Bone Marrow Transplant Telehealth Support Group

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Bone Marrow Transplant Telehealth Support Group

• Helen MacRae, Ph. D., RPsych
• Maureen Angen. PhD. RPsych
• Psychosocial Resources
• TBCC/HCS
• Alberta Cancer Board

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Outline

• Opportunity
• Fit
• If you build it(program design)
• They will come? (recruitment)
• Program delivery
• Program outcomes
• Future Directions/ Discussion

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Grant Opportunity

• 2005 AH W
• BMT Survivors Support
• 2006 CTIP
• Continued support

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Grant Objectives

• AH W
• Ensure clinical services are sustained
• implementation phases leading to routine service.
• Increase access
• Clinical telehealth services
• Province-wide
• As many regions as possible
• Provide seed funding
• new clinical services
• address a specific need (gap)
• CTIP
• Sustaining/expanding
• BC, Sask, NWT

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Fit- BMT

• TBCC Allogeneic BMT Program
• AB, NWT, SK, SE BC
• 70 allo BMT pts. ? Calgary
• Outreach
• Continued support
• Cost / Travel
• Connections

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If you build it- BMT

• Gap analysis
• Pilot program
• Consultation

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If you build it

• Format
• Psycho-educational / supportive
• Didactic
• Narrative group support
• Relaxation skills
• 6 sessions / 12 weeks (1st series) weekly
  following series
• Delivery site 3 distant sites

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If you build it

• Participants
• Post-allogeneic BMT
• Caregivers - some sessions
• Optimal 8 per program
• 4-10 served
• No participant cost

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If you build it

• BMT Content
• Each session
• Getting here
• Didactic content
• Interactive discussion/support
• Relaxation
• Healing visualization

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If you build it

• BMT Content
• Session 1 Introduction
• Session 2 Transitions/Coping
• Session 3 Family Issues
• Session 4 Fatigue/Stress Reduction
• Session 5 Sexuality
• Session 6 Summary/Closing Ritual

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They will come? - BMT

• Recruitment BMT
• Strategies
• Mail out - allo survivors lt 5 yrs
• Follow-up phone calls
• 3 Regions chosen
• Others waitlisted
• Dates, time and sites set

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They will come?

• Problems
• Limited response
• Too late for follow-up
• Back to work
• Too ill

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They will come?

• Solutions
• Face-to-face at TBCC
• Phone contact
• Consistent programming
• Nursing and physicians buy in
• local
• distant

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BMT - Remote Locations

• Participants
• Sept 2005
• Edmonton - 4
• Whitecourt 1
• St. Paul 1
• January 2006
• Edmonton 3
• Valleyview - 1
• Edson - 2

• Jan 2007
• Stony Plain 1
• Grimshaw 1
• Penticton 1
• Okotoks 1

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Program Delivery - BMT

• Technology
• Telehealth set-up
• Room setup (camera angles, room layout)
• Video Bridge (display all sites, dial out)
• Training on equipment
• Requirements for additional equipment (bells,
  music, slides etc.)

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Program Delivery

• Managing group process
• Lag time issues
• Inviting interaction from each site (active)
• Facilitator Experiences
• Group cohesion (surprised!)
• Manipulating camera angles
• Background noise at distant sites (mute)
• Relaxation response (more surprise!)

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Outcomes - BMT

• Most Helpful
• The other participants stories.
• Validation of new reality support from others
  who know what I am going ( went) through being
  able to share and help other people.

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Outcomes - BMT

• Most Helpful
• Hearing about other group members coping
  techniques and ideas on stress reduction.
• The opportunity to talk with others who have
  been through a bone marrow transplant.
• Just talking with each other.

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Outcomes

• Least Helpful
• (one comment all others N/A or left blank)
• Sometimes was difficult to feel in a
  conversation (smoothness?) because of
  technology.

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Outcomes

• Suggestions
• Morning sessions fatigue tends to be greatest
  in the afternoon.
• earlier in the day before members become too
  fatigued.
• meet outside of a hospital environment.
• Have the patients partner at a few more
  sessions.

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Future Directions

• Optimal number of sites and participants
• 6 session series (weekly)
• max of 3 distant Telehealth sites
• up to 10 participants in total
• Balancing psychoeducation and interactive group
  processes