Robbins-Welty Gregg A, Mueser Lisa, Mitchell Chandler, Pope Nicole, Arnold Robert, Park SeoYoung, White Doug, Smith Kenneth J, Reynolds Charles, Rosenzweig Margaret, Bakitas Marie, Schenker Yael
University of Pittsburgh, School of Medicine, United States.
University of Pittsburgh, Division of General Internal Medicine, United States.
Contemp Clin Trials Commun. 2018 Mar 15;10:57-61. doi: 10.1016/j.conctc.2018.03.006. eCollection 2018 Jun.
Intervention fidelity is a critical component of behavioral research that has received inadequate attention in palliative care studies. With increasing focus on the need for palliative care models that can be widely disseminated and delivered by non-specialists, rigorous yet pragmatic strategies for training interventionists and maintaining intervention fidelity are needed.
(1) Describe components of a plan for interventionist training and monitoring and maintaining intervention fidelity as part of a primary palliative care trial (CONNECT) and (2) present data about perceived training effectiveness and delivery of key intervention content.
Post-training evaluations, visit checklists, and visit audio-recordings.
Data were collected from June, 2016 through April, 2017. We include procedures for (1) identification, training and certification of oncology nurses as CONNECT interventionists; (2) monitoring intervention delivery; and (3) maintaining intervention quality. All nurses (N = 14) felt prepared to deliver key competencies after a 3-day in-person training. As assessed via visit checklists, interventionists delivered an average of 94% (SD 13%) of key content for first intervention visits and 85% (SD 14%) for subsequent visits. As assessed via audio-recordings, interventionists delivered an average of 85% (SD 8%) of key content for initial visits and 85% (SD 12%) for subsequent visits.
We present a 3-part strategy for training interventionists and monitoring and maintaining intervention delivery in a primary palliative care trial. Training was effective in having nurses feel prepared to deliver primary palliative care skills. As assessed via nursing checklists and visit audio-recordings, intervention fidelity was high.
干预保真度是行为研究的关键组成部分，但在姑息治疗研究中却未得到充分关注。随着对可由非专科人员广泛传播和提供的姑息治疗模式的需求日益增加，需要严格而务实的策略来培训干预人员并维持干预保真度。
（1）描述作为初级姑息治疗试验（CONNECT）一部分的干预人员培训、监测和维持干预保真度计划的组成部分；（2）展示有关感知到的培训效果和关键干预内容实施情况的数据。
培训后评估、访视清单和访视录音。
数据收集于2016年6月至2017年4月。我们纳入了以下程序：（1）将肿瘤护士识别、培训并认证为CONNECT干预人员；（2）监测干预实施情况；（3）维持干预质量。所有护士（N = 14）在为期3天的面对面培训后都感觉已准备好具备关键能力。通过访视清单评估，干预人员在首次干预访视中平均提供了94%（标准差13%）的关键内容，在后续访视中为85%（标准差14%）。通过录音评估，干预人员在初次访视中平均提供了85%（标准差8%）的关键内容，在后续访视中为85%（标准差12%）。
我们提出了一项在初级姑息治疗试验中培训干预人员、监测和维持干预实施的三部分策略。培训有效地让护士们感觉已准备好提供初级姑息治疗技能。通过护理清单和访视录音评估，干预保真度较高。
