» Articles » PMID: 39044760

Adapting an Intervention to Address Barriers to Pain Management in Hospice: Formative Research to Inform EMPOWER-D for Dementia Caregivers

Overview
Journal Palliat Med Rep
Specialty Critical Care
Date 2024 Jul 24
PMID 39044760
Authors
Affiliations
Soon will be listed here.
Abstract

Background: Nearly half of more than 1.7 million older Americans who receive hospice care each year have a primary or comorbid diagnosis of dementia. Pain is often undertreated in this patient population owing to myriad factors, including unmet informational needs among family caregivers.

Objective: We sought to inform the adaptation of a pain education intervention for hospice family caregivers to the context of dementia by eliciting feedback on the educational content covered in adapted intervention materials.

Design: We conducted a multimethod, formative research study to inform the adaptation of an existing, evidence-based intervention.

Setting/subjects: The study included a purposively recruited sample ( = 33) of hospice professionals ( = 18) and family caregivers ( = 15) from across the United States.

Measurements: Participants quantitatively rated the importance of each of the eight pain concerns presented in the adapted intervention materials (1 = not important to 3 = very important) and provided qualitative feedback via Zoom interview on the acceptability, clinical accuracy, and potential benefits of the adapted content. We analyzed quantitative data via descriptive statistics and qualitative data via content analysis.

Results: Participants rated the adapted educational content as highly important (range = 2.56-3.00), particularly regarding concerns about caregivers' pain assessment, communicating with the hospice team about pain, and addressing misinformation regarding pain medication outcomes. Participants also provided suggestions to strengthen specific educational messages to improve comprehension and uptake.

Conclusions: Findings support the continued development and testing of the adapted intervention.

References
1.
Starr L, Washington K, Jabbari J, Benson J, Parker Oliver D, Demiris G . Pain Management Education for Rural Hospice Family Caregivers: A Pilot Study With Embedded Implementation Evaluation. Am J Hosp Palliat Care. 2023; 41(6):619-633. PMC: 11032627. DOI: 10.1177/10499091231191114. View

2.
Becque Y, Rietjens J, van der Heide A, Witkamp E . How nurses support family caregivers in the complex context of end-of-life home care: a qualitative study. BMC Palliat Care. 2021; 20(1):162. PMC: 8521979. DOI: 10.1186/s12904-021-00854-8. View

3.
Tarter R, Demiris G, Pike K, Washington K, Parker Oliver D . Pain in Hospice Patients With Dementia: The Informal Caregiver Experience. Am J Alzheimers Dis Other Demen. 2016; 31(6):524-9. PMC: 4982799. DOI: 10.1177/1533317516653825. View

4.
Ellington L, Cloyes K, Xu J, Bellury L, Berry P, Reblin M . Supporting home hospice family caregivers: Insights from different perspectives. Palliat Support Care. 2017; 16(2):209-219. PMC: 5670030. DOI: 10.1017/S1478951517000219. View

5.
Achterberg W, Lautenbacher S, Husebo B, Erdal A, Herr K . Pain in dementia. Pain Rep. 2020; 5(1):e803. PMC: 7004504. DOI: 10.1097/PR9.0000000000000803. View