Integration of a Palliative Care Intervention into Community Practice for Lung Cancer: A Study Protocol and Lessons Learned with Implementation
| Autor: | Huong Q. Nguyen, Nora Ruel, Karisa Jahn, Thomas Cuyegkeng, Tami Borneman, Mayra Macias, Betty Ferrell, Tieu O. Phung |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Lung Neoplasms Palliative care California 03 medical and health sciences 0302 clinical medicine Quality of life (healthcare) Nursing Carcinoma Non-Small-Cell Lung Intervention (counseling) medicine Humans Community Health Services Prospective Studies 030212 general & internal medicine Lung cancer General Nursing Aged Protocol (science) business.industry Palliative Care Cancer Original Articles General Medicine Middle Aged medicine.disease Anesthesiology and Pain Medicine 030220 oncology & carcinogenesis Family medicine Practice Guidelines as Topic Conventional PCI Community practice Female business |
| Zdroj: | Journal of Palliative Medicine. 20:1327-1337 |
| ISSN: | 1557-7740 1096-6218 |
| DOI: | 10.1089/jpm.2017.0143 |
| Popis: | A notable gap in the evidence base for outpatient palliative care (PC) for cancer is that most trials were conducted in specialized oncology or academic centers with limited translation and further evaluation in "real-world" settings. Health systems are desperate for guidance regarding the most effective and sustainable PC service models.Describe the study protocol to evaluate the dissemination of a previously tested nurse-led PC intervention (PCI) for patients with lung cancer and their family caregiver in community-based settings, lessons learned in adapting and implementing the PCI, and implications for future dissemination-translational efforts Design: Two-group, prospective sequential, quasi-experimental design with Phase 1 (Usual care) followed by Phase 2 (Intervention) setting/subjects. Three Kaiser Permanente Southern California sites. Patients with stage 2-4 nonsmall cell lung cancer and their caregiver.Standard measures of quality of life (QOL; FACT-L, FACIT- SP12, City of Hope Family QOL), symptom burden, distress, and caregiver preparedness and perceived burden.Adaptations were made to the PCI (comprehensive patient/caregiver assessment, interdisciplinary care planning, and patient/caregiver education) to harmonize with existing workflows, minimize burden to patients, caregivers, and the PC team, and maximize chances of sustainability. Implementation facilitators include external competitive pressures, internal readiness, and adaptability of the PCI. Barriers include the changing lung cancer therapeutic landscape and perceived need for PC support by patients and providers, insufficient staffing, and people-dependent processes.Efforts to disseminate and implement previously tested PC models into real-world community practices need to be more realistic and consider the local context. |
| Databáze: | OpenAIRE |
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