Measuring Changes In Fluids, Fat, Muscle Mass, Proteins & Other Body Components Non-invasively Through Course Of Illness
Funder
National Health and Medical Research Council
Funding Amount
$120,000.00
Summary
The course of non-cancer related disease is difficult to assess clinically making it hard for clinicians to accurately predict the end of life course of illness for patients. No matter what the end of life disease is, death will involve multi-system organ failure and changes in body composition. These changes, including fluid distribution, muscle mass and type and fat mass as well as measures of body mass index, basal metabolic rate and arm muscle circumference can be accurately followed with no ....The course of non-cancer related disease is difficult to assess clinically making it hard for clinicians to accurately predict the end of life course of illness for patients. No matter what the end of life disease is, death will involve multi-system organ failure and changes in body composition. These changes, including fluid distribution, muscle mass and type and fat mass as well as measures of body mass index, basal metabolic rate and arm muscle circumference can be accurately followed with non-invasive multi-frequency bio-impedance. This information will provide a basis to either confirm the clinical diagnosis or lead to recommendations for change.Read moreRead less
A Study To Pilot A Clinical Trial To Test Dignity Psychotherapy For The Frail Aged
Funder
National Health and Medical Research Council
Funding Amount
$25,000.00
Summary
One of the greatest challenges today is to preserve the dignity of the frail elderly. Our study will test and perfect a strategy to trial a new approach for this population, Dignity Psychotherapy. The approach will document aspects of the senior's life that they regard as meaningful, want remembered, or of which they are proud. Among the terminally ill, the approach has had positive outcomes. Benefits for elders may include that the approach forms a foundation for holistic care.
Improving Quality Of Life Of People With Dementia Living In Residential Care Facilities A Randomised Trail Of Educat Int
Funder
National Health and Medical Research Council
Funding Amount
$777,409.00
Summary
The DIRECT study aims to determine if education of General Practitioners (GPs) and Residential Care Staff can improve the quality of life (QOL) of people with dementia living in Residential Care Facilities (RCF). Our hypothesis is that a systematic educational intervention delivered to GPs and RCF staff will improve care delivery, leading to measurable improvements in the quality of life of residential care recipients. We hypothesise that education delivered to GPs will have additive effects to ....The DIRECT study aims to determine if education of General Practitioners (GPs) and Residential Care Staff can improve the quality of life (QOL) of people with dementia living in Residential Care Facilities (RCF). Our hypothesis is that a systematic educational intervention delivered to GPs and RCF staff will improve care delivery, leading to measurable improvements in the quality of life of residential care recipients. We hypothesise that education delivered to GPs will have additive effects to education delivered to RCF staff. Dementia is the leading cause of non-fatal disease burden among older Australians. Of people with dementia, nearly half live in RCF. There appears to be much scope to improve care, and thus QOL, for people with dementia living in residential facilities. However, the most effective way to translate knowledge regarding the components of high quality care into practice is uncertain and there is a paucity of Australian data to guide practice. Education of RCF staff is likely to be the cornerstone of improved care for recipients of residential care who have dementia. GPs also play a key-role in the care of older people living in RCF, including collaboration in the development of management plans, prescription of medications and initiation of health referrals. A detailed action research process with data collected from surveys, focus groups and pilots will be used to develop educational programmes for delivery to GPs and RCF staff. The primary outcome of the study will be quality of life of the people with dementia, assessed by themselves, their family carers and the staff looking after them. Several tools incorporating different sources of information will be used to assess QOL in a comprehensive fashion. Secondary outcomes will include knowledge among GPs and RCF staff regarding dementia, markers of quality care, participants’ sleep quality, and carer satisfaction. It is anticipated that the results will fill this current gap in evidence and will be of value to policy makers and stakeholders from the Residential Care Industry and Peak Community and General Practice bodies. The study results will have tangible implications for proprietors, managers and staff from the residential care sector and policy makers. The results have potential to directly benefit the quality of life of both patients and carers.Read moreRead less
Preventing Early Language Delay In Primary Care Setting:cluster Randomised Trial
Funder
National Health and Medical Research Council
Funding Amount
$415,133.00
Summary
The trial aims to lower the numbers of children with poor expressive language skills at ages 2 and 3 years, through a sustainable early language promotion program linked to the universal Victorian Maternal and Child Health (M and CH) service, attended by more than 75% of Victorian children at 12 months of age. The trial targets the 20% of toddlers most at risk of expressive language delay, by virtue of having limited or no spoken vocabulary at 18 months of age. It also aims to lower the numbers ....The trial aims to lower the numbers of children with poor expressive language skills at ages 2 and 3 years, through a sustainable early language promotion program linked to the universal Victorian Maternal and Child Health (M and CH) service, attended by more than 75% of Victorian children at 12 months of age. The trial targets the 20% of toddlers most at risk of expressive language delay, by virtue of having limited or no spoken vocabulary at 18 months of age. It also aims to lower the numbers of children with behaviour problems (strongly linked to language delay), to determine the acceptability and cost-effectiveness of the approach, and to determine whether it differentially benefits disadvantaged children.Read moreRead less
Using N-of-1 Trials To Determine Effectiveness Of Paracetamol In Advanced Cancer Patients On Opioids
Funder
National Health and Medical Research Council
Funding Amount
$49,996.00
Summary
In advanced cancer, the prevalence of pain is very high (70-90%). Chronic pain is the most feared symptom and is not controlled in a large proportion of cancer patients. The impact on function (physical, mental, social and spiritual) and quality of life (QOL) is very significant. The role of paracetamol in the management of pain in patients with advanced cancer on opioids needs to be defined. Managing pain with treatment supported by the best possible evidence for individual patients and produci ....In advanced cancer, the prevalence of pain is very high (70-90%). Chronic pain is the most feared symptom and is not controlled in a large proportion of cancer patients. The impact on function (physical, mental, social and spiritual) and quality of life (QOL) is very significant. The role of paracetamol in the management of pain in patients with advanced cancer on opioids needs to be defined. Managing pain with treatment supported by the best possible evidence for individual patients and producing any improvement in pain will improve patients’ functional status, and will greatly improve QOL for patients and carers. N-of-1 trials are randomized, double-blind cross-over comparisons of active drug with placebo or another drug. The patient is their own control. N-of-1 trials provide objective means of testing effectiveness of medicines in individuals, providing evidence stronger than randomised controlled trial evidence for the efficacy of that drug in that individual. We will pilot N-of-1 trials of paracetamol for pain in 10 patients. If feasible, this will be a new method of obtaining strong evidence in a difficult to research population: palliative care patients.Read moreRead less
Discussing Prognosis & End-of-life Issues In Palliative Care: Current Practice & Dvlpmnt Of Evidence Based Trng Program
Funder
National Health and Medical Research Council
Funding Amount
$149,955.00
Summary
Discussing prognosis and end-of-life issues is of key importance to palliative care patients and their families. We will a) prepare evidence based communication guidelines on these topics, b) analyse audio-taped consultations to see how these issues are currently discussed and c) develop and pilot a communication training module for palliative care clinicians. This could improve clinical practice, enhance patients' and families' psychological well-being and help patients to make appropriate deci ....Discussing prognosis and end-of-life issues is of key importance to palliative care patients and their families. We will a) prepare evidence based communication guidelines on these topics, b) analyse audio-taped consultations to see how these issues are currently discussed and c) develop and pilot a communication training module for palliative care clinicians. This could improve clinical practice, enhance patients' and families' psychological well-being and help patients to make appropriate decisions and prepare for their death.Read moreRead less
Case Conferencing, Quality Of Life And Palliative Care For Clients From Remote Communities In The Northern Territory
Funder
National Health and Medical Research Council
Funding Amount
$42,750.00
Summary
This project addresses an area in the delivery of palliative care in rural and remote Top End of the NT, where research is seriously lacking. It will focus on the relationship between quality of life and communication between health providers and palliative clients and their carers. The conduit of communication will be case conferences and family conferences. There has been some research that reflects that case conferencing (in urban areas) in palliative care leads to improved quality of life (M ....This project addresses an area in the delivery of palliative care in rural and remote Top End of the NT, where research is seriously lacking. It will focus on the relationship between quality of life and communication between health providers and palliative clients and their carers. The conduit of communication will be case conferences and family conferences. There has been some research that reflects that case conferencing (in urban areas) in palliative care leads to improved quality of life (Mitchell 2006). This project will be assessing whether there is a similar association between quality of life and case conferencing in rural and remote Northern Territory. The project will also assess the dynamics of communication between palliative clients and their carers and the health providers.Read moreRead less
Prospective Study Of Medical Emergency Team Calls To Define Issues Of End Of Life Decision Making
Funder
National Health and Medical Research Council
Funding Amount
$48,700.00
Summary
A Medical Emergency Team (MET) is a specialised team of doctors and nurses from the Intensive Care Unit who urgently come to patients on the general wards whose medical condition is very unstable. They have to make crucial decisions about their treatment in a very short time. The previous research in this area has been focussed on improving medical outcomes, however it is also apparent that the patients having MET calls are often seriously ill with life limiting illnesses. This study aims to exp ....A Medical Emergency Team (MET) is a specialised team of doctors and nurses from the Intensive Care Unit who urgently come to patients on the general wards whose medical condition is very unstable. They have to make crucial decisions about their treatment in a very short time. The previous research in this area has been focussed on improving medical outcomes, however it is also apparent that the patients having MET calls are often seriously ill with life limiting illnesses. This study aims to explore the broader aspects of care at this time, which are of paramount importance to patients and their families, such as various aspects of communication, particularly focusing on changing goals of care; and also the symptoms that may be causing significant distress for the patient. This project will provide information that will assist development of interventions that will both aim to improve quality of life and also communication in the setting of medical emergencies in patients with life limiting illness.Read moreRead less
An Exploration Of Functional Decline And The Potential For Rehab In Patients With Advanced Non-small Cell Lung Cancer
Funder
National Health and Medical Research Council
Funding Amount
$50,000.00
Summary
Lung cancer is one of the commonest human cancers and the leading cause of cancer deaths. People with advanced cancer experience significant decline in functional capacity as their disease advances and they approach death. This decline is likely to have significant impact on quality of life. In lung cancer this decline can be exacerbated by chronic illnesses such as chronic obstructive pulmonary disease (COPD). While significant clinical benefits have been demonstrated in COPD patients with the ....Lung cancer is one of the commonest human cancers and the leading cause of cancer deaths. People with advanced cancer experience significant decline in functional capacity as their disease advances and they approach death. This decline is likely to have significant impact on quality of life. In lung cancer this decline can be exacerbated by chronic illnesses such as chronic obstructive pulmonary disease (COPD). While significant clinical benefits have been demonstrated in COPD patients with the introduction of pulmonary rehabilitation, little research has been conducted to either map the functional status of lung cancer patients or to explore the application of pulmonary rehabilitation in this setting. This study seeks to begin a program of work in this area through first exploring the characteristics of functional decline in this group and then assessing the feasibility and acceptability of a rehabilitation program specifically addressing the functional status needs identified.Read moreRead less
An Investigation Of Care Planning Decisions In Advanced Pulmonary And Cardiac Illness In The Bayside Health Care Region
Funder
National Health and Medical Research Council
Funding Amount
$47,726.00
Summary
There has been little Australian research to develop interventions that facilitate end of life decision making. This project will provide a framework for understanding the issues in the planning of end of life care for people with chronic and life limiting illness and the relationship of this planning to organizational policy. The care decisions in hospital records of people with advanced lung and heart disease will be reviewed and people with those diseases interviewed about the issues they exp ....There has been little Australian research to develop interventions that facilitate end of life decision making. This project will provide a framework for understanding the issues in the planning of end of life care for people with chronic and life limiting illness and the relationship of this planning to organizational policy. The care decisions in hospital records of people with advanced lung and heart disease will be reviewed and people with those diseases interviewed about the issues they experience in planning their future care. Professionals from a range of health organisations will be interviewed about their experiences of care planning for people with life limiting lung and heart disease. As a pilot, this project will be used to contribute to the development of a model for a coordinated multidisciplinary process that brings together the health care services in a region and contributes to the systematic, ongoing development of infrastructure to improve end of life care.Read moreRead less