AI Article Synopsis
- The study looked at how different people, like patients and nurses, felt about a special treatment to prevent delirium (a confused state) in cancer patients at the end of their lives in Australia.
- Researchers talked to 39 people involved in a pilot trial to understand what worked well and what didn't, using ideas from psychology to analyze their answers.
- The findings showed that the treatment fit well with the caring nature of palliative care, but also highlighted some challenges in how the treatment was carried out and understood by everyone involved.
Article Abstract
Background: Theory-based and qualitative evaluations in pilot trials of complex clinical interventions help to understand quantitative results, as well as inform the feasibility and design of subsequent effectiveness and implementation trials.
Aim: To explore patient, family, clinician and volunteer ('stakeholder') perspectives of the feasibility and acceptability of a multicomponent non-pharmacological delirium prevention intervention for adult patients with advanced cancer in four Australian palliative care units that participated in a phase II trial, the 'PRESERVE pilot study'.
Design: A trial-embedded qualitative study via semi-structured interviews and directed content analysis using Michie's Behaviour Change Wheel and the Theoretical Domains Framework.
Setting/participants: Thirty-nine people involved in the trial: nurses ( = 17), physicians ( = 6), patients ( = 6), family caregivers ( = 4), physiotherapists ( = 3), a social worker, a pastoral care worker and a volunteer.
Results: Participants' perspectives aligned with the 'capability', 'opportunity' and 'motivation' domains of the applied frameworks. Of seven themes, three were around the alignment of the delirium prevention intervention with palliative care (intervention was considered routine care; intervention aligned with the compassionate and collaborative culture of palliative care; and differing views of palliative care priorities influenced perspectives of the intervention) and four were about study processes more directly related to adherence to the intervention (shared knowledge increased engagement with the intervention; impact of the intervention checklist on attention, delivery and documentation of the delirium prevention strategies; clinical roles and responsibilities; and addressing environmental barriers to delirium prevention).
Conclusion: This theory-informed qualitative study identified multiple influences on the delivery and documentation of a pilot multicomponent non-pharmacological delirium prevention intervention in four palliative care units. Findings inform future definitive studies of delirium prevention in palliative care., ACTRN12617001070325; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373168.
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| http://dx.doi.org/10.1177/02692163221113163 | DOI Listing |
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