Development of a Cystic Fibrosis Primary Palliative Care Intervention: Qualitative Analysis of Patient and Family Caregiver Preferences.
Melissa J BasileLara DhingraStephanie DiFigliaJennifer PoloRussell PortenoyJanice WangPatricia WalkerBrandi Middour-OxlerRachel W LinnemannCatherine KierDeborah FriedmanMaria BerdellaRobert AbdullahLael M YonkerMartha MarkovitzDenis HadjiliadisMelissa ShiffmanFrancine FischerSophie PollingerMargot HardcastleNivedita ChaudharyAnna M GeorgiopoulosPublished in: Journal of patient experience (2023)
To prevent or mitigate chronic illness burden, people with cystic fibrosis (pwCF) and their family caregivers need primary (generalist-level) palliative care from the time of diagnosis forward. We used qualitative methods to explore their preferences about a screening-and-triage model (" Improving Life with CF ") developed to standardize this care. We purposively sampled and interviewed 14 pwCF and caregivers from 5 Improving Life with CF study sites. Thematic analysis was guided by a priori codes using the National Consensus Project's Guidelines for Quality Palliative Care. Participants included 7 adults and 2 adolescents with CF (3 with advanced disease), 4 parents, 1 partner (7 women; 5 people of color). Few were familiar with palliative care. Illness burden was described in multiple domains, including physical (e.g., dyspnea, pain), psychological (e.g., anxiety), and social (e.g., family well-being; impact on work/school). Most preferred survey-based screening with care coordination by the CF team. Preferences for screening approaches varied. PwCF and caregivers experience illness burden and are receptive to a CF-team delivered primary palliative care screening-and-triage model with flexible processes.
Keyphrases
- palliative care
- cystic fibrosis
- advanced cancer
- pseudomonas aeruginosa
- lung function
- quality improvement
- physical activity
- emergency department
- mental health
- healthcare
- randomized controlled trial
- systematic review
- young adults
- chronic pain
- case report
- decision making
- risk factors
- clinical practice
- polycystic ovary syndrome
- insulin resistance
- spinal cord
- sleep quality
- pregnant women
- chronic obstructive pulmonary disease
- pregnancy outcomes
- depressive symptoms
- neuropathic pain
- adipose tissue
- metabolic syndrome
- health insurance
- data analysis