Stakeholder perspectives of a pilot multicomponent delirium prevention intervention for adult patients with advanced cancer in palliative care units: A behaviour change theory-based qualitative study.

Green, A; Hosie, A; Phillips, JL; Kochovska, S; Noble, B; Brassil, M; Cumming, A; Lawlor, PG; Bush, SH; Davis, JM; Edwards, L; Hunt, J; Wilcock, J; Phillipson, C; Wesley Ely, E; Parr, C; Lovell, M; Agar, M

Stakeholder perspectives of a pilot multicomponent delirium prevention intervention for adult patients with advanced cancer in palliative care units: A behaviour change theory-based qualitative study.

Green, A

Hosie, A

Phillips, JL Kochovska, S

Noble, B Brassil, M Cumming, A Lawlor, PG Bush, SH Davis, JM Edwards, L Hunt, J Wilcock, J Phillipson, C Wesley Ely, E Parr, C Lovell, M

Agar, M

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Publisher:: SAGE Publications
Publication Type:: Journal Article
Citation:: Palliative Medicine, 2022, 36, (8), pp. 1273-1284
Issue Date:: 2022-09

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Field	Value	Language
dc.contributor.author	Green, A https://orcid.org/0000-0002-7541-3665
dc.contributor.author	Hosie, A https://orcid.org/0000-0003-1674-2124
dc.contributor.author	Phillips, JL
dc.contributor.author	Kochovska, S https://orcid.org/0000-0002-3531-0389
dc.contributor.author	Noble, B
dc.contributor.author	Brassil, M
dc.contributor.author	Cumming, A
dc.contributor.author	Lawlor, PG
dc.contributor.author	Bush, SH
dc.contributor.author	Davis, JM
dc.contributor.author	Edwards, L
dc.contributor.author	Hunt, J
dc.contributor.author	Wilcock, J
dc.contributor.author	Phillipson, C
dc.contributor.author	Wesley Ely, E
dc.contributor.author	Parr, C
dc.contributor.author	Lovell, M https://orcid.org/0000-0002-1407-2748
dc.contributor.author	Agar, M https://orcid.org/0000-0002-6756-6119
dc.date.accessioned	2022-09-30T03:47:05Z
dc.date.available	2022-09-30T03:47:05Z
dc.date.issued	2022-09
dc.identifier.citation	Palliative Medicine, 2022, 36, (8), pp. 1273-1284
dc.identifier.issn	0269-2163
dc.identifier.issn	1477-030X
dc.identifier.uri	http://hdl.handle.net/10453/162191
dc.description.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 (n = 17), physicians (n = 6), patients (n = 6), family caregivers (n = 4), physiotherapists (n = 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.Australian New Zealand Clinical Trials Registry, ACTRN12617001070325; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373168.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	SAGE Publications
dc.relation	National Breast Cancer FoundationPS-17-030
dc.relation.ispartof	Palliative Medicine
dc.relation.isbasedon	10.1177/02692163221113163
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1117 Public Health and Health Services, 1199 Other Medical and Health Sciences
dc.subject.classification	Gerontology
dc.subject.mesh	Adult
dc.subject.mesh	Australia
dc.subject.mesh	Delirium
dc.subject.mesh	Humans
dc.subject.mesh	Neoplasms
dc.subject.mesh	Palliative Care
dc.subject.mesh	Pilot Projects
dc.subject.mesh	Adult
dc.subject.mesh	Australia
dc.subject.mesh	Delirium
dc.subject.mesh	Humans
dc.subject.mesh	Neoplasms
dc.subject.mesh	Palliative Care
dc.subject.mesh	Pilot Projects
dc.subject.mesh	Humans
dc.subject.mesh	Neoplasms
dc.subject.mesh	Delirium
dc.subject.mesh	Palliative Care
dc.subject.mesh	Pilot Projects
dc.subject.mesh	Adult
dc.subject.mesh	Australia
dc.title	Stakeholder perspectives of a pilot multicomponent delirium prevention intervention for adult patients with advanced cancer in palliative care units: A behaviour change theory-based qualitative study.
dc.type	Journal Article
utslib.citation.volume	36
utslib.location.activity	England
utslib.for	1117 Public Health and Health Services
utslib.for	1199 Other Medical and Health Sciences
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/DVC (Research)
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHT - Health Technologies
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
pubs.organisational-group	/University of Technology Sydney/Centre for Health Technologies (CHT)
utslib.copyright.status	closed_access	*
pubs.consider-herdc	false
dc.date.updated	2022-09-30T03:47:04Z
pubs.issue	8
pubs.publication-status	Published
pubs.volume	36
utslib.citation.issue	8

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 (n = 17), physicians (n = 6), patients (n = 6), family caregivers (n = 4), physiotherapists (n = 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.Australian New Zealand Clinical Trials Registry, ACTRN12617001070325; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373168.

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