Development and Testing of the Palliative Care-Related Knowledge, Attitudes & Confidence in Home Health Care Questionnaires Study

Columbia University School of Nursing is conducting the "Development and Testing of the Palliative Care-Related Knowledge, Attitudes & Confidence in Home Health Care Questionnaires" or PC-KAC in HHC Study, in partnership with VNS Health. 

The PC-KAC in HHC Study was approved by both organization's Institutional Review Boards (IRBs)  and was intramurally funded by the Office of Scholarship and Research at the Columbia University School of Nursing.

Background

Palliative care provides patient- and family-centered care to individuals with serious illness.1 Home healthcare (HHC) is a growing sub-sector of the U.S. healthcare industry with the majority of patients being 65 years and older, most having serious illness, and approximately 19% dying within 12 months after admission.2-3 The need for palliative care in HHC is rising because of the complex patient population and incentives to avoid re-hospitalization.4-6 However, it is unclear if HHC clinicians are prepared to provide such care and how palliative care is perceived by HHC patients and their caregivers. A critical step is to develop setting-specific instruments to measure palliative care-related knowledge, attitudes, and confidence among clinicians, patients and informal caregivers in HHC.

Aims

Guided by the 2018 National Consensus Project Clinical Practice Guidelines for Quality Palliative Care,7 this pilot project aims to:

  1. Develop the Palliative Care-related Knowledge, Attitudes & Confidence in Home Health Care (PC-KAC in HHC) questionnaires for healthcare clinicians, patients and informal caregivers; and,
  2. Test the PC-KAC in HHC questionnaires and evaluate the instruments’ psychometric properties.

References

  1. Saunders C. The evolution of palliative care. J R Soc Med. 2001;94(9):430-432.
  2. Avalere Health. Alliance for Home Health Quality and Innovation (AHHQI) Home Health Chartbook 2020. https://ahhqi.org/images/uploads/AHHQI_2020_Home_Health_Chartbook_-_Final_09.30.2020.pdf. Updated September 30, 2020. Accessed November 13, 2020.
  3. Medicare Payment Advisory Commission (MedPAC). A Data Book: Health Care Spending and the Medicare Program. http://www.medpac.gov/docs/default-source/data-book/july2020_databook_entirereport_sec.pdf?sfvrsn=0. Updated July 17, 2020. Accessed November 13, 2020.
  4. Sullivan SS, Casucci S, Li CS. Eliminating the Surprise Question Leaves Home Care Providers With Few Options for Identifying Mortality Risk. Am J Hosp Palliat Care. 2020;37(7):542-548.
  5. Stober M. Palliative Care in Home Health: A Review of the Literature. Home Healthc Now. 2017;35(7):373-377.
  6. Famakinwa J. NAHC Pushing for Palliative Care, SNF-at-Home Medicare Benefits. Home Health Care News;10/19/2020.
  7.  Ferrell BR, Twaddle ML, Melnick A, Meier DE. National Consensus Project Clinical Practice Guidelines for Quality Palliative Care Guidelines, 4th Edition. J Palliat Med. 2018;21(12):1684-1689.
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