Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2019

Facilitating effective family carer engagement in cancer care: Development of the eTRIO education modules (#97)

Ilona Juraskova 1 , Phyllis Butow 1 2 , Rachael Keast 1 , Frances Boyle 3 4 , Daniel Costa 5 , Michael Jefford 6 , Judy Kay 7 , Bogda Koczwara 8 , Annie Miller 9 , Rachael Morton 10 , Christobel Saunders 11 , Penelope Schofield 6 12 , Sandra Turner 13 , Kate White 14 , Patsy Yates 15 , Rebekah Laidsaar-Powell 1
  1. Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), The School of Psychology, The University of Sydney, Sydney, NSW , Australia
  2. Psycho-oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, NSW
  3. School of Medicine, The University of Sydney, Sydney, NSW, Australia
  4. Patricia Ritchie Centre for Cancer Care & Research, Mater Hospital, Sydney, NSW, Australia
  5. Pain Management Research Institute, The University of Sydney, Sydney, NSW, Australia
  6. Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
  7. School of Computer Science, The University of Sydney, Sydney, NSW, Australia
  8. Flinders Centre for Innovation in Cancer, Flinders University, Adelaide, SA, Australia
  9. Cancer Council NSW, Sydney, NSW, Australia
  10. NHMRC Clinical Trials Centre, The University of Sydney, Sydney, NSW, Australia
  11. UWA Medical School, University of Western Australia, Perth, WA, Australia
  12. Department of Psychology, School of Health Sciences, Faculty of Health, Arts and Design, Swinburne University, Melbourne
  13. Westmead Clinical School, The University of Sydney, Sydney, NSW, Australia
  14. Cancer Nursing Research Unit, The University of Sydney, Sydney, NSW, Australia
  15. Queensland University of Technology, Brisbane, QLD, Australia

Aims: Family carers play an important role in cancer care. However, many carers report feeling disempowered and ill-equipped to support patients. Our group published the evidence-based ‘TRIO Guidelines’ to improve clinician’s engagement with carers and management of challenging situations in the cancer setting. To facilitate implementation of these guidelines into clinical practice, we have developed two novel online education modules: for oncology clinicians (eTRIO) and for cancer patients and carers (eTRIO-pc).

Methods: The eTRIO modules were based on extensive prior research by our group (systematic reviews, qualitative interviews, consultation analyses, and Delphi consensus guidelines). Draft module content was iteratively reviewed by an expert advisory group involving academic/clinical experts (n=13) and consumers (n=5). User experience testing of the modules was completed by clinicians (n=5), patients (n=5) and carers (n=5).

Results: Both programs utilise interactive web-technology to promote learners’ engagement and uptake of key skills. The clinician module includes 9 professionally produced short films (with embedded trigger activities) modelling effective clinician behaviours. Reflective practice is encouraged via self-assessments and clinical scenarios. The patient-carer module includes 3 professionally produced films which model key carer skills (such as advocating for a patient’s unmet needs), as well as experiential content provided via video-messages from consumers and clinicians. Interactive activities such as a consultation question list builder are also included. A national RCT is currently evaluating the effectiveness of the combined modules in improving: i) carer involvement in consultations, ii) stakeholders’ self-efficacy in clinician-patient-family communication, iii) patient/carer psychosocial outcomes and iv) healthcare costs.

Conclusions: The eTRIO programs have been rigorously developed to meet the needs of clinicians, patients, and carers in improving effective and useful carer involvement. The interventions aim to shift the status of informal carers from an underserved, vulnerable, and ill-equipped population to being confident, informed, and supported partners in cancer care.