Evaluating the feasibility, acceptability and potential effectiveness of complex nursing intervention focused on quality of life assessment on advanced cancer patients with palliative care needs

Patient QoL (potential effectiveness) assessed using the Italian version of the Palliative Outcome Scale (POS) before (period I: 3 months) and after (period II: 3 months) the intervention

1. Patient management, evaluated using an adapted version of the composite patient management score by Detmar et al. (2002). All QoL-related management actions taken by staff for patients are calculated by summarizing all the actions taken. Data is collected from medical and nursing charts and ad hoc documentation, which comprises the terminology included in the QoL tool (i.e., the POS) to collect actions delivered to patients for each of impaired QoL dimensions resulting from the POS score.
2. Acceptability of the study, evaluated in terms of number of patients accepting to participate in this study.
2.1. Acceptability of the intervention from the patients’ perspective. Once the delivery of the intervention is completed, acceptability is examined using an ad hoc semi-structured questionnaire. Patients are asked to appraise the intervention in terms of appropriateness and usefulness in collecting their own needs using a QoL tool and to suggest ways to enhance its acceptability and to identify any missing elements (Sidani & Braden, 2011).
2.2. Acceptability of the intervention from the staff’s perspective. Acceptability is assessed using an ad hoc semi-structured interview including five open questions. After implementing the intervention – at the end of a 3-month period – staff members’ acceptability is explored in terms of relevance, appropriateness and usefulness in addressing QoL of palliative care patients. To enhance the completeness and acceptability of the intervention, staff members are asked to suggest ways to modify any aspects of the intervention and their professional views on maintaining the INFO-QoL as a standard for the unit. Preliminary to staff interviews, a fundamental overview of QoL as main focus of palliative care, the intervention (i.e. the INFO-QoL) is provided, and then staff are asked to answer the following questions:
1. How would you comment on the relevance of the intervention in addressing palliative care patients’ QoL?
2. How would you overall appraise the intervention in terms of its appropriateness in addressing palliative care patients’ QoL?
3. How would you overall appraise the intervention in terms of its usefulness in addressing palliative care patients’ QoL?
4. Would you suggest ways to modify any components and/or activities of the intervention?
5. Would you maintain the INFO-QoL as a standard for the unit?
3. Feasibility of the intervention, measured in terms of time taken to organize and perform the intervention, and to train professionals on QoL. Also, deviations from the procedures, and uncompleted measurements and the reasons are recorded through structured professionals’ self-reports – checklists (fidelity of intervention). In addition, professionals are asked to rate their competence and level of confidence in delivering the intervention at different points in time.
4. Feasibility of the study, assessed in terms of time taken to obtain patient’s informed consent and recruitment and patient drop out rates.