Health care professional recruitment of patients and family carers to palliative care randomised controlled trials: A qualitative multiple case study

Implementation of the e-IPOS in Home Palliative Cancer Care: A Quasiexperimental Pilot Study

INTRODUCTION

Electronic patient-reported outcome measures (e-PROMs) offer advantages in palliative cancer care, including rapid completion, improved data quality and direct storage, improving clinical decision-making. The electronic Integrated Palliative Care Outcome Scale (e-IPOS) in this context enables thorough self-assessment by patients, enhancing symptom management and self-reflection of their current situation.

AIM

To evaluate the feasibility of implementing the e-IPOS in home palliative cancer care.

OUTCOMES

The primary outcomes included the enrollment consent rate, study retention rate, e-IPOS completion rate and response completeness, and the number of clinical assessments and interventions performed during home visits. The secondary outcomes were the number of unscheduled visits and patients' perceived quality of life.

DESIGN

A two-group quasiexperimental clinical pilot study. The control group received standard palliative care, the intervention group received standard care along with weekly e-IPOS completion during home visits. Both groups were enrolled for 4 weeks.

SETTING/PARTICIPANTS

Adults with advanced cancer from the home palliative care unit of the Istituto Nazionale dei Tumori of Milan.

RESULTS

Twenty-three patients were enrolled (74.19%), and 20 completed the study (drop-out: 13.04%). 82.5% of the expected e-IPOS responses were received, of which 96.9% were fully complete. In the intervention group, the Wilcoxon test showed an increase in identified needs and documented interventions (P < .05) and a decrease in unscheduled visits (P < .05).

CONCLUSION

It is feasible to recruit people via home palliative care for an e-IPOS implementation study. Future fully powered studies should investigate the feasibility and assess patients' perceptions of its use to better understand its clinical benefits.

How Chinese Doctors Do Things With Discursive Strategies in Palliative Care Family Meetings: A Genre Theory Analysis

Palliative care family meetings (PCFMs) can be conceivably endorsed as helpful means for bettering end of life (EOL) communication with terminally ill patients and their families. Relevant scholarship in China remains emerging and youthful, with many avenues left to explore. Few studies have delineated the structure and specified the strategies for conducting PCFMs in the Chinese context. To address this gap, this study gathered data from audio-recorded family meetings held in palliative care wards in China. Within the theoretical framework of genre theory in functional linguistics (FL) that defined genres as staged, goal-oriented social processes, utilizing thematic analysis and discourse analysis, the twofold generic structure of PCFMs was delineated, consisting of four genre stagings in the upper stratum and fourteen elemental genres in the lower stratum, with the identified attributes of elemental genres, their sequence and possibility of iteration. Doctors' discursive strategies in terms of semantics and lexicogrammar were specified as they serve to achieve communicative goals regarding knowledge, identity, and emotion. It is hoped that the results will improve the context for growing palliative care practices and positive clinical outcomes in China and provide insights into the structurization and discursiveness of practices in EOL settings.