Palliative Medicine Research

Cognitive-behavioral intervention for insomnia and worry

Patients with advanced cancer frequently experience multiple overlapping psychological and physical symptoms (pain, fatigue, insomnia, anxiety, depression). The most common approach to managing these symptoms is to focus on individual symptoms – at times to the exclusion of other more pressing symptoms. Two of the most common and stressful symptoms of patients with advanced disease are insomnia and worry. Individuals with cancer frequently spend many sleepless nights with uncontrolled symptoms and anxiety about these symptoms or the impact of the disease on their family. This study examines the impact of a cognitive-behavioral “symptom cluster” intervention on patient biobehavioral outcomes (uncertainty, sleep, immunity).

Palliative care needs assessment

Despite the benefits of palliative care in reducing symptoms and improving overall quality of life for patients with advance disease, in most cancer centers referral to such services tends to be low. Palliative care is often confused with hospice care – so referrals often come late in the disease process, when patients and families are experiencing symptom crises. This project examines the rates and predictors of referrals for palliative care services across multiple types of cancer. This study also examines predictors of distress among patients with different sites and phases of disease in order develop clinical-research collaborations to tailor palliative care services to patients who might need it most.