Challenges of recruiting hospice patients with advanced cancer to research : reflections on a delirium screening study

Rainsford, Suzanne, Bullen, Tracey, & Rosenberg, John P. (2015) Challenges of recruiting hospice patients with advanced cancer to research : reflections on a delirium screening study. Progress in Palliative Care, 23(1), pp. 24-28.

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Delirium research in palliative care, particularly in the dying phase, is possible but is frequently met with ethical and methodological challenges. This paper describes the challenges faced in a previous delirium screening study.


Within 72 hours of admission to an acute inpatient specialist palliative care unit one hundred consecutive patients over 18 years of age with advanced cancer were invited to be screened for delirium using validated screening tools.


Of the 100 consecutive admissions 49 patients were unable to participate including seven who did not meet the inclusion criteria and nine (six families and three patients) who withheld consent. The remaining 33 patients were more unwell and closer to death than those who were recruited. Reasons for non- participation included being too unwell (ten), unresponsive (nine), died (two) or discharged (three) before recruitment and exceeding the 72hour time limit (nine).


Gate keeping and physical condition of patients were the main obstacles to recruitment and is consistent with barriers faced in previous studies involving palliative care and dying patients. While it is possible and necessary to conduct studies in palliative care, including the terminal phase, as reflective practitioners we must maintain the balance between the demands for evidence-based practice and our compassion and respect for our most vulnerable of patients.

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1 citations in Scopus
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ID Code: 69010
Item Type: Journal Article
Refereed: Yes
Additional URLs:
Keywords: Palliative care, Advanced cancer, Research recruitment, Inpatient hospice, Challenges of recruiting, Delirium, Gatekeeping, Study design
DOI: 10.1179/1743291X14Y.0000000089
ISSN: 0969-9260
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000) > Nursing not elsewhere classified (111099)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Schools > School of Nursing
Copyright Owner: Copyright 2014 The Authors
Deposited On: 21 Mar 2014 01:49
Last Modified: 07 Mar 2016 14:20

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