effects of palliative care for the first makers of medical study of its kind survey, caregivers -
Shannon Carson, MD, professor of medicine and chief of the division of pulmonary diseases and Critical Care Medicine at the UNC School of Medicine and co-principal investigator Judith Nelson, MD, JD, at Memorial Sloan Kettering Cancer Center, and Christopher Cox, MD, of Duke University, conducted a four-year term the first-of its kind clinical study on the effects of palliative care for medical decision makers.
results, published July 5 in the Journal of the American Medical Association ( JAMA ) show that intensive care units in New York and Carolina North hospital, where the study was conducted, communication condition and family support that was at least as adequate as specialized interventions (palliative care) for families of chronically ill patients in the intensive care unit. The researchers focused on the study of the psychological distress of caregivers and decision makers for patients with chronic serious illness, which is defined as dependence on a respirator for more than a week.
"We have long known that patients experiencing chronic severe disease have a very difficult time because of complications of their disease, long dependence on life support, and long hospitalizations," said Carson.
These things also make it difficult and stressful for family members, caregivers, and policy makers -. which are often the same people
"It is very disruptive to their lives and work, and - to complicate matters even more - we rely on them to help a lot of -Make decision. It is very stressful for family members, "said Carson. "As a critical care physicians, we sometimes worry that we do not provide or are not able to provide the support and information that families need to help this decision in the most effective ways. "
In trying to determine what could be done to keep families better informed and possibly reduce the associated stress and relieve anxiety, Carson examined whether providing support for palliative care specialists would be beneficial . Participants in the study were randomized 365 families makers for 250 ICU patients with chronic severe disease
"We were hoping to have families come together with palliative care doctors. - At least a few once -would help families cope better down the line, "said Carson. "And so two family members randomized us meet the doctors and nurses in palliative care during the illness of their family member, or they received usual care, all the information they received was of critical care clinicians. - doctors and nurses
"what we found is that there was no advantage to having these additional meetings with clinicians in palliative care. We found that the support and communication provided by the ICU team was quite good. We concluded that if it was an interesting idea and I hope useful, for now it seems that the support from intensive care physicians regular is at least as adequate as the additional support of palliative care " said Mr. Carson.
In addition, no difference was observed in the number of days a patient was in the hospital or the patient time spent on a ventilator or other therapeutic interventions.
"as an intensivist, I find that to be a positive conclusion," he said. "We are at least as good as the gold standard in this context. He reassured. While we can always do better in communication, we at least do as well as anyone can. We will still need to consult the palliative care for difficult situations, but routine consultations for all chronically critically ill patients will not be necessary. "
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