Accounting for Treatment Preference: Exploration of Methods: A Strategy for Incorporating Patient Preferences in Interventions

2.50
Hdl Handle:
http://hdl.handle.net/10755/158165
Type:
Presentation
Title:
Accounting for Treatment Preference: Exploration of Methods: A Strategy for Incorporating Patient Preferences in Interventions
Abstract:
Accounting for Treatment Preference: Exploration of Methods: A Strategy for Incorporating Patient Preferences in Interventions
Conference Sponsor:Western Institute of Nursing
Conference Year:2005
Author:Epstein, Dana, PhD, RN
P.I. Institution Name:Dept. of Veterans Affairs, Carl. T. Hayden Medical Center, R&D Dept. ERS/151
Title:Associate Chief Nurse for Research
Co-Authors:Shannon Dirksen
An important goal of patient-centered intervention is to have interventions anchored in patients' values, relevant to their condition and lifestyle, and responsive to their preferences. In this paper, a strategy for incorporating patient preferences in the design of nursing interventions is described. The strategy was used to determine the relevance and applicability of a cognitive-behavioral treatment (CBT) to a new target population. Cognitive-behavioral treatment is effective in managing insomnia in healthy adults with persistent primary insomnia in the general population but little is known about the feasibility of CBT for insomnia in populations who suffer from and are surviving a life threatening illness. The new target population comprised breast cancer survivors with either primary or co-morbid insomnia. Since we utilized a multi-component intervention with established efficacy for persistent insomnia in the general population, we were especially interested in gaining feedback about a new population's preferences for the treatment and its components. The strategy involved three main steps. First, the participants representative of the new target population were requested to receive the intervention as originally designed. Second, they completed an instrument inquiring about their expectations of the intervention at the completion of the first session and completed an instrument measuring their satisfaction with the intervention at post-test. These responses provided initial feedback on the perception of the intervention and offered information about the intervention components found acceptable and suitable. In the third step, the participants were invited to a focus group session to discuss the intervention components in more detail and offer comments not elicited in the instruments. The following is an example of data obtained through the three steps of preference determination. At the completion of the first session, 59% of the women rated the intervention as much suitable to very much suitable but 66% thought the intervention would be not at all easy or only somewhat easy to carry out. At post-treatment, 84% to 100 % of the women rated the three treatment components as suitable for their insomnia problem while 89% to 95% thought the components were easy to carry out. Focus group sessions allowed the women to discuss their initial concerns about the appropriateness of the intervention to their problem and ease of treatment implementation at home. They told us that the preparation and ongoing encouragement we gave them regarding the difficulties they might encounter in treatment implementation, and particularly the initial increased daytime tiredness, were very helpful. They identified specific aspects of treatment they found difficult but also informed us that these were the most helpful treatment recommendations. Other examples of utilizing the preference determination strategy and women's feedback will be presented.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleAccounting for Treatment Preference: Exploration of Methods: A Strategy for Incorporating Patient Preferences in Interventionsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/158165-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Accounting for Treatment Preference: Exploration of Methods: A Strategy for Incorporating Patient Preferences in Interventions</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2005</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Epstein, Dana, PhD, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Dept. of Veterans Affairs, Carl. T. Hayden Medical Center, R&amp;D Dept. ERS/151</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Associate Chief Nurse for Research</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">dana.epstein@med.va.gov</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Shannon Dirksen</td></tr><tr><td colspan="2" class="item-abstract">An important goal of patient-centered intervention is to have interventions anchored in patients' values, relevant to their condition and lifestyle, and responsive to their preferences. In this paper, a strategy for incorporating patient preferences in the design of nursing interventions is described. The strategy was used to determine the relevance and applicability of a cognitive-behavioral treatment (CBT) to a new target population. Cognitive-behavioral treatment is effective in managing insomnia in healthy adults with persistent primary insomnia in the general population but little is known about the feasibility of CBT for insomnia in populations who suffer from and are surviving a life threatening illness. The new target population comprised breast cancer survivors with either primary or co-morbid insomnia. Since we utilized a multi-component intervention with established efficacy for persistent insomnia in the general population, we were especially interested in gaining feedback about a new population's preferences for the treatment and its components. The strategy involved three main steps. First, the participants representative of the new target population were requested to receive the intervention as originally designed. Second, they completed an instrument inquiring about their expectations of the intervention at the completion of the first session and completed an instrument measuring their satisfaction with the intervention at post-test. These responses provided initial feedback on the perception of the intervention and offered information about the intervention components found acceptable and suitable. In the third step, the participants were invited to a focus group session to discuss the intervention components in more detail and offer comments not elicited in the instruments. The following is an example of data obtained through the three steps of preference determination. At the completion of the first session, 59% of the women rated the intervention as much suitable to very much suitable but 66% thought the intervention would be not at all easy or only somewhat easy to carry out. At post-treatment, 84% to 100 % of the women rated the three treatment components as suitable for their insomnia problem while 89% to 95% thought the components were easy to carry out. Focus group sessions allowed the women to discuss their initial concerns about the appropriateness of the intervention to their problem and ease of treatment implementation at home. They told us that the preparation and ongoing encouragement we gave them regarding the difficulties they might encounter in treatment implementation, and particularly the initial increased daytime tiredness, were very helpful. They identified specific aspects of treatment they found difficult but also informed us that these were the most helpful treatment recommendations. Other examples of utilizing the preference determination strategy and women's feedback will be presented.</td></tr></table>en_GB
dc.date.available2011-10-26T20:34:26Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:34:26Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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