title: Does using the interRAI Palliative Care instrument reduce the needs and symptoms of nursing home residents receiving palliative care?
abstract: This study aimed to evaluate whether using the interRAI Palliative Care instrument (the interRAI PC) in nursing homes is associated with reduced needs and symptoms in residents nearing the end of their lives.
  
  
  
  A quasi-experimental pretest-posttest study using the Palliative care Outcome Scale (POS) was conducted to compare the needs and symptoms of residents nearing the end of their lives in the control and intervention nursing homes. Care professionals at the intervention nursing homes filled out the interRAI PC over the course of a year for all residents aged 65 years and older who were nearing the end of their lives. This intervention was not implemented in the control nursing homes.
  
  
  
  At baseline, POS scores in the intervention nursing homes were lower (more favorable) than in the control nursing homes on the items "pain", "other symptoms", "family anxiety", and the total POS score. Posttest POS scores for "wasted time" were higher (less favorable) than pretest scores in the intervention nursing homes. In the intervention nursing homes where care professionals did not have prior experience with the interRAI Long-Term Care Facilities (LTCF) assessment instrument (n = 8/15), total POS scores were lower (more favorable) at posttest.
  
  
  
  One year after introducing the interRAI PC, no reduction in residents' needs and symptoms were detected in the intervention nursing homes. However, reductions in needs and symptoms were found in the subgroup of intervention nursing homes without prior experience with the interRAI LTCF instrument. This may suggest that the use of an interRAI instrument other than the interRAI PC specifically can improve care. Future research should aim at replicating this research with a long-term design in order to evaluate the effect of integrating the use of the interRAI PC in the day-to-day practices at nursing homes.
authors.affiliation: LUCAS Centre for Care Research and Consultancy,University of Leuven,Leuven,Belgium.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Hermans
authors.affiliation: LUCAS Centre for Care Research and Consultancy,University of Leuven,Leuven,Belgium.
authors.forename: Johanna
authors.initials: J
authors.lastname: De Almeida Mello
authors.affiliation: LUCAS Centre for Care Research and Consultancy,University of Leuven,Leuven,Belgium.
authors.forename: Nele
authors.initials: N
authors.lastname: Spruytte
authors.affiliation: End-of-Life Care Research Group,Vrije Universiteit Brussels and Ghent University,Brussels,Belgium.
authors.forename: Joachim
authors.initials: J
authors.lastname: Cohen
authors.affiliation: LUCAS Centre for Care Research and Consultancy,University of Leuven,Leuven,Belgium.
authors.forename: Chantal
authors.initials: C
authors.lastname: Van Audenhove
authors.affiliation: LUCAS Centre for Care Research and Consultancy,University of Leuven,Leuven,Belgium.
authors.forename: Anja
authors.initials: A
authors.lastname: Declercq
mesh_terms: D000203:Activities of Daily Living / Q000145:classification*; D000368:Aged; D000369:Aged, 80 and over; D017281:Cost of Illness; D005260:Female; D006801:Humans; D008297:Male; D020380:Needs Assessment / Q000145:classification* / Q000639:trends; D009735:Nursing Homes / Q000458:organization & administration / Q000592:standards; D017063:Outcome Assessment, Health Care / Q000379:methods; D010166:Palliative Care / Q000379:methods* / Q000592:standards*; D011594:Psychometrics / Q000295:instrumentation / Q000379:methods
keywords: Comprehensive assessment; Nursing homes; Older adults; Palliative care; the interRAI Palliative Care instrument