Disease trajectories in nursing home patients.

Husebo, B.S., Hylen Randhoff, A., Sandvik, R., Omland, G., Gysels, M., Francke, A., Hertogh, C., Ribbe, M., Deliens, L. Disease trajectories in nursing home patients. European Journal of Palliative Care: 2011 145. Abstract. 12th EAPC Congress 'Palliative Care Reaching Out', 18-21 mei 2011, Lisbon, Portugal.
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Research aims: About 17 500 patients die in Norwegian nursing homes (NH) every year, 14-27% of these patients have diagnoses of cancer, 75% heart failure, and 80% dementia. Little is known about their last months and days regarding medical treatment, needs for multi-professional care, advance directives, and cost-benefits. To improve our knowledge about patients` prognoses, how to understand and treat their needs, and to handle prioritization, we aim to compare cancer patients with heart failure in longterm care (LTC) patients in a prospective 2 years longitudinal study. Methods: Three separate studies will be performed: 1. In depth semi-structured interviews will include 3 groups of patients and relatives (each N=10) regarding their information, needs and wishes (qualitative study). 2. Cancer (N=120) and non-cancer NH patients (N=220) will be examined comprehensively with functional measurements, and follow-up will be performed over a 2 years period, including end-of-life care. 3. Cost-benefit analyses investigate medical treatment and compare 120 cancer NH patients with matched hospital patients. Paired-Samples T-Test for repeated measures and Independent-Samples T-Test for comparison between groups will be used. Intracluster correlation coefficient analyzes by One-way analysis of variance (ANOVA). Conclusion: We expect new scientific knowledge which will contribute to better services for NH patients. At the EAPC conference we will describe the comprehensive approach of the study protocol and stimulate further international collaboration. We stimulate other countries to develop a replica of this study in their own country, and hence, joining this international collaboration, based upon relevant experiences by an international research group (experts from Norway, Catalonia, Belgium, the Netherlands and England) resulting from a PRISMA expert meeting. (aut. ref.)