Preparing Cancer Patients and Family Caregivers for Lung Surgery: Development of a Multimedia Self-Management Intervention

Abstract

The surgical treatment of lung malignancies often results in persistent symptoms, psychosocial distress, and decrements in quality of life (QOL) for cancer patients and their family caregivers (FCGs). The potential benefits of providing patients and FCGs with preparatory education that begins in the preoperative setting have been explored in multiple medical conditions, with positive impact observed on postoperative recovery, psychological distress, and QOL. However, few studies have explored the benefits of preparatory educational interventions to promote self-management in cancer surgery, including lung surgery. This paper describes the systematic approach used in the development of a multimedia self-management intervention to prepare cancer patients and their FCGs for lung surgery. Intervention development was informed by (1) contemporary published evidence on the impact of lung surgery on patients and FCG, (2) our previous research that explored QOL, symptoms, and caregiver burden after lung surgery, (3) the use of the chronic care self-management model (CCM) to guide intervention design, and (4) written comments and feedback from patients and FCGs that informed intervention development and refinement. Pilot-testing of the intervention is in process, and a future randomized trial will determine the efficacy of the intervention to improve patient, FCG, and system outcomes.

A Multimedia Self-management Intervention to Prepare Cancer Patients and Family Caregivers for Lung Surgery and Postoperative Recovery

“…17 While it may seem intuitive that there should be evidence-based, standardized preparatory interventions in cancer surgery, very few exist in the current literature. This may be secondary to several reasons: 1) time constraints for surgical teams, 2) lack of reimbursement for cancer educational and preparatory services, and 3) lack of research efforts to design evidence-based interventions.…”

“…The systematic development and content of the intervention was described elsewhere. 17 Briefly, the MSM intervention is a multi-component, multimedia model of care designed specifically for lung surgery. It provides one-on-one coaching with cancer patients and family caregivers, targeting knowledge and skills in symptom management, self-care, and post-operative recovery activities.…”

“…16, 25 The MSM intervention combines both traditional (information and technical skills) and self-management education (enhance activation and self-efficacy). 17 Intervention content is divided into four sessions (Table 1). Session 1 focuses on what to expect before surgery and during hospitalization after surgery.…”

A stakeholder-driven approach to improve the informed consent process for palliative chemotherapy

“…Patient engagement is common in the development of educational or decision support interventions [25,56–60] and upheld in best practices. [25,26] In practice however, patients are frequently relegated to narrow project roles that lack true influence over the process.…”

“…[23,24] Patients commonly participate in advisory panels[25,26,56], focus groups (e.g. to set content priorities) [57,59] or participate in alpha and beta testing [26,60]. These processes are useful, but not necessarily sufficient to promote meaningful stakeholder-research exchanges and true impact.…”