Do preparation and life completion discussions improve functioning and quality of life in seriously ill patients? Pilot randomized control trial.

Journal Article

BACKGROUND: Significant palliative care intervention has focused on physical pain and symptom control; yet less empirical evidence supports efforts to address the psychosocial and spiritual dimensions of experience. OBJECTIVE: To evaluate the impact of an intervention (Outlook) that promotes discussions of end-of-life preparation and completion on health outcomes in dying persons, including pain and symptoms, physical function, emotional function (anxiety and depression), spiritual well-being, and quality of life at the end of life. DESIGN: A three-arm pilot randomized control trial. Subjects were recruited from inpatient and outpatient hospital, palliative care, and hospice settings. Intervention subjects met with a facilitator three times and discussed issues related to life review, forgiveness, and heritage and legacy. Attention control subjects met with a facilitator three times and listened to a nonguided relaxation CD. True control subjects received no intervention. MEASUREMENTS: Preoutcomes and postoutcomes included the Memorial Symptom Assessment Scale, QUAL-E, Rosow-Breslau ADL Scale, Profile of Mood States anxiety sub-scale, the CESD short version, and the Daily Spiritual Experience Scale. RESULTS: Eighty-two hospice eligible patients enrolled in the study; 38 were women, 35 were African American. Participants' primary diagnoses included cancer (48), heart disease (5) lung disease (10), and other (19) Ages ranged from 28-96. Participants in the active discussion intervention showed improvements in functional status, anxiety, depression, and preparation for end of life. CONCLUSIONS: The Outlook intervention was acceptable to patients from a variety of educational and ethnic backgrounds and offers a brief, manualized, intervention for emotional and spiritual concerns.

Full Text

Duke Authors

Cited Authors

  • Steinhauser, KE; Alexander, SC; Byock, IR; George, LK; Olsen, MK; Tulsky, JA

Published Date

  • November 2008

Published In

Volume / Issue

  • 11 / 9

Start / End Page

  • 1234 - 1240

PubMed ID

  • 19021487

Electronic International Standard Serial Number (EISSN)

  • 1557-7740

Digital Object Identifier (DOI)

  • 10.1089/jpm.2008.0078


  • eng

Conference Location

  • United States