Clinical trial – conducted at National Cancer Institute on end-of-life decision making for cancer patients
The National Cancer Institute consducted a clinical trial to find out if viewing the end-of-life video influences decision making of the preferred care given to the patients who suffer from malignant tumors. The purpose of the clinical trial was to determine whether supplementing a verbal description by use of goals-of-care video is likely to improve the end-of-life decision making processes for the patients suffering from malignanat glioma. Research have shown that individuals suffering from advanced cancer, are more comfortable when they are involved in the planning of their end-of-life care. Poor communication can disrupt proper discussions between the patients and the physicians.
Advanced care planning documents are papers that state the type of care that a patient would prefer to be given at the time when they cannot speak (end-of-life). The end-of-life care is divided into three categories. First is life-prolonging care. This care involve extreme measures. For instance, the cardiopulmonary resuscitation (CPR) as well as use of the machines that help to in keeping the cancer patient breathing. The second is basic medical care. This care include just some medicines to treat various treatable infections. The third is the comfort care. This involve keeping the cancer patient free of pain as well as relieveing the disease symptoms but has no life-prolonging medications. Thus, for every patient it is important to communicate information about their preferred end-of-life care that they would prefer when they will not be able to speak for themselves. Patients can only make informed decision when they have enough information.
In this clinical trial by the National Cancer Institute, 50 patients of ge between 27-77 years who suffered from malignant gloima (brain tumor) were involved. The clinical trial was to test whether the patients would make a more informed decisions after watching a video showing the end-of-life treatment options. The reason for choosing malignant gloima was because the this tumour affected people in a wide age blacket. In the clinical trial, 27 patients were subjected to a verbal explanation group. These patients listenend to the verbal narrative that explained the categories of end-of-life care as wellas the limitations of each category of care. The remaining 23 patients were subjected to the verbal narrative and after listening they watched a 6-minute video which was a combination of the same narrative and some visual images of every category of care being explained.
For every patient, the end-of-life care preferred was recorded as well as each patient’s willingness to undergo the cardiopulmonary resuscitation (CPR). The patients were questioned about how well they understood the typeof care explained in the video or the narrative as well as their experience with the video. The clinical trial result indicated that patients were more comfortable watching the video. The video seem to provide the patients with more accurate picture about their clinical reality. The clinical trial indicated that, before the patient make their decision, they must have all the required information to be able to make informed decision about the category of end-of-life care that they prefer, (National Cancer Institute, 2010).
The clinical trial indicated that the end-of-life video play an important role in helping the malignant tumor patients to make decision. The video help patients to understand the CPR. Thus, patients are able to express their preferred end of life care. Since most cancer patients avoid CPR because of its aggressive nature, positive use of video to educate them can help them have crucial information that can assist them in making well informed decisions about the type of end-of-life care they preferred. The research subjects suffering from malignant gloima who viewed the video as well as listened to the verbal description of end-of-life care preferred the comfort measures instead of CPR because they were more informed about the matter, (El-Jawahri, et al. 2009).
El-Jawahri, A., et al. (2009). Use of Video to Facilitate End-of-Life Discussions With Patients With Cancer: A Randomized Controlled Trial. Retrieved November 6, 2014 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3040012/
National Cancer Institute, (2010). Video Eases End-of-Life Care Discussions. Retrieved November 6, 2014 from http://www.cancer.gov/clinicaltrials/results/summary/2010/end-of-life-video0110