Aims: It is well established that family/friend carers have unique informational and emotional needs, and navigating triadic (health professional-patient-carer) interactions can be complex. Despite this, oncology health professionals (HPs) typically receive limited education in effective communication with carers. We designed and piloted a novel evidence-based online education program for oncology HPs detailing strategies for managing and supporting carer involvement (eTRIO).
Methods: In this pre-post evaluation study, HPs completed baseline measures prior to eTRIO, with post-intervention measures at 1 and 12 weeks. Measures included: 13 item self-efficacy in carer communication scale (primary outcome), 7 item applied knowledge scale, and single item attitudes towards carer involvement in decisions measure. A sub-set of participants completed feedback interviews. Qualitative data was analysed deductively using Thematic Analysis informed by Proctor’s Implementation Outcomes.
Results: Forty-six HPs (16 nurses, 12 social workers, 4 doctors, 4 psychologists, 10 other allied health) completed the intervention (average time spent on module was 66 minutes) and 1-week follow-up measures, 41 completed 12-week follow-up. Health professionals showed a statistically significant increase in self-efficacy to communicate with carers post-intervention (CI [12.99, 20.47]), which was maintained at 12-weeks (CI [8.00, 15.72]). There was no change in applied knowledge or decision-making attitudes.
Fifteen HPs completed interviews. Implementation of eTRIO was deemed feasible and acceptable, with many clinicians finding the module engaging, particularly the clinical scenario videos and interactive activities. HPs found eTRIO appropriately addressed the issue of carer communication. Regarding adoption, HPs reflected that following training they implemented eTRIO strategies into their clinical work.
Conclusion: eTRIO provided HPs with confidence to effectively include and support carers, and to manage complex carer situations such as family conflict. These gains are noteworthy, as conflict with families/carers is a contributor to HP burnout and anxiety. eTRIO is brief, relevant and easy to disseminate, making it a suitable professional development tool for improving carer engagement.