Personalized Experiences to Inform Improved Communication for Minorities With Life Limiting Illness
29. januar 2021 opdateret af: University of Colorado, Denver
The purpose of this research is to develop patient-centered palliative care interventions to improve patient-provider communication and Quality of Life (QoL) of ethnic and racial minority patients living with life-limiting illnesses.
Eliciting personal experiences is an effective way for patients to communicate their cultural values and beliefs.
This study will assess how to integrate the patients' personal experience narratives into the electronic health record (EHR).
The primary hypothesis is that the implementation of a patient-centered intervention to elicit personal experiences that are included in the EHR will improve patient-provider communication and patients' QoL.
Studieoversigt
Status
Afsluttet
Betingelser
Detaljeret beskrivelse
Racial and ethnic minority patients with a Life Limiting Illnes (LLI) in the United States are underserved in many ways, including quality of palliative care.
Specific disparities have been reported in palliative care for minority patients, including sub-optimal patient-provider communication and resulting lower QoL.
A potential approach to improve communication is to elicit patients' personal narratives that address their cultural or spiritual values and beliefs, and include them in the EHR.
The objective of this observational study is to assess the feasibility and efficacy of a palliative care nursing intervention designed to 1) identify barriers and facilitators for eliciting and recording relevant narratives from the perspectives of the key stakeholders: minority patients with LLI; 2) to conduct usability testing, applying a user-system-environment evaluation process to determine essential requirements for integration of the patient-centered narratives into the EHR; and 3) identify barriers and facilitators of integration of the patient's narrative into daily workflow from the perspectives of key stakeholders: acute care bedside nurse.
Undersøgelsestype
Observationel
Tilmelding (Faktiske)
38
Kontakter og lokationer
Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.
Studiesteder
-
-
Colorado
-
Aurora, Colorado, Forenede Stater, 80045
- University Of Colorado Hospital
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-
Deltagelseskriterier
Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.
Berettigelseskriterier
Aldre berettiget til at studere
18 år og ældre (Voksen, Ældre voksen)
Tager imod sunde frivillige
Ja
Køn, der er berettiget til at studere
Alle
Prøveudtagningsmetode
Ikke-sandsynlighedsprøve
Studiebefolkning
Inpatient population description:
Patient's on inpatient with the following diagnoses:
- COPD
- Heart Failure
- Cancer
Nurse patient population:
Bedside nurses who are involved in the care of a patient who is participating in the storytelling intervention with the diagnoses listed above.
Beskrivelse
Inclusion Criteria: Patients
- 18 years of age or older
- able to read English
- capable of giving informed consent
- self-identifying as part of a racial or ethnic minority
diagnosed with at least one LLI. The operational definition of LLI eligible for this study includes the following diagnoses:
- metastatic solid cancer or inoperable lung cancer;
- COPD with FEV1 values < 35% predicted or oxygen dependence;
- New York Heart Association Class III or IV heart failure (CHF).
Inclusion criteria: Nurse
- 18 years of age or older
- Confirm verbally that they were involved in the care of a patient who is participating in the storytelling intervention
Studieplan
Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
Kohorter og interventioner
Gruppe / kohorte |
Intervention / Behandling |
|---|---|
|
Inpatient Participants
Patients admitted to University of Colorado Hospital with at least one of the following diagnoses:
|
The storytelling intervention consists of an audio-recorded interview with each patient participant prompted the participant to share their story with questions such as: tell me about your illness, tell me how your illness has affected your emotions, relationships, and spirituality.
The interview transcripts will be used to co-create a 1 page patient story using these criteria:1) written in the first person; 2) nonjudgmental; 3) captures the participant's voice; 4) accurately reflects content of the interview; and 5) non-labeling.
Once the story has been approved by the participant, I will upload it to the EHR.
|
|
Nurse Participants
Bedside nurses who provide care at the inpatient level for the following diseases:
|
Once the patient's story is uploaded to the EHR, automatic alerts will be sent to the participant's EHR-assigned nurses.
For usability testing, nurse participants will 1) provide content expertise of the workflow processes, and 2) put the storytelling intervention through in-house usability testing to check the "strength" of EHR features and user-friendliness.
Data will be collected with exit interviews and completion of a questionnaire: the System Usability Scale which asks them to rank their satisfaction with specific elements such as: how the story is labeled and presented in the EHR, any technical navigation EHR difficulties, and use of the material.
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Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Number of Completed Exit Interviews From Patients on Feasibility of Their Use of Their Narrative Integrated Into EHR
Tidsramme: 1-2 weeks
|
Using an observational design, this measure (exit interviews) were completed with 20 inpatient participants and 18 nurse participants.
The qualitative data from the interviews were used to define and refine the storytelling intervention.
The data collected from the exit interview is qualitative in nature and therefore does not have a numerical value.
|
1-2 weeks
|
Andre resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Usability Assessment Via the System Usability Scale(SUS), Range of 0 to 100, With Higher Number Representing a Better Outcome SUS Scores Have a Range of 0 to 100, the Higher the Number Represents a Better Outcome.
Tidsramme: 1-2 weeks
|
This study will utilize an observational design to define and refine the storytelling intervention, seeking input from the key stakeholders: providers (acute care bedside nurses).The SUS scale is a 10 item Likert scale which gives a global view of subjective assessment of usability with five item responses options from strongly agree to strongly disagree.
SUS yields a single number representing a composite measure of the overall usability of the system being studied.
Note that scores for individual items are not meaningful on their own.
To calculate the SUS score, first sum the score contributions from each item.
Each item's score contribution will range from 0 to 4. For items 1,3,5,7, and 9, the score contribution is the scale position minus 1.
For items 2,4,6,8, and 10, the contribution is 5 minus the scale position.
Multiply the sum of the scores by 2.5 to obtain the overall value of the SUS, with the higher the number, the better the outcome.
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1-2 weeks
|
Samarbejdspartnere og efterforskere
Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.
Sponsor
Samarbejdspartnere
Publikationer og nyttige links
Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.
Datoer for undersøgelser
Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.
Studer store datoer
Studiestart (Faktiske)
15. november 2017
Primær færdiggørelse (Faktiske)
30. november 2018
Studieafslutning (Faktiske)
30. november 2018
Datoer for studieregistrering
Først indsendt
8. december 2017
Først indsendt, der opfyldte QC-kriterier
28. december 2017
Først opslået (Faktiske)
5. januar 2018
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
18. februar 2021
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
29. januar 2021
Sidst verificeret
1. januar 2021
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- 17-1885.cc
- 1K99NR016686-01A1 (U.S. NIH-bevilling/kontrakt)
Plan for individuelle deltagerdata (IPD)
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