The effect of Palliative Daycare on Hope: A comparison of Daycare Patients with Two Control Groups Randomized Trial of a Social Networking Intervention for Cancer-Related Distress Improving the evidence base in palliative care to inform practice and policy: thinking outside the box. Do age and quality of life of patients with cancer influence quality of life of the caregiver? Role of a Medical Social Worker in Improving Quality of Life for Patients with Advanced Cancer with a Structured Multidisciplinary Intervention Does gender influence outcomes from a multidisciplinary intervention for quality of life designed for patients with advanced cancer? Supportive-affective group experience for persons with life-threatening illness: reducing spiritual, psychological, and death-related distress in dying patients. The Relation of Social Isolation, Loneliness, and Social Support to Disease Outcomes Among the Elderly Therapeutic Exercise during Outpatient Radiation Therapy for Advanced Cancer: Feasibility and Impact on Physical Well-Being The Duke–UNC Functional Social Support Questionnaire: Measurement of Social Support in Family Medicine Patients Supportive-expressive group therapy: the transformation of existential ambivalence into creative living while enhancing adherence to anti-cancer therapies. Effectiveness of palliative day care in improving pain, symptom control, and quality of life. Does a social model of hospice day care affect advanced cancer patients’ use of other health and social services? A prospective quasi-experimental trial Impacting quality of life for patients with advanced cancer with a structured multidisciplinary intervention: a randomized controlled trial. Impact of a structured multidisciplinary intervention on quality of life of older adults with advanced cancer. A hypothesis about Spiegel et al.'s 1989 paper on Psychosocial intervention and breast cancer survival. INSPIRE (INvestigating Social and PractIcal suppoRts at the End of life): Pilot randomised trial of a community social and practical support intervention for adults with life-limiting illness
Background : Despite expansion in palliative daycare services , research has not demonstrated an improvement in patient outcomes . This study aim ed to determine the effect of palliative daycare on hope . Methods : This was a prospect i ve cohort study that compared three groups of patients : a daycare group and two control groups , one recruited before daycare opened and a matched comparison group .  Patients were interviewed at baseline and at two follow-ups using the Herth Hope Index . Results : In all , 22 daycare patients completed a baseline interview ( T1 ) ; 12 a second ( T2 ) ; and 9 a third ( T3 ) . Corresponding numbers were : before group ( 56 , 34 , 24 ) and matched group ( 49 , 29 , 19 ) . An independent sample s t-test confirmed a significant difference between the groups from T1 to T2 ( mean difference=3.20 , p=0.007 ) , with the daycare group experiencing an increase in hope not seen in the other groups . However , this was not maintained . Conclusion : Daycare may effect an initial improvement in hope . The study suffered from attrition and the sample was small . Further robust evaluation of daycare is needed Background Web and mobile technologies appear to hold promise for delivering evidence -informed and evidence -based intervention to cancer survivors and others living with trauma and other psychological concerns .  Health-space.net was developed as a comprehensive online social networking and coping skills training program for cancer survivors living with distress . Purpose The purpose of this study was to evaluate the effects of a 12-week social networking intervention on distress , depression , anxiety , vigor , and fatigue in cancer survivors reporting high levels of cancer-related distress . Methods We recruited 347 participants from a local cancer registry and internet , and all were r and omized to either a 12-week waiting list control group or to immediate access to the intervention . Intervention participants received secure access to the study website , which provided extensive social networking capabilities and coping skills training exercises facilitated by a professional facilitator . Results Across time , the prevalence of clinical ly significant depression symptoms declined from 67 to 34 % in both conditions . The health-space.net intervention had greater declines in fatigue than the waitlist control group , but the intervention did not improve outcomes for depression , trauma-related anxiety symptoms , or overall mood disturbance . For those with more severe levels of anxiety at baseline , greater engagement with the intervention was associated with higher levels of symptom reduction over time . Conclusions The intervention result ed in small but significant effects on fatigue but not other primary or secondary outcomes . Results suggest that this social networking intervention may be most effective for those who have distress that is not associated with high levels of anxiety symptoms or very poor overall psychological functioning . Trial Registration NumberThe trial was registered with the Clinical Trials.gov data base ( Clinical Trials.gov # NCT01976949 ) The adoption of evidence -based hierarchies and research methods from other disciplines may not completely translate to complex palliative care setting s. The heterogeneity of the palliative care population , complexity of clinical presentations , and fluctuating health states present significant research challenges . The aim of this narrative review was to explore the debate about the use of current evidence -based approaches for conducting research , such as r and omized controlled trials and other study design s , in palliative care , and more specifically to ( 1 ) describe key myths about palliative care research ; ( 2 ) highlight substantive challenges of conducting palliative care research , using case illustrations ; and ( 3 ) propose specific strategies to address some of these challenges . Myths about research in palliative care revolve around evidence hierarchies , sample heterogeneity , r and om assignment , participant burden , and measurement issues . Challenges arise because of the complex physical , psychological , existential , and spiritual problems faced by patients , families , and service providers . These challenges can be organized according to six general domains : patient , system/organization , context / setting , study design , research team , and ethics . A number of approaches for dealing with challenges in conducting research fall into five separate domains : study design , sampling , conceptual , statistical , and measures and outcomes . Although r and omized controlled trials have their place whenever possible , alternative design s may offer more feasible research protocol s that can be successfully implemented in palliative care . Therefore , this article highlights " outside the box " approaches that would benefit both clinicians and research ers in the palliative care field . Ultimately , the selection of research design s is dependent on a clearly articulated research question , which drives the research process OBJECTIVE There are significant burdens associated with providing care for loved ones with cancer . However , caregiver quality of life ( QOL ) is often overlooked . With the increasing number of older adults with cancer , it is important to determine whether a patient 's age and QOL have any association with the caregiver 's QOL . The objective of our study was to describe caregiver QOL and explore whether patient age and other psychosocial factors impact caregiver QOL . MATERIAL S AND METHODS Baseline information from patients with advanced cancer undergoing radiation and their caregivers , who were enrolled in a r and omized , controlled clinical trial to test the effectiveness of a structured , multidisciplinary QOL intervention , was analyzed for this study . Caregivers completed the Caregiver Quality of Life Index-Cancer ( CQOLC ) Scale . Both patients and caregivers completed the  Linear Analogue Self- Assessment ( LASA ) to measure QOL , and Profile of Mood States ( POMS ) to measure mood states . RESULTS Overall , 131 patient-caregiver pairs participated in the study . At baseline , caregivers of older adults ( ≥65years ) had higher mental ( P=0.01 ) , emotional ( P=0.003 ) , spiritual ( P<0.01 ) , and social support ( P=0.03 ) LASA QOL scores . Caregivers of older adults also had higher baseline QOL ( CQOLC , P=0.003 ) and mood ( POMS , P=0.04 ) than caregivers of younger adults . Caregivers of patients with higher LASA QOL scores had higher overall ( P=0.02 ) , mental ( P=0.006 ) , physical ( P=0.02 ) , emotional ( P=0.002 ) , and spiritual LASA QOL scores ( P=0.047 ) . CONCLUSIONS Caregivers of older adults with advanced cancer demonstrated better QOL and fewer mood disturbances compared to caregivers of younger patients . When patients have good QOL , caregivers also had good QOL Abstract Background : Patients with advanced cancer face multiple challenges to their quality of life ( QOL ) . The goal of this study was to investigate the impact of participation in a multidisciplinary intervention , including a social service component , on improving the QOL of patients with advanced cancer undergoing radiation therapy . Design : A total of 115 participants with newly diagnosed advanced stage cancer , who were receiving radiation therapy  , were r and omly assigned to either participate in an 8-session structured multidisciplinary intervention or to receive st and ard care . Each 90-minute session was led by either a psychologist or psychiatrist and co-led with a nurse , physical therapist , chaplain , and /or social worker . The sessions were design ed to address the domains that impact QOL : emotional , spiritual , physical , and social domains ( support , community re sources , financial and legal issues , and advance directives ) . QOL was assessed , at baseline , 4 ( end of treatment ) , 8 and 27 weeks . The primary endpoint was overall QOL assessed on a 0–100 scale at Week 4 . Results : A total of 115 patients were enrolled from October 2 , 2000 to October 28 , 2002 .  Overall QOL at Week 4 averaged 10 points higher in the intervention group than in the control group ( 80 vs. 70 points , p = 0.047 ) which was an increase of 3 % from baseline in the intervention group versus a decrease of 9 % in the control group ( p = 0.009 ) . Of the subscores reflecting patient 's opinion regarding their QOL , there was improvement in all social domains which contributed to the overall improvement in QOL . Significant changes from baseline to Week 4 scores were seen in the areas of financial concerns ( p = 0.025 ) and legal issues ( p = 0.048 ) . Conclusions : A social work component within a structured multi-disciplinary intervention results in significant advantages in the social domain of QOL , and contributes to clinical ly meaningful improvements in the overall QOL for patients with advanced cancer undergoing active medical treatment . Numerous studies have documented the financial burdens and social changes that may occur with the diagnosis of cancer . However , previous research has not examined the role of a social worker in providing financial , social , and legal education , in a structured multidisciplinary intervention , and its direct impact on QOL . Outlined in this paper is the role of the medical social worker in a clinical trial , how education was provided and strategies for future interventions Purpose Cancer treatment can profoundly impact the patient ’s quality of life ( QOL ) . It has been well documented that there are gender differences in the symptoms associated with cancer treatment . This study explores the impact of gender on QOL for patients with newly diagnosed advanced cancer . Methods A r and omized , controlled clinical trial in patients receiving radiotherapy for advanced cancer demonstrated maintenance of QOL with a six session multidisciplinary structured intervention compared to controls . This current study reports the gender differences in that trial . Outcome measures included the functional assessment of cancer therapy-general ( FACT-G ) , linear analog self- assessment ( LASA ) , and profile of mood states ( POMS ) at baseline and weeks 4 , 27 , and 52 . Kruskal – Wallis was used to compare QOL scores . Results One hundred thirty-one patients ( 45 women and 86 men , mean age 58.7 ) participated in the clinical trial . At week 4 postintervention , women in the intervention group had statistically significant improvement in their FACT-G score , FACT-G physical well-being subscale , LASA fatigue , POMS total score , POMS fatigue – inertia subscale , and POMS confusion – bewilderment subscale ( p < 0.05 ) . Men receiving the intervention had a smaller decrease in FACT-G score compared to controls ( p = 0.048 ) and also worsened on the LASA financial ( p = 0.02 ) . At week 27 , the only gender difference was that intervention group men had more POMS anger – hostility ( p = 0.009 ) . By week 52 , there were no statistically significant gender differences in any of the QOL measures . Conclusions Gender-based differences appear to play a role in the early , but not late , response to a multidisciplinary intervention to improve QOL for patients with advanced cancer , suggesting that early interventions can be tailored for each gender BACKGROUND Attention to psycho-socio-spiritual needs is considered critical by patients with life-threatening illnesses and their caregivers .  Palliative care interventions that address these needs -- particularly spirituality -- are lacking . OBJECTIVE To evaluate the effects of an innovative program to address psycho-socio-spiritual needs in patients with life-threatening illnesses . DESIGN A group intervention entitled Life-Threatening Illness Supportive-Affective Group Experience ( LTI-SAGE ) was developed for reducing patient spiritual , emotional , and death-related distress . SETTING /SUBJECTS African American and Caucasian patients ( n = 69 ) from two hospitals in St. Louis , Missouri , with life-threatening medical conditions ( cancer ; human immunodeficiency virus/acquired immune deficiency syndrome [ HIV/AIDS ] ; geriatric frailty ; liver , kidney , pulmonary , or cardiovascular disease ) were r and omly assigned to intervention or control groups . Intervention patients participated in a maximum of 12 LTI-SAGE groups over a 12-month period . Control patients received st and ard care . MEASUREMENTS Outcome measures were depression symptoms , anxiety , spiritual well-being , and death-related emotional distress . RESULTS After attrition , 51 ( 73.9 % ) patients completed the trial . At the end of the trial , after factoring in compliance , intervention patients had significantly fewer depression symptoms and death-related feelings of meaninglessness and significantly better spiritual well-being than did control patients . CONCLUSIONS The use of the LTI-SAGE model for enhancing the end-of-life illness experience is promising Objectives : This study examined relations between social isolation , loneliness , and social support to health outcomes in a sample of New Mexico seniors . Method : We used r and om-digit dialing to obtain a r and om sample of 755 southern New Mexico seniors . Participants answered questions pertaining to demographics , social isolation and loneliness , social support , and disease diagnosis including diabetes , hypertension , heart disease , liver disease , arthritis , emphysema , tuberculosis , kidney disease , cancer , asthma , and stroke . The sample allowed for comparison of Caucasian and Hispanic participants . Results : Correlational and logistic analyses indicated that belongingness support related most consistently to health outcomes . Ethnic subgroup analysis revealed similarities and differences in the pattern of associations among the predictor and outcome variables . Discussion : The results demonstrate the importance of social variables for predicting disease outcomes in the elderly and across ethnic groups Cheville AL , Girardi J , Clark MM , Rummans TA , Pittelkow T , Brown P , Hanson J , Atherton P , Johnson ME , Sloan JA , Gamble G : Therapeutic exercise during outpatient radiation therapy for advanced cancer : Feasibility and impact on physical well-being . Objective : To characterize the feasibility of delivering a structured physical therapy ( PT ) program as part of a multidisciplinary intervention to patients undergoing outpatient radiation therapy for advanced cancer . Design : A single-blinded , r and omized , controlled trial at a quaternary medical center outpatient clinic . One hundred three adults undergoing radiation therapy for advanced cancer with prognoses ≥6 mos and 5-yr survival estimates ≤50 % were r and omized to usual care or participation in eight 90-min , multidisciplinary interventional sessions with 30 mins of each session devoted to PT . PT consisted of truncal and limb isodynamic strengthening targeting major upper- and lower-limb muscle groups as well as education and provision with instructional material s.  Physical well-being and fatigue were assessed with Linear Analog Scale of Assessment . The Profile of Mood States-Short form , including Fatigue-Inertia and Vigor-Activity subscales , was also administered . Results : PT session attendance was 89.3 % . Relative to baseline , mean physical well-being Linear Analog Self Assessment scores at week 4 improved in the intervention group , 0.4 ( SD , 23.6 ) , and declined significantly in the control group , −10.0 ( SD , 21.5 ) ( P = 0.02 ) . Fatigue and vigor were not significantly different between the groups . All intergroup differences had resolved at 8 and 27 wks . Baseline characteristics were not associated with the magnitude or direction of change in outcomes related to physical functioning . Conclusions : Delivery of a st and ardized resistive exercise PT intervention is feasible during outpatient radiation therapy and is associated with preserved physical well-being . However , benefits were not sustained , and fatigue was not affected A 14-item , self-administered , multidimensional , functional social support question naire was design ed and evaluated on 401 patients attending a family medicine clinic . Patients were selected from r and omized time-frame sampling blocks during regular office hours . The population was predominantly white , female , married , and under age 45 . Eleven items remained after test-retest reliability was assessed over a 1- to 4-week follow-up period . Factor analysis and item remainder analysis reduced the remaining 11 items to a brief and easy-to-complete two-scale , eight-item functional social support instrument . Construct validity , concurrent validity , and discriminant validity are demonstrated for the two scales ( confidant support — five items and affective support —three items ) . Factor analysis and correlations with other measures of social support suggest that the three remaining items ( visits , instrumental support , and praise ) are distinct entities that may need further study Supportive-Expressive Group Therapy ( SEGT ) has been developed and manualised in the research setting , but there have been few clinical accounts of its utility . In this qualitative review of its application in the Melbourne-based r and omised control trial ( RCT ) for women with advanced breast cancer , SEGT is considered from the perspective of the structure and framework of therapy , its therapists , the issues that develop in exploring its common themes and what constitutes a well functioning group . Groups move through identifiable developmental phases . The mature group process transforms existential ambivalence into creative living , evidence d by humour , celebration , assertiveness , altruism , new creative pursuits and eventually courageous acceptance of dying . Challenges and pitfalls include avoidance , non-containment of ambivalence , intolerance of difference , anti-group phenomena and splitting . A key element is the medicalization of the group culture whereby members and co-therapists explore health beliefs and attitudes about care . This promotes compliance with anti-cancer treatments , including both the initiation of and perseverance with chemotherapy .  This mechanism could prove to be a potentially important pathway in promoting longer survival To evaluate the effectiveness of palliative day care in improving pain , symptom control , and quality of life ( QOL ) , 120 consecutive new referrals to five specialist palliative day care centers were recruited into a prospect i ve comparative study . Fifty-three comparison patients were identified as those patients receiving usual palliative care services ( home care , inpatient care ) , but did not attend day care .  Patients were assessed at 3 interviews ( baseline , 6 - 8 weeks , and 12 - 15 weeks ) using measures of health-related quality of life : McGill Quality of Life Question naire ( MQOL ) and Palliative Care Outcome Scale ( POS ) . There were two main analyses : 1 ) patient demographic data were analyzed using chi-square ( chi(2 ) ) , and 2 ) QOL data were compared , based on distribution of scores , using the Mann-Whitney test ( MQOL and POS ) , and Wilcoxon Signed Rank for within group differences ( POS data only ) ; P < 0.05 was taken as significant . The patients were representative of those attending palliative day care in the UK . At baseline , the day care group were ( non-significantly ) worse than the comparison group in the MQOL support domain ( P = 0.065 ) . The comparison group had marginally more severe pain at baseline ( P = 0.053 ) and more severe symptoms at second assessment ( P = 0.025 ) . Both patient groups maintained overall health-related quality of life during the three months of the study . Palliative day care was not found to improve overall health-related quality of life . The limitations of the QOL measures in identifying the effects ( patient outcomes ) of palliative day care and the differences between the two patient groups ( age , employment , unequal sample sizes ) were limitations of the study and indicate the need for further research in this area Background Hospice day care ( HDC ) services have developed but no trials evaluate their impact on the other health and social care services . Purpose The purpose of this study was to evaluate the effect of HDC on the use of health and social services in a prospect i ve quasi-experimental study . Methods The trial compared consecutive patients receiving HDC , with two control groups : a ‘ before ’ group and a ‘ st and ard care ’ group .  All data was collected in face to face interviews at baseline and then at 6–8 weeks and 12–15 weeks . The health and social service use at baseline and follow-up interviews were examined by five categories ( community , hospice , social care support , hospital , and therapist ) . The multivariate analysis of covariance ( MANCOVA ) was used to test service use differences between groups , adjusting for potential confounders . Results In total , 37 , 50 , and 76 patients were recruited to the day care , st and ard care and before groups . Patients in the HDC group used significantly more social care support ( 11.5 ± 18.9 versus 3.2 ± 10.0 , P = 0.015 ) and therapists ( 0.9 ± 1.7 versus 0.2 ± 0.4 , P = 0.009 ) than the st and ard care at the baseline . The therapist service use from the baseline to the first follow-up reduced ( mean change ± SD , −0.3 ± 0.6 ; 95%CI , −0.7 to 0.0 ) in the HDC group and increased in the st and ard care group ( mean change ± SD , 0.1 ± 0.5 ; 95%CI , −0.1 to 0.3 ) , the difference was significant ( P = 0.003 ) . No other changes in service use were significant in other study periods . Conclusions HDC appears to supplement existing services with little effect on the other community and hospital services PURPOSE The primary goal of this study was to evaluate the feasibility and effectiveness of a structured , multidisciplinary intervention targeted to maintain the overall quality of life ( QOL ) , which is more comprehensive than psychosocial distress , of patients undergoing radiation therapy for advanced-stage cancer . PATIENTS AND METHODS Radiation therapy patients with advanced cancer and an estimated 5-year survival rate of 0 % to 50 % were r and omly assigned to either an eight-session structured multidisciplinary intervention arm or a st and ard care arm . The eight 90-minute sessions addressed the five domains of QOL including cognitive , physical , emotional , spiritual , and social functioning . The primary end point of maintaining overall QOL was assessed by a single-item linear analog scale ( Linear Analog Scale of Assessment or modified Spitzer Uniscale ) . QOL was assessed at baseline , week 4 ( end of multidisciplinary intervention ) , week 8 , and week 27 . RESULTS Of the 103 participants , overall QOL at week 4 was maintained by the patients in the intervention ( n = 49 ) , whereas QOL at week 4 significantly decreased for patients in the control group ( n = 54 ) . This change reflected a 3-point increase from baseline in the intervention group and a 9-point decrease from baseline in the control group ( P = .009 ) . Intervention participants maintained their QOL , and controls gradually returned to baseline by the end of the 6-month follow-up period . CONCLUSION Although intervention participants maintained and actually improved their QOL during radiation therapy , control participants experienced a significant decrease in their QOL . Thus , a structured multidisciplinary intervention can help maintain or even improve QOL in patients with advanced cancer who are undergoing cancer treatment BACKGROUND Patients experience reductions in quality of life ( QOL ) while receiving cancer treatment and several approaches have been proposed to address QOL issues . In this project , the QOL differences between older adult ( age 65 + ) and younger adult ( age 18 - 64 ) advanced cancer patients in response to a multidisciplinary intervention design ed to improve QOL were examined . METHODS This study was registered on Clinical Trials.gov , NCT01360814 . Newly diagnosed advanced cancer patients undergoing radiation therapy  were r and omized to active QOL intervention or control groups . Those in the intervention group received six multidisciplinary 90-minute sessions design ed to address the five major domains of QOL . Outcomes measured at baseline and weeks 4 , 27 , and 52 included QOL ( Linear Analogue Self- Assessment ( LASA ) , Functional Assessment of Cancer Therapy-General ( FACT-G ) ) and mood ( Profile of Mood States ( POMS ) ) . Kruskall-Wallis methodology was used to compare scores between older and younger adult patients r and omized to the intervention . RESULTS Of 131 patients in the larger r and omized controlled study , we report data on 54 evaluable patients ( 16 older adults and 38 younger adults ) r and omized to the intervention . Older adult patients reported better overall QOL ( LASA 74.4 vs. 62.9 , p = 0.040 ) , higher social well-being ( FACT-G 91.1 vs. 83.3 , p = 0.045 ) , and fewer problems with anger ( POMS anger-hostility 95.0 vs. 86.4 , p = 0.028 ) . Long-term benefits for older patients were seen in the anger-hostility scale at week 27 ( 92.2 vs. 84.2 , p = 0.027 ) and week 52 ( 96.3 vs. 85.9 , p = 0.005 ) . CONCLUSIONS Older adult patients who received a multidisciplinary intervention to improve QOL while undergoing advanced cancer treatments benefited differently in some QOL domains , compared to younger adult patients . Future studies can provide further insight on how to tailor QOL interventions for these age groups In a r and omized prospect i ve study of 86 metastatic breast cancer patients by Spiegel et al. in 1989 , the 50 who took part in a group psychosocial intervention  survived on average 18 months longer than the 36 controls who did not . Because the control survival curve looked unusually steep , lacking an expected right-skewed tail , both curves were compared with that of a population from the same region having metastatic breast cancer . When transformed to life-table format , the curves of the control sample and the regional population , neither group having had an intervention , were almost identical for a year , and differed strikingly after 20 months . This led to the hypothesis that the 12 control patients surviving for more than 20 months were an extremely aberrant sample , being subject to the strong biasing influence of possible confounders , of which a considerable number are known , but not including those accounted for in the study . Corollaries to the hypothesis are that the intervention had no effect ; that the intervention curve was in fact equivalent to a control curve with mild sampling departure from that of the regional population ; and that , therefore , the repetition of the study now under way would not yield confirmation of the 1989 study , but rather , would support the hypothesis and the first two corollaries Background For most people , home is the preferred place of care and death . Despite the development of specialist palliative care and primary care models of community based service delivery , people who are dying , and their families/carers , can experience isolation , feel excluded from social circles and distanced from their communities . Loneliness and social isolation can have a detrimental impact on both health and quality of life . Internationally , models of social and practical support at the end of life are gaining momentum as a result of the Compassionate Communities movement . These models have not yet been subjected to rigorous evaluation . The aims of the study described in this protocol are : ( 1 ) to evaluate the feasibility , acceptability and potential effectiveness of The Good Neighbour Partnership ( GNP ) , a new volunteer-led model of social and practical care/support for community dwelling adults in Irel and who are living with advanced life-limiting illness ; and ( 2 ) to pilot the method for a Phase III R and omised Controlled Trial ( RCT ) . Design The INSPIRE study will be conducted within the Medical Research Council ( MRC ) Framework for the Evaluation of Complex Interventions ( Phases 0–2 ) and includes an exploratory two-arm delayed intervention r and omised controlled trial . Eighty patients and /or their carers will be r and omly allocated to one of two groups : ( I ) Intervention : GNP in addition to st and ard care or ( II ) Control : St and ard Care . Recipients of the GNP  will be asked for their views on participating in both the study and the intervention . Quantitative and qualitative data will be gathered from both groups over eight weeks through face-to-face interviews which will be conducted before , during and after the intervention . The primary outcome is the effect of the intervention on social and practical need . Secondary outcomes are quality of life , loneliness , social support , social capital , unscheduled health service utilisation , caregiver burden , adverse impacts , and satisfaction with intervention . Volunteers engaged in the GNP will also be assessed in terms of their death anxiety , death self efficacy , self-reported knowledge and confidence with eleven skills considered necessary to be effective GNP volunteers . Discussion The INSPIRE study addresses an important knowledge gap , providing evidence on the efficacy , utility and acceptability of a unique model of social and practical support for people living at home , with advanced life-limiting illness . The findings will be important in informing the development ( and evaluation ) of similar service models and policy elsewhere both nationally and internationally . Trial registration IS RCT N18400594 18th February 2015
Individuals managing the challenges of life-limiting illness require adequate social support to maintain quality of life .
Qualitative research reports that patients value highly the social support obtained in palliative care interventions such as day care and group therapies .
This systematic review aims to summarise existing quantitative evidence on palliative care interventions that facilitate social support .