title: Translating and testing the ENABLE: CHF-PC concurrent palliative care model for older adults with heart failure and their family caregivers.
abstract: BACKGROUND
  Heart failure (HF) and palliative care (PC) organizations recommend early PC to improve the quality of life of patients living with HF.
  
  
  OBJECTIVE
  We conducted a two-phase formative evaluation study to translate a cancer-focused concurrent PC intervention into one that would be appropriate for rural-dwelling adults with New York Heart Association Class III-IV HF and their primary caregivers.
  
  
  METHODS
  Phase I: We tailored the intervention for an HF population via literature review, expert consultation, and clinician (N=15) small group interviews. Phase II: We enrolled 11 patient/caregiver dyads to assess intervention feasibility and satisfaction. We assessed participants' experiences and satisfaction after session/week three and session/week six via digitally recorded interviews. Clinician and participant interviews were transcribed and content analyzed. Outcome measures were evaluated for completion rates and effect sizes.
  
  
  RESULTS
  Phase I: Clinicians described barriers to initiating PC in HF, triggers for initiating PC, and suggestions for intervention improvement. Phase II: Participants were able to complete the majority of study sessions, measures, and interviews. Satisfaction interviews revealed the content to be relevant and comprehensive in addressing HF patient and caregiver primary concerns; however, participants unanimously suggested making the intervention available earlier in the illness trajectory. Efficacy measures demonstrated small to medium effect sizes.
  
  
  CONCLUSIONS
  We tailored and demonstrated feasibility of providing an early, concurrent palliative care intervention to patients with advanced HF and their caregivers. Based on this experience we are now conducting an efficacy trial in a racially diverse sample.
authors: 1 School of Nursing, University of Alabama at Birmingham , Birmingham, Alabama.
authors: J Nicholas
authors: JN
authors: Dionne-Odom
authors: Alan
authors: A
authors: Kono
authors: Jennifer
authors: J
authors: Frost
authors: Lisa
authors: L
authors: Jackson
authors: Daphne
authors: D
authors: Ellis
authors: Ali
authors: A
authors: Ahmed
authors: Andres
authors: A
authors: Azuero
authors: Marie
authors: M
authors: Bakitas
mesh_terms: D000368:Aged; D017028:Caregivers / Q000523:psychology*; D005260:Female; D006333:Heart Failure / Q000523:psychology* / Q000628:therapy*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D017060:Patient Satisfaction; D011788:Quality of Life; D012424:Rural Population; D014175:Translating