Table 2 The intervention focused on quality of life measurement

1. Name of intervention

 The INtervention FOcused on Quality of Life Measurement (The INFO-QoL)

2. Goals of intervention

 a. Ultimate goal: to prevent/manage impaired quality of life in advanced cancer patients with palliative care needs in hospice setting and promote measurement of patient’s quality of life

 b. Immediate goals:

  i. To reduce prevalence and/or severity of patient’ s problems/needs

  ii. To identify patients at risk of developing impairments in QoL dimensions

  iii. To increase staff awareness of problems/needs, their trajectory, and appropriate intervention to address them

  iv. To inform individual care plans based on impaired QoL dimensions and local policies

3. Components and activities

 a. Component 1: ensure that treatment plans and evaluations focus on patient rather than disease

  i. Goal: to educate staff about QoL issues and about interventions that promote a better QoL

  ii. Activities: discuss the following topics:

   – What is QoL in palliative care patients?

   – What are the dimensions that contribute to a person’s QoL?

   – What are the determinants of changes in self-assessment of QoL?

   – How staff should propose, use, and score QoL tools to patients

   – How palliative care staff can effect changes in patients to improve their QoL

 b. Component 2: the Palliative Outcome Scale (POS) as an integral component of the intervention

  i. Goal: patient and family education on using outcome measures

  ii. Activities: present the purpose of QoL assessment to patients and their families; educate patients on using the POS

 c. Component 3: QoL measurement using the POS

  i. Goal: to promote cohesive, coordinated patient- and family-centered care

  ii. Activities: screening (i.e., baseline) and monitoring individual patients (morning shift), record individual and overall scores on individual INFO-QoL form, and discuss results to inform clinical decision during unit staff briefing

4. Mode of delivery

 a. Component 1: small group education session (6–8 palliative care nurses)

  i. Use combination of written and verbal presentation and group discussion

  ii. Written presentation: case-based materials, self-study binders, poster

  iii. Verbal presentation: evidence on QOL issue in palliative care

  iv. Group discussion: elicit case discussions to focus on issues related to patients’ QoL

 b. Component 2: nurses-patient and family face-to-face interaction

  i. Use combination of written material and verbal communication

  ii. Written materials, such as handout on QoL issues, and poster with large print and simple language hanging in the inpatient hospice unit

  iii. Verbal communication using a slow rate of speech, simple and common words, short sentences, and a teach-back technique

 c. Component 3: individual QoL measurement

  i. Nurse team leader is responsible to manage the measurement (i.e., schedule the measurement, prepare documentation, assign patient to nurse or nursing assistant, oversee completion of QoL measurement)

  ii. Nurse or nursing assistant who perform the QoL measurement motivates patient to improve compliance

  iii. Staff discusses results and gives feedback of results and care plan to patient

5. Dose

 a. Component 1: self-study binders given 2 weeks before the education bundle program session; one small group education session of 3-h duration (repeated at different time points to allow all staff to participate)

 b. Component 2: education session of about 10/15-min duration

 c. Component 3: measurement within day 3 from admittance, days 8–10, day 15 and then once a week; patient feedback at the same day of the measurement