title: Effect of a Nurse-Led Psychoeducational Intervention on Healthcare Service Utilization Among Adults With Advanced Cancer.
abstract: OBJECTIVE
  To examine differences in healthcare service utilization among patients with advanced cancer participating in a nurse-led psychoeducational intervention.
  
  
  METHODS
  Secondary analysis of trial data.
  
  
  METHODS
  Four Michigan cancer centers.
  
  
  METHODS
  484 patients with advanced cancer.
  
  
  METHODS
  Patients were randomized to three groups.
  
  
  METHODS
  Study arm (brief, extensive, or control), ED visitation (one or more times versus none), inpatient hospitalizations (one or more times versus none), and covariates.
  
  
  RESULTS
  No significant differences in ED visits or inpatient hospitalizations were observed among study arms. ED visits were more frequent for patients with lung or colorectal cancer, more comorbidities, and lower baseline QOL. Baseline QOL was associated with inpatient hospitalizations in the adjusted analysis.
  
  
  CONCLUSIONS
  The psychoeducational intervention, either in brief or extensive format, is unlikely to increase healthcare service utilization.
  
  
  CONCLUSIONS
  Efficacious nurse-led psychoeducational interventions to improve QOL do not place undue burdens on the healthcare system and may improve care.
authors.affiliation: VA Center for Clinical Management Research in Ann Arbor, MI.
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Martinez
authors.affiliation: University of Michigan in Ann Arbor.
authors.forename: Christopher
authors.initials: C
authors.lastname: Friese
authors.affiliation: Yale University in New Haven, CT.
authors.forename: Trace
authors.initials: T
authors.lastname: Kershaw
authors.affiliation: Michigan State University.
authors.forename: Charles W
authors.initials: CW
authors.lastname: Given
authors.affiliation: University of Michigan in Ann Arbor.
authors.forename: A Mark
authors.initials: AM
authors.lastname: Fendrick
authors.affiliation: University of Michigan in Ann Arbor.
authors.forename: Laurel
authors.initials: L
authors.lastname: Northouse
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008824:Michigan; D008875:Middle Aged; D009369:Neoplasms / Q000451:nursing* / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010353:Patient Education as Topic; D010361:Patients / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D013997:Time Factors
keywords: advanced cancer; healthcare service utilization; psychoeducational intervention; psychosocial intervention