Backgrounds: Patients with hematological cancers and their caregivers request more realistic information about disease trajectory and prognosis. The aim of the study was to evaluate the implementation of an adapted SICP concept into the hematological department at Copenhagen University Hospital in Denmark.
Methods: For evaluating the adaptation and implementation of the SICP the outlined framework in the updated guidelines for complex interventions by the UK Medical Research Council was used combined with an action research design with 5 haematological doctors, 5 nurses, 6 patients with haematological malignancies, and 4 caregivers. For evaluating the effectiveness of the adapted concept as well as understanding the processes of change, a combination of quantitative and qualitative methods was performed with two questionnaire scales, focus group, and dyad interviews.
Results: There were no significant correlations between before and after on either of the two scales. Among the individual questions within the two scales, seven questions showed significant difference from before to after the course or between participants and control group. The analysis of the questionnaire data points to that participants might increase confidence in their own abilities to include existential aspects in patient care and make changes in care plan, if needed. It also seemed that nurses and doctors who found it important to care for patients’ existential concerns and believe this to be an important part of their job were more likely to participate in the SICP concept. The qualitative analysis points to the importance of interdisciplinarity of the nurse and doctor in the SICP because then the patient’s and caregiver’s preferences are integrated in the treatment and care plan, and it strengthens conversations involving medical, holistic, and existential issues. It particularly seemed how time allocated for the conversation and the preparatory materials for the conversations highly influenced outcome of the conversation.
Conclusions: The implementation of adapted SICP is feasible in a hematological setting, and it facilitated overcoming barriers for offering more existential consultations in hematology. SICP concept have been implemented to all staff members of the myeloma/lymphoma clinic and to be integrated timely throughout the disease trajectory starting at the time of diagnosis.