Transcript Multidisciplinary Care Tools: Teamwork and family

Implementation and Evaluation of
Telephone Assisted Interventions
Mary Sormanti, Ph.D., MSW
Columbia University
School of Social Work
Project Goals & Rationale
• Development & implementation of telephone
support groups for people coping with eol issues
• Development of an evaluation model
• Dissemination of outcomes & procedural issues
• Student instruction about intervention
development and evaluation
Goal/Rationale
Why Develop & implement telephone support groups
for people coping with eol issues?
• Accessibility
• Affordability
• Empirical evidence of positive
psychosocial outcomes
Goal/Rationale
Why develop an evaluation model?
• We want to know if what we do makes a difference
• Forces us to be clear about our targets of intervention as well
as the interventions themselves
• Encourages a discussion of goals with our clients
• Provides us with insight that might not be obtained otherwise
• Enhances the link between research and practice (mutual)
• Necessary component of an ethical accountable profession
• Managed Care environment demands it
Goal/Rationale
Developing an evaluation model also will help
to answer the following questions:
• Are these types of groups feasible from agency &
client perspectives?
• Will agencies support their use?
• Will people attend?
• Will participants be satisfied?
• Will the groups lead to hoped-for client changes?
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Will participants have higher self-esteem?
Will participants experience better quality of life
Will participants be less depressed?
Will participants perceive change in qol?
Goal/Rationale
Why disseminate outcomes &
procedural issues?
• Add to existing practice knowledge
• Others can learn from my mistakes!
• Encourage innovation
• Demonstrate that evaluation is doable
Project Overview to Date
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Relationship-Building with Agency – Cancer Care, New York City
Determination of Group to be Served
Intervention Development
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Development of Measurement Plan
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Recruitment of Group Members
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Facilitation of Group for Women with Advanced Ovarian Cancer
• Interviews with former telephone group participants
• Interviews with agency staff
• Development of group parameters
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Deciding upon relevant “targets”
Reviewing measurement literature
Choosing & locating appropriate measures
Compilation of Measurement Packet
• Review of agency records
• Screening interviews
• Attainment of pre- & post-group data
• Analysis of group process
PROGRAM
ELEMENTS
GOALS
OPERATIONALIZATION
Identification Process
 Target individuals who are
confronted with end- of-life
issues
 Advanced/metastatic
illness
Willingness to talk
about dying

Intervention Process
 Provision of emotional
support
 Facilitation of grief work
 Enabling open discussion of
issues related to dying
 Encourage discussion of
affect
 Maintain focus on
difficult feelings
 Universalize & normalize
experiences
 Facilitate communication
with family and friends
 Problem-solve
strategies
for coping
with losses and demands
 Explore spiritual needs
Program Outcomes
 Enhanced adjustment
to dying process
 Improved quality of life
 Decreased psych.
distress
 Increased self-esteem
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Challenges
• Philosophical
• Organizational/Procedural
• Uncontrollable
Philosophical Challenges
• Defining “end of life”
• Deciding how to advertise the
group
• Is it okay to ask dying people to
participate in research?
Organizational/Procedural
Challenges
• Good eol measures hard to find
• Balancing “agendas” & priorities
• university – community agency
• Commitment & incentive
Uncontrollable Challenges
• Collaborator availability
• Participants’ illnesses
• Initial knowledge limitations
Next Steps
• Data Analysis for Group #1
• Content
• Process
• Outcomes
• Implement Group #2
• Revisit student involvement
• Dissemination
What I’ve Learned
Managing a project off-site is less than
ideal…but doable if:
• Everyone involved agrees to goals
• Everyone involved understands their role
• Everyone involved commits to their part in
reaching those goals
• Everyone involved benefits
What I’ve Learned
Practice research is time intensive…but
limited time can be maximized by:
• Establishing realistic goals at the start
• Anticipating obstacles - and solutions
• Insuring incentives for all involved
References for Measures
• Morasso, G., Costantini, M., Borreani, C., & Capelli, M. (1996).
Assessing psychological distress in cancer patients.
Validation of a self-administered questionnaire. Oncology,
53(4), 295-302.
• Osobo, D., Rodrigues, G., Myles, J. et al. (1998). Interpreting
the significance of health-related quality of life scores.
Journal of Clinical Oncology, 16, 139-144
• Rosenberg, M. (1965). Society and the adolescent selfimage. Princeton, NJ: Princeton University Press.
• http://www.facit.org