Specialised Paediatric Palliative Care: Assessing Family, Healthcare Professionals and Health System Outcomes in a Multi-site Context of Various Care Settings
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 70
- 试验地点
- 5
- 主要终点
- Change in Caregiver QOL - QOLLTI-F Questionnaire
研究概览
简要总结
This study evaluates the effectiveness of an existing Specialised Paediatric Palliative Care programme and reports on its potential to improve patient-, family-, health professionals-, and healthcare-related outcomes. Data will be compared between an intervention and a comparison group.
详细描述
The number of children and adolescents living with life-limiting conditions and potentially in need for specialised paediatric palliative care (SPPC) is rising. As a highly complex subfield of palliative care, paediatric palliative care focuses on the support and involvement of the entire family, and on the impact not only at the patient level, but also at the family and health systems level. Ideally, a specialised multiprofessional team fills the complex healthcare needs of children and their families. A consultative care model might be well-suited to address each family's most important needs. The question, however, of how SPPC is beneficial for whom and under what circumstances remain largely unanswered as validation of innovative care programmes in controlled studies is lacking.
This study's overall target is to evaluate the effectiveness of SPPC and to report on its potential to improve patient-, family-, health professional-, and healthcare-related outcomes. The primary objective is to explore how SPPC influences the quality of life (QOL) of caregivers, i.e. parents. Secondary objectives are to explore how SPPC influences the QOL of patients including their symptom severity and distress as well as the QOL of their siblings and of healthcare professionals not specialised in PPC. Further objectives are to determine whether the provision of SPPC reduces the utilisation of healthcare resources and direct and indirect health-related costs for families, and to evaluate implementation outcomes such as adoption, i.e., the uptake of SPPC.
This interventional multi-centre study will apply a hybrid design to determine the clinical effectiveness (comparative effectiveness research) of an existing SPPC programme, while gathering information on its delivery and potential implementation in a real-life situation.
This study will be conducted in compliance with the protocol, the current version of the Declaration of Helsinki, the ICH-GCP as well as all national legal and regulatory requirements.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- — 至 18 Years(Child, Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Children suffering from a life-limiting condition and potentially in need of SPPC, their parents and siblings as applicable will be eligible to enter the study, along with all HCP involved in their care at all study sites. The potential need for SPPC is defined per indication criteria based on the Zurich SPPC programme's guidelines:
- •Increase in (unplanned) hospital admissions during the last months
- •Medical adverse events from which the child is not recovering completelyIncreasing symptom burden
- •Unsatisfactory response to treatments
- •Conflicting treatment goals
- •Estimated life expectancy less than 6-12 months
- •Patient's/parents' wish for PC support
- •Inclusion criteria:
- •Children, aged 0-18 years, suffering from a life-limiting condition of various origins and potentially in need of SPPC (for Zurich, additionally enrolment in the SPPC programme)
- •Parents (mothers and fathers) of included children
- •Siblings, aged >8 years, of included families
- •All health care professionals involved in the care of included families
- •Proficiency in French or German language
- •Signed Informed Consent after being informed
排除标准
- •Neonates with medical complications due to prematurity and/or birth complications and treated in a neonatal intensive care unit
- •Children with an estimated life expectancy of <48 hours
结局指标
主要结局
Change in Caregiver QOL - QOLLTI-F Questionnaire
时间窗: Up to day 330 after study entry
Longitudinal assessment of self-reported caregiver (parental) Quality of Life (QOL) using the QOLLTI-F (Quality of Life in Life Threatening Illness - Family Carer Version) questionnaire.
次要结局
- Change in Siblings QOL - KIDSSCREEN-27 Questionnaire(Up to day 630 after study entry)
- Professional's QOL (ProQOL) Questionnaire(Cross-sectional at the end of study year 2)
- Change in parental QOL during bereavement - WHOQOL-BREF Questionnaire(Up to 1 year after the child's death)
- Chang in grief - "Würzburger Trauerinventar (WüTi)" Questionnaire(Up to 1 year after the child's death)
- Change in child's symptoms - Memorial Symptom Assessment Scale (MSAS) Questionnaire(Up to day 330 after study entry)
- Change in Child's QOL - DISABKIDS Chronic Generic Measure (DCGM-37) Questionnaire(Up to day 330 after study entry)
