This trial investigates the experience and satisfaction of care in patients with cancer that has spread to other places in the body (advanced) and their caregivers living in underserved areas of Kenya, Nigeria, Ghana, South Africa, India and Ethiopia as part of Project Extension for Community Healthcare Outcomes (ECHO). Project ECHO is a model of medical education and care management that empowers clinicians to provide better care to more people where they live. Understanding the experiences and satisfaction of patients and caregivers may help improve healthcare workforce capacity and increase access to specialty care for the world's rural and underserved populations.
PATIENT: Scheduled to receive treatment at participating primary care practice for advanced cancer
PATIENT: 18 years or older
PATIENT: Willing to be accessible to the research team for follow-up by telephone or in person
PATIENT: Prognosis of at least 1 year as ascertained by the treating physician
Unable to understand and sign consent
Parallel
Extension of Community Health (ECHO) Telementoring Clinic
Other interventionParticipate in ECHO clinics presenting cases for guidance and feedback
In-Country Workshops
Other interventionIn-Country Workshops Participate in hands-on training and workshops
Professional Oncology Educations Programs
Other interventionReceive 5 core online lectures
Medical Chart Review
Other interventionMedical charts are reviewed for data collection
Questionnaire Administration
Other interventionComplete questionnaire(s)
Change in patients' quality of life
Measured by Functional Assessment of Cancer Illness Therapy FACT-General (FACT-G). A 27-item compilation of general questions divided into four primary domains: Physical Well-Being, Social/Family Well-Being, Emotional Well-Being, and Functional Well-Being. Each question is assessed using a Likert scale ranging from 0 to 4. The FACT-G total score is the sum of the domain scores..
Change in patients' symptom distress
Will be assessed by the Edmonton Symptom Assessment Scale, Symptom Distress Scores, (ESAS-SDS). The ESAS is a validated questionnaire measuring 10 symptoms (pain, fatigue, nausea, depression, anxiety, drowsiness, shortness of breath, appetite, sleep, and well-being). It has good reliability and can be completed within minutes. The ESAS-SDS will be calculated by the sum of the symptom scores of measures ESAS Pain, ESAS Fatigue, ESAS nausea, ESAS Depression, ESAS anxiety, ESAS drowsiness, ESAS Dyspnea, ESAS Appetite, ESAS Well-being.
Patients' satisfaction of care
Assessed by FAMCARE P16, a self-report scale assessing patient experience and satisfaction with outpatient palliative oncology care, which is composed of 16 items rated from 1 (very dissatisfied) to 5 (very satisfied). The items are not specific for a particular tumor type or symptom but are broadly relevant for outpatients with advanced cancer; the summed items produce a single satisfaction score.
Caregivers' satisfaction of care
Assessed by FAMCARE -cg scale, which measures the degree of experience and satisfaction of the caregivers with health care in terms of information provided, availability of care, physical individual with advanced cancer care, and psychological care for patients.
Providers' efficacy in knowledge of delivering palliative care
Assessed by completing the Palliative Care Participant Initial Survey
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