THE EFFECTS OF HOME NURSING-CARE FOR PATIENTS DURING TERMINAL ILLNESSON THE BEREAVEDS PSYCHOLOGICAL DISTRESS

Background: Although some studies have examined the effects of termina l illness care models such as hospice care on survivor outcomes, no st udies could be found that examined whether nursing care affected such outcomes. Objective: To determine whether specialized oncology home ca re services provided to terminally ill patients with lung cancer posit ively influenced bereavement psychological distress among survivors, c ompared with other models of care.Methods: A secondary analysis was pe rformed to test the effects of home nursing care for terminally ill pa tients on spousal psychological distress during bereavement. Forty-six patient-spousal dyads were randomly assigned to either an oncology ho me care group (OHC), a standard home care group, or an office care con trol group. Patient-spousal dyads were entered into the study 2 months after the patient's diagnosis of lung cancer and received follow-up u ntil the patient died. Bereaved spouses continued to receive follow-up for 25 months after the patient's death. Results: Psychological distr ess was significantly lower initially among spouses of patients that r eceived the OHC intervention compared with the other two groups. Signi ficant mean group differences were found on the subscales of depressio n and paranoid ideation; marginal group differences were found on the subscales of hostility and psychoticism. There were no significant dif ferences among the groups at 25 months. Conclusions: These results sug gest that the bereaved's psychological distress can be positively infl uenced depending on how their loved one is cared for during the termin al phase of illness.