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Planning and optimising CHAT&PLAN:: a conversation-based intervention to promote person-centred care for older people living with multimorbidity

Planning and optimising CHAT&PLAN:: a conversation-based intervention to promote person-centred care for older people living with multimorbidity
Planning and optimising CHAT&PLAN:: a conversation-based intervention to promote person-centred care for older people living with multimorbidity
Background Older people are more likely to be living with cancer and multiple long-term conditions, but their needs, preferences for treatments, health priorities and lifestyle are often not identified or well-understood. There is a need to move towards a more comprehensive person-centred approach to care that focuses on the cumulative impact of a number of conditions on daily activities and quality of life. This paper describes the intervention planning process for CHAT& PLANTM, a structured conversation intervention to promote personalised care and support self-management in older adults with complex conditions. Methods A theory-, evidence- and person-based approach to intervention development was undertaken. The intervention planning and development process included reviewing relevant literature and existing guidelines, developing guiding principles, conducting a behavioural analysis and constructing a logic model. Optimisation of the intervention and its implementation involved qualitative interviews with older adults with multimorbidity (n = 8), family caregivers (n = 2) and healthcare professionals (HCPs) (n = 20). Data were analysed thematically and informed changes to the intervention prototype. Results Review findings reflected the importance of HCPs taking a person-centred (rather than disease-centred) approach to their work with older people living with multimorbidity. This approach involves HCPs giving health service users the opportunity to voice their priorities, then using these to underpin the treatment and care plan that follow. Findings from the planning stage indicated that taking a structured approach to interactions between HCPs and health service users would enable elicitation of individual concerns, development of a plan tailored to that individual, negotiation of roles and review of goals as individual priorities change. In the optimisation stage, older adults and HCPs commented on the idea of a structured conversation to promote person-centred care and on its feasibility in practice. The idea of a shared, person-centred approach to care was viewed positively. Concerns were raised about possible extra work for those receiving or delivering care, time and staffing, and risk of creating another “tick-box” exercise for staff. Participants concluded that anyone with the appropriate skills could potentially deliver the intervention, but training was likely to be required to ensure correct utilisation and self-efficacy to deliver to the intervention. Conclusions CHAT&PLAN, a structured person-centred conversation guide appears acceptable and appealing to HCPs and older adults with multimorbidity. Further development of the CHAT&PLAN intervention should focus on ensuring that staff are adequately trained and supported to implement the intervention.
1932-6203
Corbett, Teresa
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Cummings, Amanda
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Lee, Kellyn
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Calman, Lynn
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Fenerty, Vicky
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Farrington, Naomi
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Lewis, Lucy
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Young, Alexandra
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Boddington, Hilary
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Wiseman, Theresa
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Richardson, Alison
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Foster, Claire
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Bridges, Jackie
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Corbett, Teresa
bce81837-17ae-46c3-a6b1-43a7e1f07f9c
Cummings, Amanda
7c5f6bd2-979b-456d-9368-8edd13c06691
Lee, Kellyn
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Calman, Lynn
9ae254eb-74a7-4906-9eb4-62ad99f058c1
Fenerty, Vicky
5edbe55b-e185-4e44-a81d-34065cc28df7
Farrington, Naomi
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Lewis, Lucy
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Young, Alexandra
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Boddington, Hilary
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Wiseman, Theresa
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Richardson, Alison
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Foster, Claire
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Bridges, Jackie
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Corbett, Teresa, Cummings, Amanda, Lee, Kellyn, Calman, Lynn, Fenerty, Vicky, Farrington, Naomi, Lewis, Lucy, Young, Alexandra, Boddington, Hilary, Wiseman, Theresa, Richardson, Alison, Foster, Claire and Bridges, Jackie (2020) Planning and optimising CHAT&PLAN:: a conversation-based intervention to promote person-centred care for older people living with multimorbidity. PLoS ONE, 15 (10), [e0240516]. (doi:10.1371/journal.pone.0240516).

Record type: Article

Abstract

Background Older people are more likely to be living with cancer and multiple long-term conditions, but their needs, preferences for treatments, health priorities and lifestyle are often not identified or well-understood. There is a need to move towards a more comprehensive person-centred approach to care that focuses on the cumulative impact of a number of conditions on daily activities and quality of life. This paper describes the intervention planning process for CHAT& PLANTM, a structured conversation intervention to promote personalised care and support self-management in older adults with complex conditions. Methods A theory-, evidence- and person-based approach to intervention development was undertaken. The intervention planning and development process included reviewing relevant literature and existing guidelines, developing guiding principles, conducting a behavioural analysis and constructing a logic model. Optimisation of the intervention and its implementation involved qualitative interviews with older adults with multimorbidity (n = 8), family caregivers (n = 2) and healthcare professionals (HCPs) (n = 20). Data were analysed thematically and informed changes to the intervention prototype. Results Review findings reflected the importance of HCPs taking a person-centred (rather than disease-centred) approach to their work with older people living with multimorbidity. This approach involves HCPs giving health service users the opportunity to voice their priorities, then using these to underpin the treatment and care plan that follow. Findings from the planning stage indicated that taking a structured approach to interactions between HCPs and health service users would enable elicitation of individual concerns, development of a plan tailored to that individual, negotiation of roles and review of goals as individual priorities change. In the optimisation stage, older adults and HCPs commented on the idea of a structured conversation to promote person-centred care and on its feasibility in practice. The idea of a shared, person-centred approach to care was viewed positively. Concerns were raised about possible extra work for those receiving or delivering care, time and staffing, and risk of creating another “tick-box” exercise for staff. Participants concluded that anyone with the appropriate skills could potentially deliver the intervention, but training was likely to be required to ensure correct utilisation and self-efficacy to deliver to the intervention. Conclusions CHAT&PLAN, a structured person-centred conversation guide appears acceptable and appealing to HCPs and older adults with multimorbidity. Further development of the CHAT&PLAN intervention should focus on ensuring that staff are adequately trained and supported to implement the intervention.

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Planning and optimising CHAT&PLAN a conversation-based intervention to promote person-centred care for older people living with multimorbidity - Accepted Manuscript
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Accepted/In Press date: 21 September 2020
Published date: 16 October 2020

Identifiers

Local EPrints ID: 444625
URI: http://eprints.soton.ac.uk/id/eprint/444625
ISSN: 1932-6203
PURE UUID: 97fbf301-af9b-4254-93dc-e5507dda4592
ORCID for Teresa Corbett: ORCID iD orcid.org/0000-0002-5620-5377
ORCID for Lynn Calman: ORCID iD orcid.org/0000-0002-9964-6017
ORCID for Vicky Fenerty: ORCID iD orcid.org/0000-0002-1712-5614
ORCID for Theresa Wiseman: ORCID iD orcid.org/0000-0002-3355-1269
ORCID for Alison Richardson: ORCID iD orcid.org/0000-0003-3127-5755
ORCID for Claire Foster: ORCID iD orcid.org/0000-0002-4703-8378
ORCID for Jackie Bridges: ORCID iD orcid.org/0000-0001-6776-736X

Catalogue record

Date deposited: 27 Oct 2020 19:56
Last modified: 26 Nov 2021 03:05

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Contributors

Author: Teresa Corbett ORCID iD
Author: Amanda Cummings
Author: Kellyn Lee
Author: Lynn Calman ORCID iD
Author: Vicky Fenerty ORCID iD
Author: Lucy Lewis
Author: Alexandra Young
Author: Hilary Boddington
Author: Theresa Wiseman ORCID iD
Author: Claire Foster ORCID iD
Author: Jackie Bridges ORCID iD

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