Acceptability and Usability of an Evidence-Based Program to Coach Newly Diagnosed Patients
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Date
2021-05
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Publisher
The Ohio State University
Abstract
Introduction & Background
1.8 million Americans are diagnosed with cancer every year. Telling loved ones, especially children, about a cancer diagnosis can be very difficult. However, disclosure to children is important to cope with changes and hardships that can follow the diagnosis. Healthcare providers play a large role in coaching cancer patients; however, many may feel unqualified to teach parents about disclosure of the cancer diagnosis to children. Thus, an evidence-based workshop entitled "How Should We Tell the Kids?" was developed and implemented to train healthcare staff on cancer disclosure coaching to help parents and grandparents. Participants completed a workshop evaluation and self-assessment (current practices along with pre- and post-workshop confidence in coaching parents in the cancer disclosure conversation). Five, two-hour workshops were delivered to 78 healthcare staff members by interactive lecture and role-playing. The purpose of this study is to understand the acceptability and usability of the workshop.
Methods
Based on findings from the previous evaluations, a semi-structured follow-up interview protocol was developed to understand the relevance and format of the topics covered in the workshop, how the attendee implemented what they learned into their practice, their experiences with holding disclosure conversations, the usefulness of the resources provided and what could be improved about the program. The interviews were transcribed verbatim and thematically analyzed using NVivo 12 software by two independent coders. Quantitative data was analyzed using the descriptive statistics in SPSS version 24.
Results
Healthcare staff (n = 7) were interviewed (mean years in job title = 3.6 years, mean years in profession = 10.8). All seven participants reported that the program was relevant. Among the staff, the following themes emerged: acceptability, impact of the program, and practice. Analysis of the interview data showed that participants held value in the comprehensiveness of the program, especially in regards to the resources – which included books, videos, and websites – provided. Healthcare staff felt more confident holding disclosure conversations and were discussing disclosure with patients much more frequently in comparison to before the program. Facilitators to holding these conversations included altruism, knowledge, resources, and continuity. Barriers included time, the difficulty of the conversations, anxiety, and COVID-19. Despite the acceptability of the program, participants suggested a variety of changes to improve both the content and delivery of the program.
Conclusions
The "How Should We Tell the Kids" program was the first program developed to educate healthcare professionals about cancer diagnosis disclosure coaching for patients who are parents. The information, and in particular, the resources, included in this program are acceptable among a wide range of oncology healthcare staff. Future iterations will include suggestions for patient needs and outcomes related to this coaching and other objective metrics of quality improvement.