Development and Initial Validation of a Palliative Care Readiness Tool for Older Adults with Cancer.
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PROJECT SUMMARY Older adults with cancer suffer from multi-morbidity and age-related physiological changes that can result in high symptom burden, diminished quality of life, and increased complexity of care. While early palliative care (PC) is associated with positive health outcomes such as symptom relief and improved quality of life, older adults with cancer utilize PC services to a lesser extent than their younger counterparts. They request not to be referred to PC or miss PC appointments when referred and delay PC until symptoms are uncontrollable or end of life is near. This low uptake of PC could stem from negative views of PC, lack of knowledge or awareness of PC, or the notion that they don’t ‘need’ PC or are not ‘ready’ for PC. Measuring readiness for early PC may increase the uptake of PC by increasing knowledge and awareness of PC and debunking negative perceptions of PC among older adults with cancer. Unfortunately, there are no tools available to measure readiness for early PC among adults or older adults with cancer. Thus, there is a critical need to develop and validate a tool that measures readiness for early PC in this group. To fulfill this gap, we propose developing the Palliative Care Readiness tool (PALCARE) that measures early PC readiness in older adults with cancer and establish its content validity and preliminary convergent validity and test-retest reliability. The project has three specific aims: a) develop the PALCARE tool to measure PC readiness in older adults with cancer; b) establish the content validity of the PALCARE tool; c) establish the preliminary convergent validity and test-retest reliability of the PALCARE tool. Results of this study will allow the primary oncology team to measure readiness for early PC in older adults with cancer and provide targeted PC that is congruent with their readiness level. The PALCARE tool will also help clinicians educate and support older adults with cancer who are not yet ready for PC. Ultimately the use of PALCARE can improve early PC utilization among older adults with cancer and improve their quality of life. Upon successfully completing this project, we will seek extramural funding from National Institute of Health for R15 renewal or R21 to further establish the psychometric validity and reliability of the PALCARE tool. Subsequently, we would seek R01 funding to conduct an intervention study that would examine the effectiveness of the PALCARE tool and develop targeted interventions to improve health outcomes in older adults with cancer. This project also provides opportunity for hands-on research training for several graduate and undergraduate students from the fields of nursing and health sciences. With expertise in instrument development, palliative care, and geriatric oncology, our interdisciplinary research team is well suited to conduct the proposed study. This project will enhance the research environment at the growing University of North Carolina at Charlotte with a large and diverse body of undergraduate students.
