Collins Anna, McLachlan Sue-Anne, Hill Mike, Collins Sue, Philip Jennifer
Department of Medicine, St Vincent's Hospital, The University of Melbourne, Fitzroy, VIC, Australia.
Medical Oncology, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia.
Palliat Med. 2020 Sep;34(8):1108-1117. doi: 10.1177/0269216320932766. Epub 2020 Jun 19.
Communities have limited understanding of palliative care, creating barriers to informed choice around consideration of a full range of care options in the event of serious illness. Few empirically tested interventions are available to educate community about palliative care, and ultimately improve timely access to these services.
To test the acceptability (primary outcome), and feasibility of a narrative approach to public health communication seeking to improve attitudes to possible access to palliative care in the event of serious illness.
Randomised phase II trial with six parallel experimental conditions. Outcomes tested included measures of acceptability, feasibility and change in attitudes to possible access to palliative care post-intervention. Contrasts planned for exploratory testing included format, message content and narrator.
SETTING/PARTICIPANTS: Community-based sample of consecutive English-speaking adults who volunteered their participation in response to a study advertisement distributed online through established community groups.
A narrative approach to public health communication was found to be acceptable to community members, and feasible to deliver online. Exploratory data suggested it immediately improved attitudes towards possible access to palliative care in the event of serious illness, with the narrative detailing a description of the evidence delivered by a healthcare professional appearing to be the most promising strategy.
This study provides preliminary data to inform a future, longitudinal trial evaluating effectiveness and ultimately other evidence-based, public health approaches to improve community engagement with palliative care. Further studies are required to confirm the generalisability of findings to a broader representative sample and other settings including internationally.
社区对姑息治疗的了解有限，这在重病情况下围绕全面护理选择的知情选择方面造成了障碍。几乎没有经过实证检验的干预措施可用于向社区宣传姑息治疗，并最终改善及时获得这些服务的情况。
测试一种叙事性公共卫生沟通方法的可接受性（主要结果）和可行性，该方法旨在改善在重病情况下对可能获得姑息治疗的态度。
具有六个平行实验条件的随机II期试验。测试的结果包括可接受性、可行性的测量以及干预后对可能获得姑息治疗的态度变化。计划用于探索性测试的对比包括形式、信息内容和叙述者。
设置/参与者：基于社区的连续说英语的成年人样本，他们通过既定社区团体对在线发布的研究广告做出回应，自愿参与。
一种叙事性公共卫生沟通方法被社区成员认为是可接受的，并且在网上实施是可行的。探索性数据表明，它立即改善了对重病情况下可能获得姑息治疗的态度，详细描述医疗保健专业人员提供的证据的叙述似乎是最有前景的策略。
本研究提供了初步数据以供未来的纵向试验参考，该试验评估有效性以及最终评估其他基于证据的公共卫生方法，以改善社区对姑息治疗的参与度。需要进一步的研究来确认研究结果对更广泛的代表性样本和包括国际上其他环境的普遍性。
