The CHARMS pilot study: a multi-method assessment of the feasibility of a sexual counselling implementation intervention in cardiac rehabilitation in Ireland

Pilot and Feasibility Studies

Noeleen Fallon¹  Andrew W. Murphy²  Sally Doherty³  Tiny Jaarsma⁴  Amirhossein Jalali⁵  Martin O’Donnell⁵  John Newell⁵  Patrick J. Murphy⁶  Jenny Mc Sharry⁶  Maureen D’Eath⁶  Molly Byrne⁶  Elaine Toomey⁶  Chris Noone⁶  Paddy Gillespie⁷  Dympna Casey⁸  Elaine E. Steinke⁹ 

[1] Cardiac Rehabilitation Unit, Tallaght Hospital;Department of General Practice, NUI Galway;Department of Psychology, Royal College of Surgeons in Ireland;Department of Social and Welfare Studies, Linköping University;HRB Clinical Research Facility, NUI Galway;Health Behaviour Change Research Group, School of Psychology, NUI Galway;School of Business and Economics, NUI Galway;School of Nursing and Midwifery, NUI Galway;School of Nursing, Wichita State University;

关键词: Behaviour change;    Implementation intervention;    Complex intervention;    Cardiac rehabilitation;    Cardiovascular disease;    Sexual counselling;   

DOI  :  10.1186/s40814-018-0278-4

来源: DOAJ

【 摘 要 】

Abstract Background Many people living with cardiovascular disease (CVD) are affected by sexual problems associated with the condition. International guidelines recommend all patients with CVD should receive sexual counselling, yet this is rarely provided by health professionals. The current study piloted the Cardiac Health and Relationship Management and Sexuality (CHARMS) intervention, a complex multi-level intervention designed to increase the implementation of sexual counselling guidelines in hospital-based cardiac rehabilitation (CR) in Ireland. Methods The CHARMS intervention, consisting of awareness training and skills development for staff, and education and support for patients, was implemented in two CR centres. Following a repeated measures design, quantitative and qualitative feasibility, fidelity, cost, and outcome data were collected from staff and patients at baseline (T1, pre-intervention), at 3 months post-baseline (T2, post-intervention), and at 6 months post-baseline (T3, post-intervention). Data were organised according to a 14-point reporting framework of methodological issues that should be examined in pilot and feasibility studies. To inform a future definitive trial, potential solutions to identified feasibility issues were generated using the ADePT process for decision-making after pilot and feasibility trials. Results Most elements of the study protocol were executed smoothly, and intervention implementation was successful. Patients’ (N = 42) responses to the intervention were positive. The reporting framework and the ADePT process facilitated the identification of two overarching feasibility problems, as well as solutions to be implemented in a definitive trial: (1) a high level of patient attrition in the pilot study, to be addressed through the use of financial incentives, reducing the length of the patient questionnaire, and providing a telephone survey option; and (2) negative staff perceptions, to be addressed through an augmented staff intervention, reframing ‘sexual counselling’ as ‘sexual education and support’ to fit with professional role perceptions, and reviewing all intervention terminology with a CR staff member to ensure acceptability. Conclusions This article reports the successful piloting of a novel sexual counselling implementation intervention in cardiac rehabilitation. The utilisation of an extended reporting framework and the ADePT process facilitated the identification of adaptations necessary to ensure the feasibility of a definitive trial, thereby maximising methodological transparency.

【 授权许可】

Unknown