Personalized Experiences to Inform Improved Communication for Minorities With Life Limiting Illness

Completed

Interventions: Behavioral: Storytelling Intervention for Patient Participants
Behavioral: Storytelling Intervention for Nurse Participants

Brief Summary: The purpose of this research is to develop patient-centered palliative care interventions to improve patient-provider communication and Quality of Life (QoL) of ethnic and racial minority patients living with life-limiting illnesses. Eliciting personal experiences is an effective way for patients to communicate their cultural values and beliefs. This study will assess how to integrate the patients' personal experience narratives into the electronic health record (EHR). The primary hypothesis is that the implementation of a patient-centered intervention to elicit personal experiences that are included in the EHR will improve patient-provider communication and patients' QoL.

Detailed Description: Racial and ethnic minority patients with a Life Limiting Illnes (LLI) in the United States are underserved in many ways, including quality of palliative care. Specific disparities have been reported in palliative care for minority patients, including sub-optimal patient-provider communication and resulting lower QoL. A potential approach to improve communication is to elicit patients' personal narratives that address their cultural or spiritual values and beliefs, and include them in the EHR. The objective of this observational study is to assess the feasibility and efficacy of a palliative care nursing intervention designed to 1) identify barriers and facilitators for eliciting and recording relevant narratives from the perspectives of the key stakeholders: minority patients with LLI; 2) to conduct usability testing, applying a user-system-environment evaluation process to determine essential requirements for integration of the patient-centered narratives into the EHR; and 3) identify barriers and facilitators of integration of the patient's narrative into daily workflow from the perspectives of key stakeholders: acute care bedside nurse.

Recruitment & Eligibility

Inclusion Criteria

Patients

18 years of age or older
able to read English
capable of giving informed consent
self-identifying as part of a racial or ethnic minority
diagnosed with at least one LLI. The operational definition of LLI eligible for this study includes the following diagnoses:
1. metastatic solid cancer or inoperable lung cancer;
2. COPD with FEV1 values < 35% predicted or oxygen dependence;
3. New York Heart Association Class III or IV heart failure (CHF).

Inclusion criteria: Nurse

18 years of age or older
Confirm verbally that they were involved in the care of a patient who is participating in the storytelling intervention

Exclusion Criteria

Not provided

Arm && Interventions

Group	Intervention	Description
Inpatient Participants	Storytelling Intervention for Patient Participants	Patients admitted to University of Colorado Hospital with at least one of the following diagnoses: * Heart Failure * COPD * Cancer
Nurse Participants	Storytelling Intervention for Nurse Participants	Bedside nurses who provide care at the inpatient level for the following diseases: * Heart Failure * COPD * Cancer

Primary Outcome Measures

Name	Time	Method
Number of Completed Exit Interviews From Patients on Feasibility of Their Use of Their Narrative Integrated Into EHR	1-2 weeks	Using an observational design, this measure (exit interviews) were completed with 20 inpatient participants and 18 nurse participants. The qualitative data from the interviews were used to define and refine the storytelling intervention. The data collected from the exit interview is qualitative in nature and therefore does not have a numerical value.

Secondary Outcome Measures