Is early integration of palliative home care in oncology treatment feasible and acceptable for advanced cancer patients and their health care providers? A phase 2 mixed-methods study.
Journal
BMC palliative care
ISSN: 1472-684X
Titre abrégé: BMC Palliat Care
Pays: England
ID NLM: 101088685
Informations de publication
Date de publication:
23 Nov 2020
23 Nov 2020
Historique:
received:
27
03
2020
accepted:
19
10
2020
entrez:
24
11
2020
pubmed:
25
11
2020
medline:
15
7
2021
Statut:
epublish
Résumé
To support the early integration of palliative home care (PHC) in cancer treatment, we developed the EPHECT intervention and pilot tested it with 30 advanced cancer patients in Belgium using a pre post design with no control group. We aim to determine the feasibility, acceptability and perceived effectiveness of the EPHECT intervention. Interviews with patients (n = 16 of which 11 dyadic with family caregivers), oncologists and GPs (n = 11) and a focus group with the PHC team. We further analyzed the study materials and logbooks of the PHC team (n = 8). Preliminary effectiveness was assessed with questionnaires EORTC QLQ C-30, HADS and FAMCARE and were filled in at baseline and 12, 18 and 24 weeks. In the interviews after the intervention period, patients reported feelings of safety and control and an optimized quality of life. The PHC team could focus on more than symptom management because they were introduced earlier in the trajectory of the patient. Telephone-based contact appeared to be insufficient to support interprofessional collaboration. Furthermore, some family caregivers reported that the nurse of the PHC team was focused little on them. Nurses of PHC teams are able to deliver early palliative care to advanced cancer patients. However, more attention needs to be given to family caregivers as caregiver and client. Furthermore, the home visits by the PHC team have to be further evaluated and adapted. Lastly, professionals have to find a more efficient way to discuss future care.
Sections du résumé
BACKGROUND
BACKGROUND
To support the early integration of palliative home care (PHC) in cancer treatment, we developed the EPHECT intervention and pilot tested it with 30 advanced cancer patients in Belgium using a pre post design with no control group. We aim to determine the feasibility, acceptability and perceived effectiveness of the EPHECT intervention.
METHODS
METHODS
Interviews with patients (n = 16 of which 11 dyadic with family caregivers), oncologists and GPs (n = 11) and a focus group with the PHC team. We further analyzed the study materials and logbooks of the PHC team (n = 8). Preliminary effectiveness was assessed with questionnaires EORTC QLQ C-30, HADS and FAMCARE and were filled in at baseline and 12, 18 and 24 weeks.
RESULTS
RESULTS
In the interviews after the intervention period, patients reported feelings of safety and control and an optimized quality of life. The PHC team could focus on more than symptom management because they were introduced earlier in the trajectory of the patient. Telephone-based contact appeared to be insufficient to support interprofessional collaboration. Furthermore, some family caregivers reported that the nurse of the PHC team was focused little on them.
CONCLUSION
CONCLUSIONS
Nurses of PHC teams are able to deliver early palliative care to advanced cancer patients. However, more attention needs to be given to family caregivers as caregiver and client. Furthermore, the home visits by the PHC team have to be further evaluated and adapted. Lastly, professionals have to find a more efficient way to discuss future care.
Identifiants
pubmed: 33228662
doi: 10.1186/s12904-020-00673-3
pii: 10.1186/s12904-020-00673-3
pmc: PMC7685643
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
174Subventions
Organisme : Agentschap voor Innovatie door Wetenschap en Technologie
ID : SBO-IWT 140009
Références
Am Soc Clin Oncol Educ Book. 2013;:144-50
pubmed: 23714482
J Clin Oncol. 2015 May 1;33(13):1438-45
pubmed: 25800768
Eur J Cancer. 2016 Sep;65:61-8
pubmed: 27472648
Palliat Med. 2009 Dec;23(8):698-707
pubmed: 19825895
Lancet Oncol. 2018 Mar;19(3):394-404
pubmed: 29402701
J Clin Oncol. 2017 Mar 10;35(8):834-841
pubmed: 28029308
J Palliat Med. 2000 Fall;3(3):287-300
pubmed: 15859670
Ann Oncol. 2005 Jul;16(7):1185-91
pubmed: 15849218
JAMA. 1998 May 13;279(18):1489-91
pubmed: 9600488
Palliat Med. 2018 Jul;32(7):1275-1282
pubmed: 29741457
Palliat Med. 2017 Jan;31(1):72-81
pubmed: 27495814
Oncologist. 2015 Jan;20(1):77-83
pubmed: 25480826
BMJ Support Palliat Care. 2019 May 8;:
pubmed: 31068333
J Clin Oncol. 2018 Apr 10;36(11):1096-1102
pubmed: 29474102
Oncol Nurs Forum. 2013 Jan;40(1):E32-40
pubmed: 23269779
J Natl Compr Canc Netw. 2013 Mar;11 Suppl 1:S11-6
pubmed: 23520181
J Interprof Care. 2013 Jul;27(4):313-9
pubmed: 23181267
BMJ. 2008 Sep 29;337:a1655
pubmed: 18824488
Psychol Med. 1997 Mar;27(2):363-70
pubmed: 9089829
Health Place. 2014 May;27:77-83
pubmed: 24577161
BMC Palliat Care. 2013 Feb 15;12:7
pubmed: 23414145
Support Care Cancer. 2015 Sep;23(9):2677-85
pubmed: 25676486
Curr Oncol. 2014 Apr;21(2):84-90
pubmed: 24764697
BMC Geriatr. 2018 Feb 14;18(1):47
pubmed: 29444645
Soc Sci Med. 1993 Mar;36(5):693-701
pubmed: 8456339
J Palliat Med. 2010 Sep;13(9):1071-7
pubmed: 20799902
Eur J Cancer. 2002 Mar;38 Suppl 4:S125-33
pubmed: 11858978
Ann Oncol. 2015 Sep;26(9):1953-1959
pubmed: 26088196
N Engl J Med. 2010 Aug 19;363(8):733-42
pubmed: 20818875
Lancet. 2014 May 17;383(9930):1721-30
pubmed: 24559581
J Support Oncol. 2013 Jun;11(2):68-74
pubmed: 23967494
J Palliat Med. 2011 Apr;14(4):459-64
pubmed: 21417739
Palliat Support Care. 2013 Oct;11(5):415-23
pubmed: 23040412
Trials. 2014 Jul 05;15:267
pubmed: 24996765
Ann Palliat Med. 2016 Jan;5(1):22-9
pubmed: 26841812
Cochrane Database Syst Rev. 2013 Jun 06;(6):CD007760
pubmed: 23744578
J Palliat Med. 2014 May;17(5):553-8
pubmed: 24588685
J Palliat Med. 2015 Nov;18(11):962-9
pubmed: 26305992
Curr Oncol. 2016 Dec;23(6):374-377
pubmed: 28050132
JAMA. 2009 Aug 19;302(7):741-9
pubmed: 19690306
BMC Health Serv Res. 2015 Dec 15;15:554
pubmed: 26666301