Advancing Spiritual Care Through Research

Israeli Ministry of Health funds end-of-life outcomes study

Rambam Health Care Campus, in Haifa, Israel received a 2-year research grant from the Ministry of Health, together with JDC-Eshel, as part of the National Plan to Advance Palliative Care. The study is titled “The impact of psycho-social-spiritual interventions on medical end of life outcomes.” Especially exciting is that this is the first time that Israel’s Ministry of Health is funding spiritual care research, making this a landmark study. Congratulations to Mike Schultz and his team!

Research Goals
To assess the extent to which psycho-social-spiritual (“p-s-s”) interventions (visits with the psychologist, social worker, or spiritual care provider) influence the palliative care outcomes for cancer patients at the end of their lives, if at all. In particular, we will examine the following measures, each of which relates to an explicit or implicit goal of palliative care:

Primary goal:
1) Use of aggressive treatments in the final two weeks of life, including acute hospital care (ICU hospitalization or multiple trips to the ER), intubation, resuscitation, dialysis, central catheterization, pleural drain, and CPAP (continuous positive airway pressure).

Secondary goals:
2) # of days hospitalized as a percent of total # of days from being enrolled in study until death.
3) # of days between the last systemic oncologic treatment and death.
4) Completion of advanced directives or the appointment of a health care proxy (HCP).
5) # of days enrolled in hospice, if any.
6) Place of death (Home/nursing home vs. hospital).

Research Hypotheses 
We anticipate finding a positive correlation between increased psycho-social-spiritual (“p-s-s”) interventions and time from last treatment to death, completion of advanced directives, and use of hospice. We anticipate finding a negative correlation between p-s-s intervention and the use of aggressive treatments in the EoL, dying in the hospital, and the percent of remaining life hospitalized.

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