Clinicians' Views of Educational Interventions for Carers of Patients With Breathlessness Due to Advanced Disease: Findings From an Online Survey

被引:13
作者
Ewing, Gail [1 ]
Penfold, Clarissa [1 ]
Benson, John A. [1 ]
Mahadeva, Ravi [4 ]
Howson, Sophie [2 ]
Burkin, Julie [4 ]
Booth, Sara [1 ]
Lovick, Roberta [3 ]
Gilligan, David [4 ]
Todd, Christopher [5 ]
Farquhar, Morag [6 ]
机构
[1] Univ Cambridge, Cambridge, England
[2] Cambridge & Peterborough NHS Fdn Trust, Cambridge, England
[3] Lay Carer Representat, Cambridge, England
[4] Cambridge Univ Hosp NHS Fdn Trust, Cambridge, England
[5] Univ Manchester, Manchester, Lancs, England
[6] Univ Cambridge, Inst Publ Hlth, Dept Publ Hlth & Primary Care, Forvie Site,Robinson Way, Cambridge CB2 0SR, England
关键词
Breathlessness; intervention; carers; advanced disease; survey; palliative care; clinician views; OBSTRUCTIVE PULMONARY-DISEASE; HOSPICE PALLIATIVE CARE; FAMILY CAREGIVERS; SUPPORT NEEDS; LAY CARERS; OF-LIFE; CANCER; COPD; END; PREVALENCE;
D O I
10.1016/j.jpainsymman.2016.08.015
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Context. Carers' needs in advanced disease, and specifically in relation to breathlessness, are well evidenced. Publications on educational interventions for carers of patients with advanced disease that focus on symptoms are scarce and absent for breathlessness. Objectives. To establish current education provided by clinicians for carers of patients with breathlessness in advanced disease, views about educating carers about breathlessness, and relevant outcomes for a future randomized controlled trial of an educational intervention for carers. Methods. An online survey was completed by 365 clinicians: medical, nursing, and allied health professionals from primary care, hospital, and hospice. Descriptive statistics summarized respondent characteristics and survey responses, and the Chisquared test was applied. Content analysis of free-text comments was conducted. Results. Most clinicians reported educating carers by educating patients at clinical contacts with patients. Carer involvement was largely an ` add-on'; an active carer education strategy, where all carers were invited to attend, was not currently apparent. Clinicians endorsed the importance of educating carers about breathlessness through increasing carer confidence and/ or control, helping patients' better self-manage breathlessness and potentially reducing admissions. Joint education with patients, giving practical advice, and strategies for helping patients were advised. To inform a future trial, clinicians identified improvement in patient outcomes, particularly patient quality of life as very important in enhancing clinician adoption of an educational intervention for carers. Conclusion. This survey revealed an appetite among clinicians for an educational intervention for carers of patients with breathlessness in advanced disease and provided important insights to underpin a future Phase II randomized controlled trial. Crown Copyright (C) 2016 Published by Elsevier Inc. on behalf of American Academy of Hospice and Palliative Medicine. All rights reserved.
引用
收藏
页码:265 / 271
页数:7
相关论文
共 28 条
[1]   Prescribing palliative oxygen: a clinician survey of expected benefit and patterns of use [J].
Abernethy, AP ;
Currow, DC ;
Frith, P ;
Fazekas, BS .
PALLIATIVE MEDICINE, 2005, 19 (02) :168-170
[2]  
[Anonymous], 2010, European Journal of Palliative care, V17, P286
[3]   The dyspnea-anxiety-dyspnea cycle - COPD patients' stories of breathlessness: "It's scary/when you can't breathe" [J].
Bailey, PH .
QUALITATIVE HEALTH RESEARCH, 2004, 14 (06) :760-778
[4]   A systematic review of informal caregivers' needs in providing home-based end-of-life care to people with cancer [J].
Bee, Penny E. ;
Barnes, Pamela ;
Luker, Karen A. .
JOURNAL OF CLINICAL NURSING, 2009, 18 (10) :1379-1393
[5]   'The Hidden Client' - women caring for husbands with COPD: their experience of quality of life [J].
Bergs, D .
JOURNAL OF CLINICAL NURSING, 2002, 11 (05) :613-621
[6]  
Booth Sara, 2003, Palliat Support Care, V1, P337
[7]   Symptoms in patients receiving palliative care: a study on patient-physician encounters in general practice [J].
Borgsteede, Sander D. ;
Deliens, Luc ;
Beentjes, Barry ;
Schellevis, Francois ;
Stallman, Wirn A. B. ;
Van Eijk, Jacques ThM ;
Van der Wal, Gerfit .
PALLIATIVE MEDICINE, 2007, 21 (05) :417-423
[8]   A review of the information and support needs of family carers of patients with chronic obstructive pulmonary disease [J].
Caress, Ann-Louise ;
Luker, Karen A. ;
Chalmers, Karen I. ;
Salmon, Margaret P. .
JOURNAL OF CLINICAL NURSING, 2009, 18 (04) :479-491
[9]   Developing and evaluating complex interventions: the new Medical Research Council guidance [J].
Craig, Peter ;
Dieppe, Paul ;
Macintyre, Sally ;
Michie, Susan ;
Nazareth, Irwin ;
Petticrew, Mark .
BMJ-BRITISH MEDICAL JOURNAL, 2008, 337 (7676) :979-983
[10]   Do the Trajectories of Dyspnea Differ in Prevalence and Intensity By Diagnosis at the End of Life? A Consecutive Cohort Study [J].
Currow, David C. ;
Smith, Joanna ;
Davidson, Patricia M. ;
Newton, Phillip J. ;
Agar, Meera R. ;
Care, M. Pall ;
Abernethy, Amy P. .
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 2010, 39 (04) :680-690