The Pilot Palliative ARNP (Advanced Registered Nurse Practitioner) Liaison Program (The PAL Program): Improving Communication Between Patients, Oncologists, and Hospice, Promoting Timely Hospice Referrals and Bringing Education and Research Efforts to Hospice and Palliative Care

Brief Summary

Detailed Description

OBJECTIVES: Primary * To assess the effect of the palliative advanced registered nurse practitioner liaison program (PAL) on length of patient's enrollment in hospice care. Secondary * To evaluate the impact of the PAL program on patient's knowledge about hospice services. * To evaluate the impact of the PAL program on patient and family or caregiver's psychological stress during palliative treatments. OUTLINE: Patients are randomized to 1 of 2 arms. * Arm I (advanced registered nurse practitioner \[ARNP\] intervention): Patients and their families or caregiver receive information from an ARNP about terminal cancer, resources available for supportive care, and the benefits of palliative care. After transition to hospice, patients receive pain and palliative medicine, psychology, social services, chaplaincy, and patient support group intervention arranged by the ARNP. Patients complete the Patient Questionnaire about overall quality of life and mental, emotional, and physical well being at baseline and at 3 weeks after intervention or at time of enrollment in hospice. Patients and their families or caregivers are contacted by the ARNP weekly. * Arm II (no ARNP intervention): Patients and their families or caregivers complete the same Patient Questionnaire, administered by a clinical research assistant (CRA), as in Arm I. Patients and their families or caregivers receive no ARNP intervention. After transition to hospice, patients receive routine hospice care. Patients participate in this study for a duration of 21 days while in hospice care. At the completion of the study, patients in both arms complete questionnaires about pain management, social, emotional, and spiritual and mental well-being. Patients' families or caregivers complete the Caregiver Questionnaire and the Hospice Family Satisfaction Survey 3 weeks after patient's death.

Primary Outcomes

Secondary Outcomes

• Effects of incorporating a palliative care advanced registered nurse practitioner liaison program in the late-stage cancer care process
• Patient and family or caregiver psychological stress, as measured by the functional assessment of cancer therapy general (FACT-G) survey
• Increased knowledge of hospice services as assessed by a knowledge survey