This article presents a metasynthesis of the literature from 1996 through 2005 on randomized clinical or controlled trials comparing effects of tailored interventions to those of control conditions or other interventions. A search was conducted for publications written in English using the terms "patient-centered interventions," "tailored interventions," and "individualized interventions," using Ovid and Elton B. Stephens Company (EBSCO) Host databases. A total of 245 publications were located after deleting duplicates. An additional six studies were identified from two syntheses of intervention research. A total of 63 studies met the inclusion criteria, and 49 of these reported that tailored interventions were superior to control conditions for one or more of the main outcomes. The evidence strongly supports the efficacy of tailored behavioral interventions and provides beginning support for the efficacy of tailored psychosocial and biological interventions.
The nursing home is a major setting for death and dying in the United States, yet palliative care approaches are underused in these facilities. Nurse practitioners are increasingly responsible for the management of these patients and their families. Although they are well suited to provide palliative care, most nurse practitioners have not received formal education about this specialty practice.The purpose of this project was to develop, implement, and evaluate an online educational program designed to improve the knowledge of nurse practitioners who are directing and delivering care in nursing home facilities across the United States. Aims included (1) develop and deliver three learning modules; (2) measure improvement in knowledge by comparing pretest and posttest examination scores; and (3) describe relationships between nurse practitioner characteristics and examination scores. This educational project was based on the well-established End-of-Life Nursing Education Consortium curriculum.One hundred seven nurse practitioners registered for the program; 99 completed the program. Program evaluations were extraordinarily positive. Strong reliability of the test was demonstrated. A statistically significant difference in the mean pretest and posttest scores indicated significant learning gains among the participants. Reported level of confidence in providing palliative care increased from the beginning to the end of the program. Nearly 93% of participants reported changing their practice as a result of this program. These findings support both the need and the strength of the program.
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