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. 2018 Jun 11;17(1):85.
doi: 10.1186/s12904-018-0340-2.

Using co-design to develop an intervention to improve communication about the heart failure trajectory and end-of-life care

Lisa Hjelmfors  1 , Anna Strömberg  2   3 , Maria Friedrichsen  4 , Anna Sandgren  5 , Jan Mårtensson  6 , Tiny Jaarsma  4
Affiliations

Using co-design to develop an intervention to improve communication about the heart failure trajectory and end-of-life care

Lisa Hjelmfors et al. BMC Palliat Care. .

Abstract

Background: The aim of this paper was to describe the development of an intervention that is developed to improve communication about the heart failure (HF) trajectory and end-of-life care. We also present data that provides a first insight in specific areas of feasibility of the intervention.

Methods: Co-design was used and patients, family members and health care professionals were constructive participants in the design process of the intervention. Feasibility of the intervention was tested in two areas; acceptability and limited efficacy.

Results: Two communication tools were designed and evaluated; 1) a Question Prompt List (QPL) for patients and family members and 2) a communication course for professionals which was web -based with one face-to-face training day with simulation. Data on feasibility was collected with questionnaires that were developed for this study, from the 13 participants who completed the course (all nurses). They reported improved knowledge, confidence and skills to discuss the HF trajectory and end-of-life care. The QPL was evaluated to be a useful tool in communication with patients and family members.

Conclusions: In a co-design process, future users identified the need for a QPL and a communication course. These communication tools can be used as a dual intervention to improve communication about the HF trajectory and end-of-life care. The QPL can help patients and families to ask questions about the HF trajectory and end-of-life care. The communication course can prepare the professionals to be knowledgeable, confident and skilled to discuss the questions in the QPL. Before the tools are ready for implementation in clinical practice, further studies testing the feasibility of the intervention are needed, including also patients and their families.

Keywords: Co-design; Communication; End-of-life care; Heart failure; Illness trajectory; User perspective.

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the Regional Ethical board in Linköping, Dnr. 2013/244–31. The participants were informed about the confidential handling of study data, and written informed consent was obtained from all participants.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
The co-design process used in the study included phase 1, developing the intervention, and phase 2, testing the acceptability and limited efficacy of the intervention
Fig. 2
Fig. 2
Timeline of the co-design process including two ideas groups with patients, family members and health care professionals, participating in the development of the intervention. During 2016 the intervention was further developed by the research group and in 2017, acceptability and limited efficacy of the intervention was tested
Fig. 3
Fig. 3
The number of participants agreeing (strongly agree/agree) to have knowledge/confidence/skills to discuss questions in part 1–2 of the QPL, before and after the course, N = 13. Abbreviations: QPL Question Prompt List
Fig. 4
Fig. 4
The number of participants agreeing (strongly agree/agree) to have knowledge/confidence/skills to discuss questions in part 3–5 of the QPL, before and after the course, N = 13. Abbreviations: ICD Implantable Cardioverter Defibrillator, CRT Cardiac Resynchronisation Therapy, PM Pacemaker, QPL Question Prompt List
See this image and copyright information in PMC

References

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