Comparing caregiver and nurse perceptions of discomfort in advanced cancer patients with hypoactive delirium

A Comparison of Healthcare Provider and Caregiver Perception of Discomfort in Advanced Cancer Patients Who Have a Hypoactive Delirium

This study looks at how caregivers and nurses view the discomfort of advanced cancer patients with hypoactive delirium to see if their opinions match and what factors might influence their views.

Quick facts

• Study type: Observational
• Enrollment: 100 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: M.D. Anderson Cancer Center (Academic / other)
• Locations: 1 site (Houston, Texas)
• Trial ID: NCT05837039 on ClinicalTrials.gov

What this trial studies

This observational study aims to assess how caregivers perceive the discomfort levels of patients with hypoactive delirium who are at the end of life. It will utilize the Caregiver Survey of Patient Discomfort to gather insights from caregivers and compare these perceptions with those of bedside nurses using the Healthcare Provider Survey of Patient Discomfort. Additionally, the study will explore associations between patient and caregiver demographics and their survey responses to better understand the factors influencing these perceptions.

Who should consider this trial

Good fit: Ideal candidates include advanced cancer patients who are actively dying and unable to respond to questioning.

Not a fit: Patients who are not in the advanced stages of cancer or those who are responsive and able to communicate may not benefit from this study.

Why it matters

Potential benefit: If successful, this study could improve the understanding of discomfort in advanced cancer patients, leading to better palliative care practices.

How similar studies have performed: While there may be limited studies directly comparing caregiver and nurse perceptions in this specific context, the approach of assessing discomfort in palliative care settings has shown promise in improving patient care.

Eligibility criteria

Patient Inclusion Criteria:

1. Patients with advanced cancer. Advanced cancer is defined as locally invasive, metastatic or recurrent cancer. Hematologic malignancies will also be included.
2. Patients who are admitted to the acute palliative care unit (APCU) at MD Anderson Cancer Center.
3. Patients who are unable to respond to questioning in the past 24 hours as determined by the attending physician, fellow physicians, or nursing staff of the APCU.
4. Patients who are considered to be actively dying, as defined as likely to die during the admission and not regain consciousness. The physical exam findings that will be utilized to help define those patients who are actively dying may include one but not limited to one of the following symptoms: pulseless of the radial artery, Cheyne-stokes breathing, peripheral cyanosis, apnea periods, respiration with mandibular movement, turbulent airway noise produced on inspiration and/or expiration due to airway secretions commonly known as the "death rattle", and loss of nasolabial folds The presence of these signs will be based on the reporting of the attending physician, fellow physicians or nursing staff of the APCU.
5. Patients who have an unpaid adult caregiver at bedside age 18 years or older, who is willing and able to provide informed consent and who has been present at bedside for at least 3 hours a day.

Patient Exclusion Criteria:

1. Patients who had a hyperactive or mixed delirium in which they either had high level of arousal due to delirium or had mixed episodes of arousal and agitation with periods of unresponsiveness.
2. A family member or caregiver who cannot provide informed consent, or who cannot speak and read English.

Caregiver Inclusion Criteria:

1\. Unpaid adult caregiver at bedside age 18 years or older, who is willing and able to provide informed consent, able to speak and read English, and who has been present at bedside for at least 3 hours a day.

Nursing Provider Inclusion Criteria:

1\. Nursing providers in the acute palliative care unit who are providing direct patient care to eligible patients.

Where this trial is running

Houston, Texas

• M D Anderson Cancer Center — Houston, Texas, United States (Recruiting)

Study contacts

• Principal investigator: Michael Tang, MD — University of M D Anderson Cancer Center
• Study coordinator: Michael Tang, MD

Conditions Hypoactive Delirium