Efficacy of a Training Intervention on the Quality of Case Coordinators and Nurses' Decision Support for Patients Deciding About the Place of Care at the End Of-Life: A Randomized Control Trial
Most terminal cancer patients prefer home palliation yet die in an institution. Some
experience decisional conflict when weighing options regarding place of care. Community Case
Managers and Nurses are well positioned to identify decisional needs and provide decision
support; however, they generally lack skills and confidence in doing so. This study aims to
determine whether the quality of case managers and nurses' decision support can be improved
with a theory-based skills-building intervention.
In phase one a needs assessment will be conducted with about 20 key informants. In phase
two, nurses will be randomly allocated to an intervention or control group. The
intervention, informed by the needs assessment, is comprised of: an auto-tutorial; an
interactive skills building workshop; a decision support protocol; performance feedback, and
Participants will be assessed: a) at baseline (quality of decision support); b) after the
auto-tutorial (knowledge); and six to eight weeks after the other interventions (quality of
decision support; confidence and intention to integrate decision support into practice).
Between group differences in the primary outcome (quality of decision support scores) will
be analyzed using a repeated measures ANOVA.
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject)
Decision support quality audit using simulated patients measured by the validated and reliable Decision Support Analysis Tool
Annette O'Connor, MD
Ottawa Hospital Research Institute
Canada: Health Canada