Panate Pukrittayakamee Palliative Care Panate Pukrittayakamee

Outline Definition of Research methodology in Palliative Care Academic subjects Research methodology in Palliative Care A seminal research article Evaluation of its contribution

Definition Holistic treatment for advanced diseases Academic subjects Multidisciplinary team approach To promote quality of life To support patients during a dying process Academic subjects Pain, physical complications Bereavement and psychological reactions Social, spiritual aspects, law and ethics (WHO, 2011; Ferris et al, 2009; Clark, 2009; von Gunten, 2009; King's College London)

Research methods Clinical trial (Bennett, 2007) Development of new treatment Survey research (Addington-Hall, 2007) Using a questionnaire to ask for opinion Epidemiological research (Costantini and Higginson, 2007) Prevalence or associated factors of disease Qualitative research (Payne, 2007) To explore experiences of patients

Research article Early Palliative Care for Patients with Metastatic Non–Small-Cell Lung Cancer (Temel et al, 2010) The New England Journal of Medicine

Research summary Randomized-Controlled Trial (RCT) 151 Patients were divided into two groups Early palliative care with standard treatment Only standard treatment Outcomes of treatment were measured by Rating scale for quality of life Rating scale for depression and anxiety Survival time

Outcome Outcome of early palliative treatment Better quality of life Lower incidence of depression Longer survival time

Evaluation Reliable Methodology Contribution RCT Enough sample size and sufficient power Contribution Great impact to the trend in clinical practice Palliative care should be initiated early Helping patients understand prognosis and plan their lives (Temel et al, 2011) It should be implemented in outpatient unit

Limitation This concept cannot be applied to other advanced diseases Inadequate supply of palliative care teams (Nieder and Norum, 2012)

Conclusion Palliative care is designed to improve quality of life in advanced diseases It requires knowledge in medicine, psychiatry and social issue Both quantitative and qualitative researches can be used Early palliative care is a research topic that changes attitude of physicians Early Palliative treatment should be provided early in order to improve quality of life

List of References WHO. (2011). Palliative care for older people: better practices. Copenhagen, WHO Regional Office for Europe. Ferris, F. et al. (2009). “Palliative Cancer Care a Decade Later: Accomplishments, the Need, Next Steps—From the American Society of Clinical Oncology.” Journal of Clinical Oncology 27(18): 3052-3058. Clark, D. (2009). International progress in creating palliative medicine as a specialized discipline. Oxford Textbook of Palliative Medicine (4 ed.). G. Hanks et al. Oxford University Press.

List of References von Gunten, C., Buckholz, G., Ferris, F. (2009). Education and training in palliative medicine: training specialists in palliative medicine. Oxford Textbook of Palliative Medicine (4 ed.). G. Hanks et al. Oxford University Press. King’s College London. (2014, 14/07/14). “Palliative Care MSc.” Retrieved 14/07/14, from http://www.kcl.ac.uk/prospectus/graduate/palliative-care. Bennett, M. (2007). Principles of designing clinical trials in palliative care. Research methods in palliative care. J. Addington-Hall et al. New York, Oxford University Press: 13-26.

List of References Addington-Hall, J. (2007). Survey design. Research methods in palliative care. J. Addington-Hall et al. New York, Oxford University Press: 45-60. Costantini, M. and Higginson, I. (2007). Experimental and quasi-experimental designs. Research methods in palliative care. J. Addington-Hall et al. New York, Oxford University Press: 85-98. Payne, S. (2007). Qualitative methods of data collection and analysis. Research methods in palliative care. J. Addington-Hall et al. New York, Oxford University Press: 139-162.

List of References Temel, J. et al. (2010). “Early Palliative Care for Patients with Metastatic Non–Small-Cell Lung Cancer.” The New England Journal of Medicine 383(8): 733-742. Temel, J. et al. (2011). “Longitudinal Perceptions of Prognosis and Goals of Therapy in Patients With Metastatic Non–Small-Cell Lung Cancer: Results of a Randomized Study of Early Palliative Care.” Journal of Clinical Oncology 29(17): 2319-2326. Nieder, C. and Norum J. (2012). “Early palliative care in patients with metastatic non-small cell lung cancer.” Annals of Palliative Medicine 1(1): 84-86.