The overall objective of this study is to identify whether the systematic anticipation of highly structured specialized palliative home care into primary care influences the quality of care and care utilization. Quality of care focusses on the sense of security of patients and family caregivers, satisfaction with care of patients, family caregivers, general practitioners, home care nurses and specialized palliative care nurses, and availability and access to advanced directives. Health care utilization focus on the number of hospitalizations and the length of hospital stays.
The University Center for Palliative Care from the Inselspital Bern conducts this monocentric mixed-methods controlled study and is responsible for informed consent. Data consists of questionnaires of patients, their family caregivers, general practitioners, home care nurses and if involved specialized palliative home care nurses. Patients and their family caregivers will fill out baseline questionnaires and follow-up questionnaires at 2, 8, 16 and 24 weeks. Patient follow-up will end if the patient dies or the study ends. Family caregivers will be asked to fill out a questionnaire two months after the patient's death. General practitioners, home care nurses and specialised palliative home care nurses will fill out questionnaires after the patient's death or at the end of the study. Patient survival data will be collected from administrative health data after the end of the study. Additionally, a nested qualitative study with semi-structured qualitative interviews with patients, family caregivers and care providers will provide an in-depth understanding of preferences, needs, experiences from this phase of life.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
SINGLE
Enrollment
149
Specialist palliative home care teams will initiate care as usual, including managing a systematic and collaborative process of advance care planning with patients, family caregivers, GPs and SPITEX nurses using the "Betreuungsplan", information packages and regular case meetings. The GP was additionally provided with educational palliative care information by the study team.
University Hospital Inselspital Bern
Bern, Switzerland
Sense of security of patients
Measured by questionnaire Sense of Security in Care - Patients' Evaluation (SEC-P), This questionnaire has 3 subscales namely, the Care Interaction scale; the Identity scale and the Mastery scale. Higher score indicate a higher level of sens of security at home of the patient.
Time frame: From 2 months before the date of baseline measurement (retrospectively), to six months after the baseline measurement (prospectively).
Number of patients who define advance directives
Measured by questionnaire
Time frame: From 2 months before the date of baseline measurement (retrospectively), to six months after the baseline measurement (prospectively).
Access to advance directives of the patients for the ambulant care providers
Measured by questionnaire
Time frame: From 2 months before the date of baseline measurement (retrospectively), to six months after the baseline measurement (prospectively).
Satisfaction with care of patient
Measured by questionnaire Modified FAMCARE Scale P16. 16 Questions on care with answers (Likert-type scale 1 to 5) ranging from "very satisfied with care" to "very dissatisfied with care"
Time frame: From 2 months before the date of baseline measurement (retrospectively), to six months after the baseline measurement (prospectively).
Satisfaction with care of GP
Measured by questionnaire
Time frame: From date of baseline measurement of patient to study completion, an average of 6 months, or shorter if patient deceases
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.