PUB038 A Multimedia Self-Management Intervention to Prepare Patients and Family Caregivers for Lung Surgery

Abstract

Due to healthcare environment changes and advances in surgical care, patients are discharged from the hospital earlier and earlier following lung surgery. Patients often require significant postoperative care, and the greater proportion of the caregiving burden has fallen on family caregivers (FCGs). There are few evidence-based, dyadic interventions developed specifically for lung surgery patients and FCGs. In this study, we tested the feasibility and acceptability of a multimedia self-management intervention to prepare patients and their FCGs for lung surgery. Patients and their FCGs were sequentially enrolled into a usual care group or an intervention group, which received the multimedia (15 minute video and print material) intervention, Preparing for Your Lung Surgery. Intervention content development was guided by the chronic care self-management model (CCM). The intervention was delivered in two doses: before surgery and before hospital discharge. Patient and FCG outcomes were assessed at baseline (before surgery), before hospital discharge, and at 4 weeks post-discharge. Intervention usability and acceptability data were obtained from both patients and FCGs. A total of 53 patients/FCGs were enrolled in the study (23 usual care, 30 intervention). We observed little difference in all outcome scores for the usual care group from pre- to post-intervention. A significant, clinically meaningful improvement in emotional well-being subscale score was seen in the intervention group from pre- to post- intervention (16.0 versus 20.0, p=0.005). Patient activation (confidence in managing overall healthcare) for the intervention group improved from pre- to post-intervention (71.0 versus 75.5). Intervention group patients had more confidence in self-care at hospital discharge (20.5 versus 18.9). Intervention group FCGs reported less objective caregiving burden (extent to which care responsibilities are viewed as disruptive) at hospital discharge (13.4 versus 16.2). Statistically significant improvements in recovery-related knowledge scores from pre-to post-intervention were observed for both patients (8.8 versus 9.8; p<.001) and FCGs (8.8 versus 9.6; p=0.02) in the intervention group. Mean length of hospital stay was 4.1 for usual care and 3.2 for intervention group. Intervention usability and acceptability scores were high (3.7/4.0 for patients, 3.6/4.0 for FCGs). A multimedia self-management intervention that begins before surgery was feasible and acceptable in preparing patients and FCGs for lung surgery. A randomized trial is needed to test the efficacy of the intervention on patient/FCG outcomes and healthcare resource use.