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Development and feasibility of a communication training to assist caregivers with advanced care planning

Published online by Cambridge University Press:  14 September 2022

Allison J. Applebaum Open the ORCID record for Allison J. Applebaum [Opens in a new window] ,
Rebecca Gebert Open the ORCID record for Rebecca Gebert [Opens in a new window] ,
Mia Behrens ,
Morgan Loschiavo ,
Patricia A. Parker ,
Kelly M. Shaffer ,
Alan Carver  and
Eli L. Diamond
Allison J. Applebaum*
Affiliation:
Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
Rebecca Gebert
Affiliation:
Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
Mia Behrens
Affiliation:
Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
Morgan Loschiavo
Affiliation:
Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
Patricia A. Parker
Affiliation:
Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
Kelly M. Shaffer
Affiliation:
University of Virginia School of Medicine, Charlottesville, VA
Alan Carver
Affiliation:
Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, NY
Eli L. Diamond
Affiliation:
Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, NY
*
Author for correspondence: Allison J. Applebaum, Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, 641 Lexington Avenue, 7th Floor, New York, NY 10022, USA. E-mail: applebaa@mskcc.org
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Abstract

Objective

Caregivers are critical in advanced care planning (ACP) discussions, which are difficult but necessary to carry out patients’ goals of care. We developed and evaluated the feasibility and acceptability of a communication training to equip caregivers of patients with malignant brain tumors with skills to navigate ACP conversations.

Method

Caregivers completed a 2-h virtual training addressing ACP Discussions with Your Loved One and ACP Discussions with the Medical Team. A pre-training assessment was completed at baseline and a training evaluation was completed one day post-training. A subset of participants completed semi-structured interviews 2 months post-training.

Results

Of 15 caregivers recruited, 9 attended the training and 4 completed qualitative interviews. Post-training, 40% felt confident in discussing ACP with loved ones and 67% felt confident doing so with healthcare professionals; 100% reported feeling confident in using skills learned in the training to facilitate these conversations. Data from qualitative interviews highlighted additional benefits of the training in empathic communication skills and fostering social support.

Significance of results

Our communication skills training shows promise in supporting caregivers’ skills and confidence in engaging in ACP discussions with patients and healthcare providers. A future randomized controlled trial with a larger and more diverse caregiving sample is needed to determine training efficacy.

Keywords

Advanced care planningCancer caregiversCaregiversCommunication skillsCommunication training
Type
Original Article
Information
Palliative & Supportive Care , Volume 21 , Issue 2 , April 2023 , pp. 188 - 195
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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