using Phase of Illness to Evaluate Care Outcomes for Patients Admitted to a Specialist Palliative Care Unit in Ireland.
- Authors
Lucey, Michael; O'Reilly, Martina; Currow, David; Eagar, Kathy; Walsh, Declan; Conroy, Marian; Twomey, Feargal; O'Reilly, Val; Doherty, Mairéad; Coffey, Siobhain; Sheridan, John; Moran, Sue
- Abstract
Background: In health care, clinical effectiveness involves evaluating the degree to which clinical interventions achieve beneficial patient and caregiver outcomes. Objective: To evaluate the clinical effectiveness of care in a specialist palliative care unit (SPCU) in Ireland, including an analysis of the temporal relationship among admission, Phase of Illness and patient and family distress. Design/Measurements: A consecutive case series with prospectively collected admission data (n = 400). Using a casemix tool (Phase of Illness), pain, other symptoms, psychological and family distress, and performance status were documented on admission and then daily by medical staff. Results: Three hundred forty-two (85%) patients had complete data recorded on day 1. After admission, there were linear correlations between days since admission and progressive improvements in pain (Cramer's V = 0.131, p < 0.001), other symptoms (V = 0.206, p < 0.001), psychological distress (V = 0.101, p < 0.001), and family distress (V = 0.124, p < 0.001). Forty-three percent were in an unstable phase on admission. Nearly two thirds (60.7%) of these unstable patients converted to a stable phase within 48 hours of admission. Over the first 72 hours, 70.7% of unstable patients converted to a stable phase. There was also a significant correlation between phase stabilization and pain and symptom control (p = 0.007). Stable phase over the first 4 days and first 14 days was associated with significantly higher performance status. Conclusion: This study demonstrates the significant clinical effectiveness of SPCU admission across the different aspects of patient and family care.
- Subjects
IRELAND; HOSPICE care; HOSPITAL patients; LONGITUDINAL method; MEDICAL quality control; PALLIATIVE treatment; PSYCHOLOGICAL stress; SYMPTOMS; PAIN measurement; TREATMENT effectiveness; DESCRIPTIVE statistics
- Publication
Journal of Palliative Medicine, 2020, Vol 23, Issue 4, p535
- ISSN
1096-6218
- Publication type
Article
- DOI
10.1089/jpm.2019.0295