Verifying intervention fidelity procedures for a palliative home care intervention with pilot study results.
Ubolrat Piamjariyakul, Angel Smothers, Stephanie Young and 8 others
PMID 34196013WHAT IT FOUND
In a pilot with 10 families, nurse telephone palliative coaching was delivered as planned, with delivery ratings ≥93%.
Patients reported using breathlessness tools, and 50% completed Advance Directives. Small pilot, not proof of effectiveness.
Key findings
01All 10 intervention participants attended every planned FamPALcare session, and the nurse observer rated overall fidelity delivery at ≥93% across the 10 sessions.
02At 3 months, 50% of patients were reported to have completed Advance Directive forms, and a 39% breathlessness improvement (p < .05) was reported after completion of FamPALcare.
03Teach-back showed that one participant needed reinforcement on managing the intervention, one on fatigue, two on hospice and Advance Directives, and three on community resources.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study included only 20 patients and families, with 10 in the intervention group. It was a pilot focused on fidelity, not a definitive test of whether FamPALcare improves patient outcomes. The paper did not report outcomes for the standard care control group. The reported breathlessness improvement was based on pre- and post-intervention measures in the intervention group, not a between-group comparison. The interventionist was from the participants' cultural background and the study was conducted in rural Appalachia, so transfer to other settings is uncertain. The paper gives both a planned session length of 1 to 1.5 hours and an actual average of 45 minutes, so the delivered dosage is not fully clear.
Declared interests
No conflict of interest was declared by the authors.
The easy way to misread this
Do not read the 39% breathlessness improvement (p < .05) or 50% Advance Directive completion as proof that FamPALcare works. The intervention combined telephone coaching, breathlessness strategies, Advance Directive discussion, mailed materials, scripts, and teach-back, and this was a pilot with 10 intervention participants.