Educational intervention to improve palliative care knowledge among informal caregivers of cognitively impaired older adults

Abstract

Objective Lack of palliative care knowledge among caregivers may pose an access barrier for cognitively impaired older adults, who may benefit from the specialized care. Therefore, this study aims to examine the effectiveness of an educational intervention in improving palliative care knowledge among informal caregivers of cognitively impaired older adults. Method Using a one-group, pre- and post-test intervention design, this study implemented an individual, face-to-face educational intervention with an informational brochure for 43 informal caregivers of chronically or seriously ill older adults (50+) with cognitive impairment, recruited from communities in West Alabama. Their level of knowledge about palliative care was assessed by the Palliative Care Knowledge Scale (PaCKS). The pre- and post-test scores were compared by the Wilcoxon signed-ranks test, and the racial subgroup (Whites vs. Blacks) comparison was made by the Mann–Whitney U test. Results There was a statistically significant difference between the pre- and post-test scores (z = 5.38, p < 0.001), indicating a statistically significant effect of the educational intervention in improving palliative care knowledge among participants. There was a significant difference (U = 143, p < 0.05) between Whites and Blacks in the pre-test, which, however, disappeared in the post-test (U = 173.50, p > 0.05), suggesting that the amount of increased PaCKS scores were significantly greater for Blacks (Mdn = 9.50) than for Whites (Mdn = 4.00, U = 130.50, p < 0.05). Significance of results This study demonstrated that a one-time educational intervention can improve the level of palliative care knowledge among informal caregivers of chronically or seriously ill older adults with cognitive impairment, particularly among Black caregivers. Therefore, further educational efforts can be made to promote palliative care knowledge and reduce racial disparities in palliative care knowledge and its use.

Improving Breast Cancer Family Caregivers’ Palliative Care Literacy: A Pilot Randomized Trial

“…Although the effect size for palliative care literacy became large in both the early and late stage groups at 3 months, those in the late stage group showed an early effect at 1 month, suggesting that family caregivers of patients with early-stage cancer may need time to improve their knowledge, or perhaps that those facing late-stage breast cancer were more interested in improving their palliative care literacy. Previous interventions have been shown to improve palliative care literacy among laypeople and family caregivers (Hoerger et al, 2017; Kozlov et al, 2017; Noh et al, 2021); however, these interventions were “stand alone” interventions rather than part of a broader or cancer-focused SFM intervention. Family caregivers nationally report low knowledge of palliative care (Dionne-Odom et al, 2019) and are interested in prognostic information, including about incurable cancer (Applebaum et al, 2018; Kang et al, 2021).…”

Willingness to Discuss End-of-Life Care Wishes Among Rural Black/African American Residents of the Alabama Black Belt

“…We categorized the dichotomous, age variable for simplicity (Altman & Royston, 2006), as commonly used previously (Lee & Lee, 2018; Matejkowski et al, 2014). Age 50 was selected as the cutoff to convert to two groups because those in later middle age are more likely to be involved in caregiving for older adults, including end-of-life care, therefore, more likely to be exposed to and consider end-of-life issues (Noh et al, 2021b). Furthermore, Blacks/African Americans have earlier onset of chronic/ serious illnesses and shorter life expectancy than the general population and may experience end-of-life issues earlier than in the conventional older adulthood (65+).…”

A Review of Instruments Measuring the Basic Knowledge of Palliative Care Concepts in Teenagers

“…When professionals (M = 12.74, SD = 0.58) were compared to community members (M = 10.92, SD = 2.2), the scores were found to be significantly different (t (83.87), p < 0.001), which represent professionals are more knowledgeable of palliative care concepts as expected. A strength of this tool is that it has been used in various populations: the public in Jordan (Abuelzeet et al, 2023), cancer patients in Iranian (Atena et al, 2022), patients with neuroinflammatory disease (Ben-Zacharia et al, 2023), theorydriven role model stories in diverse older populations (Hoe et al, 2021), Latino community leaders (Johnson et al, 2022), cross-sectional survey of young adults (Mallon et al, 2021), public knowledge in Northern Ireland (Mcllfatrik, 2021), informal caregivers of cognitively impaired older adults (Noh et al, 2021), scoping literature review in the general public (Patel & Lyons, 2020), development and validation of the Palliative Care Attitudes Scale (PCAS-9) (Perry et al, 2020), and Asian populations (Shen et al, 2020). The PaCKS tool has not been implemented in any study focused primarily on teenagers; however, it has been found to be inclusive of this population.…”