Using Whole-Person-Care Guide in Patients Receiving Care for Cancer or Complications From Cancer Treatment

OBJECTIVES:

• To determine what patient needs are detected from NEST13+ interviews of cancer patients and their caregivers.
• To determine the concordance among patient, caregiver, and team goals.
• To determine palliative care services provided.

OUTLINE: Participants are assigned sequentially to 1 of 2 intervention groups.

• Group 1 (NEST13+): Patients and caregivers undergo NEST13+ interviews at the time of admission to Northwestern Memorial Hospital (caregivers answer the NEST13+ interviews from the patient's perspective). A NEST13+ care plan is then derived from both patient and caregiver responses. Research MD or RN presents patient's NEST13+ findings and recommended interventions for integration with actual care. On the day of discharge, patients and caregivers undergo a second NEST13+ interview.
• Group 2 (control): Patients and caregivers undergo a sham interview at the time of admission to Northwestern Memorial Hospital. On the day of discharge, patients and caregivers undergo a NEST13+ interview as in group 1.

Medical charts for all patients are reviewed by a member of the research staff to document needs assessments in domains covered by NEST and to document palliative care-related decisions. Abstracted chart review by blinded experts is also performed to evaluate palliative care quality based on National Comprehensive Cancer Network guidelines.

PROJECTED ACCRUAL: A total of 500 patients and 250 caregivers will be accrued for this study.

DISEASE CHARACTERISTICS:

• Confirmed diagnosis of cancer
• Admitted to one of the two oncology units at Northwestern Memorial Hospital either for treatment of cancer or treatment-related complications

• Complications include, but are not limited to, any of the following:

• Febrile neutropenia
• Infection
• Esophagitis from radiochemotherapy
• Malnutrition
• Spinal cord compression
• Bone pain secondary to metastatic bone disease
• Thrombocytopenia

PATIENT CHARACTERISTICS:

• Able to read and understand English

PRIOR CONCURRENT THERAPY:

• See Disease Characteristics