ORLANDO, FL—Reliability and validity testing of a new instrument, the Nursing Assessment of Family Caregiver Knowledge and Action Tool (NAFCKAT) has found it to be potentially useful at identifying patient and family caregivers who need additional support and purposeful follow-up by the health care team, according to a study presented at the ONS 40th Annual Congress.
“Older adults are at increased risk for experiencing cancer treatment side-effect related symptoms,” said Patricia Geddie, MS, CNS, AOCNS®, of Orlando Health, Orlando, Florida.
In the United States, there are 50 million family caregivers who lack knowledge, skill preparation, and experience in handling symptoms in patients with cancer in the home setting.
Understanding family caregiver knowledge and action for cancer treatment symptoms is important to prevention of unplanned hospital admissions in older adults with cancer; however, how prepared family caregivers are to recognize and manage these symptoms in the home setting remains unclear, Geddie explained. “No measures of nursing assessment of family caregiver knowledge and action exist for these symptoms.”
Geddie and colleagues developed the NAFCKAT to standardize nurse assessment of family caregivers and guide future interventions to facilitate home care. The tool includes 11 items, two subscales (fever and dehydration), uses common language for observed behaviors, provides predetermined response options, and takes an average of 10 minutes to complete.
NAFCKAT was evaluated in a three-step process. In the first step, they identified item development, response options, and format.
“The second step was an inter-reliability study with oncology clinic nurses,” Geddie explained. “Nurse raters were asked to view and record responses from three researcher-developed video vignettes of family caregiver interviews.”
The third step was a validity study of gender, education, caregiving experience, and cancer experience. The NAFCKAT was administered with family caregivers via structured interview format with predetermined response choices.
Results showed that excellent inter-rater reliability was obtained, greater than 95%, with 48.8% of the total sample scoring 11 points, the top score.
Mean score for the total sample was 9.22 (SD 2.13), “indicating a fairly high level of knowledge and plan of action for fever and dehydration symptoms,” Geddie said.
Significant differences were found in mean total scores for gender (P<0.05) and in mean fever subscale scores for females, college educated, and experience (P<0.05).
No significant within-group differences in mean dehydration subscale scores were identified in any of the known group analyses.
Study limitations include all study participants were white and only one site was included in the study. Recommendations include refining the dehydration scale.
“NAFCKAT has potential in the outpatient setting,” reported Geddie. It can establish a baseline of patients and family caregiver knowledge and identify a potential need for additional support.
Underwriting or funding source provided by Lupus Foundation of Florida.