5 results on '"Palmisano, Lucia"'
Search Results
2. Randomized controlled trial of a home-based palliative approach for people with severe multiple sclerosis
- Author
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Solari, Alessandra, Giordano, Andrea, Patti, Francesco, Grasso, Maria Grazia, Confalonieri, Paolo, Palmisano, Lucia, Ponzio, Michela, Borreani, Claudia, Rosato, Rosalba, Veronese, Simone, Zaratin, Paola, and Battaglia, Mario Alberto
- Subjects
Multiple sclerosis ,caregivers ,symptom burden ,palliative care ,quality of life ,randomized controlled trial - Published
- 2017
3. Randomized controlled trial of a home-based palliative approach for people with severe multiple sclerosis.
- Author
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Solari, Alessandra, Giordano, Andrea, Patti, Francesco, Grasso, Maria Grazia, Confalonieri, Paolo, Palmisano, Lucia, Ponzio, Michela, Borreani, Claudia, Rosato, Rosalba, Veronese, Simone, Zaratin, Paola, and Battaglia, Mario Alberto
- Subjects
PALLIATIVE treatment ,MULTIPLE sclerosis ,HEALTH outcome assessment ,QUALITY of life ,DYADS ,PATIENTS - Abstract
Background: Evidence on the efficacy of palliative care in persons with severe multiple sclerosis (MS) is scarce. Objective: To assess the efficacy of a home-based palliative approach (HPA) for adults with severe MS and their carers. Methods: Adults with severe MS-carer dyads were assigned (2:1 ratio) to either HPA or usual care (UC). At each center, a multi-professional team delivered the 6-month intervention. A blind examiner assessed dyads at baseline, 3 months, and 6 months. Primary outcome measures were Palliative care Outcome Scale-Symptoms-MS (POS-S-MS) and Schedule for the Evaluation of Individual Quality of Life-Direct Weighting (SEIQoL-DW, not assessed in severely cognitively compromised patients). Results: Of 78 dyads randomized, 76 (50 HPA, 26 UC) were analyzed. Symptom burden (POS-S-MS) significantly reduced in HPA group compared to UC (p = 0.047). Effect size was 0.20 at 3 months and 0.32 at 6 months, and statistical significance was borderline in per-protocol analysis (p = 0.062). Changes in SEIQoL-DW index did not differ in the two groups, as changes in secondary patient and carer outcomes. Conclusion: HPA slightly reduced symptoms burden. We found no evidence of HPA efficacy on patient quality of life and on secondary outcomes. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
4. Home-based palliative approach for people with severe multiple sclerosis and their carers: study protocol for a randomized controlled trial.
- Author
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Solari, Alessandra, Giordano, Andrea, Grasso, Maria Grazia, Confalonieri, Paolo, Patti, Francesco, Lugaresi, Alessandra, Palmisano, Lucia, Amadeo, Roberta, Martino, Giovanni, Ponzio, Michela, Casale, Giuseppe, Borreani, Claudia, Causarano, Renzo, Veronese, Simone, Zaratin, Paola, and Battaglia, Mario Alberto
- Subjects
MULTIPLE sclerosis ,PALLIATIVE treatment ,CLINICAL trials ,QUALITY of life - Abstract
Background: Preliminary evidence suggests that palliative care may be useful for people with severe multiple sclerosis (MS). The aim of this study is to determine the effectiveness of a home-based palliative approach (HPA) for people with severe MS and their carers. Methods/design: This is a single-blind randomized controlled trial with a nested qualitative study. Seventy-five severe MS-carer dyads are being randomized (at three centers, one in each area of Italy) to HPA or usual care (UC) in a 2:1 ratio. Each center has a specially trained team consisting of four professionals (physician, nurse, psychologist, social worker). The team makes a comprehensive assessment of the needs of the dyads. HPA content is then agreed on, discussed with the patient's caring physician, and delivered over six months. The intervention is not intended to replace existing services. At later visits, the team checks the HPA delivery and reviews/modifies it as necessary. HPA and UC dyads are assessed at home by a blind examiner at baseline, and three and six months later; they also receive monthly telephone interviews. Dyads assigned to UC receive the examiner's visits and telephone interviews, but not the team visits. Primary outcome measures are changes in symptoms (Palliative care Outcome Scale-Symptoms-MS, POS-S-MS), and quality of life (the Schedule for the Evaluation of Individual Quality of Life-Direct Weighting (SEIQoL-DW), not assessed in patients with severe cognitive compromise) at three and six months. Other outcomes are changes in patient functional status and mood; changes in carer quality of life, mood and caregiving burden; costs; incorporation with standard care; unplanned hospital admissions; referrals to hospice; and deaths. The experience of participants will be evaluated qualitatively by individual semi-structured interviews (HPA patients and carers) and focus group meetings (HPA patients' caring physicians). Discussion: The results of our study will show whether the HPA is feasible and beneficial to people with severe MS and their carers living in the three Italian geographic areas. The nested qualitative study will add to the understanding of the strengths and limitations of the intervention. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
5. Low quality of life and psychological wellbeing contrast with moderate perceived burden in carers of people with severe multiple sclerosis
- Author
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Giordano, A, Cimino, V, Campanella, A, Morone, G, Fusco, A, Farinotti, Palmisano, L, Confalonieri, P, Lugaresi, A, Grasso, Mg, Ponzio, M, Veronese, S, Patti, Francesco, Solari, A, on behalf of the, Pensami, Project, Giordano, Andrea, Cimino, Vincenzo, Campanella, Angela, Morone, Giovanni, Fusco, Augusto, Farinotti, Mariangela, Palmisano, Lucia, Confalonieri, Paolo, Lugaresi, Alessandra, Grasso, Maria Grazia, Ponzio, Michela, Veronese, Simone, Patti, Francesco, Solari, Alessandra, and PeNSAMI project
- Subjects
Male ,Palliative care ,health care facilities, manpower, and services ,Hospital Anxiety and Depression Scale ,Severity of Illness Index ,Outcome measure ,0302 clinical medicine ,Primary progressive multiple sclerosis ,Cost of Illness ,Surveys and Questionnaires ,Medicine ,030212 general & internal medicine ,Depression (differential diagnoses) ,health care economics and organizations ,Aged, 80 and over ,Secondary progressive multiple sclerosis ,Illness burden ,Middle Aged ,humanities ,Caregivers ,Neurology ,Spouse ,behavior and behavior mechanisms ,Anxiety ,Secondary progressive multiple sclerosi ,Female ,medicine.symptom ,Clinical psychology ,Adult ,Employment ,Quality of life ,Multiple Sclerosis ,03 medical and health sciences ,Young Adult ,Quality of life (healthcare) ,Humans ,Socioeconomic status ,Aged ,Psychiatric Status Rating Scales ,business.industry ,social sciences ,Caregiver ,Mood ,Cross-Sectional Studies ,Primary progressive multiple sclerosi ,Socioeconomic Factors ,Multivariate Analysis ,Linear Models ,Perception ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
Background: Few studies have investigated wellbeing and burden in carers of peoplewith severe multiple sclerosis (PwSMS). Objectives: To assess the impact of providing care to PwSMS, and explore variables associated with perceived carer burden. Methods: Cross-sectional assessment of health-related quality of life (HRQOL), mood symptoms (Hospital Anxiety and Depression Scale, HADS), and perceived carer burden (22-item Zarit Burden Interview, ZBI) in 78 PwSMS carers. Multivariate linear regression explored carer and PwSMS factors associated with ZBI score. Results: Carers (61%women, mean age 60.2 years, 53% spouse/partner) had significantly lower HRQOL (all SF-36 scales) than the norm, especially for Role Limitation Emotional/Physical, and Emotional Wellbeing. Sixty-eight percent had pathologic (≥8) Anxiety, and 44% had pathologic Depression scores on HADS. Nonetheless, perceived carer burdenwas only moderate (mean ZBI score 35.6, SD 14.3). High carer anxiety (p < 0.0001), low household income (p= 0.009), and living with the PwSMS (p= 0.02) were independent predictors of perceived burden. Conclusions: Caring for PwSMS has a detrimental effect on HRQOL and psychological wellbeing. High carer anxiety, loweconomic status, and living in predict higher burden. It is crucial to recognize PwSMS carers as full partners in the provision of care, and to respond to their own needs.
- Published
- 2016
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