The CHARMS pilot study: A multi-method assessment of the feasibility of a sexual counselling implementation intervention in cardiac rehabilitation in Ireland: A multi-method assessment of the feasibility of a sexual counselling implementation intervention in cardiac rehabilitation in Ireland

Elaine Toomey, Andrew Murphy, Patrick Murphy, Dympna Casey, Molly Byrne, Chris Noone, Martin O’Donnell, Paddy Gillespie, John Newell, Maureen D'Eath

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Abstract

Many people living with cardiovascular disease (CVD) are affected by sexual problems associated with the condition. International guidelines recommend all patients with CVD should receive sexual counselling, yet this is rarely provided by health professionals. The current study piloted the Cardiac Health and Relationship Management and Sexuality (CHARMS) intervention, a complex multi-level intervention designed to increase the implementation of sexual counselling guidelines in hospital-based cardiac rehabilitation (CR) in Ireland. The CHARMS intervention, consisting of awareness training and skills development for staff, and education and support for patients, was implemented in two CR centres. Following a repeated measures design, quantitative and qualitative feasibility, fidelity, cost, and outcome data were collected from staff and patients at baseline (T1, pre-intervention), at 3 months post-baseline (T2, post-intervention), and at 6 months post-baseline (T3, post-intervention). Data were organised according to a 14-point reporting framework of methodological issues that should be examined in pilot and feasibility studies. To inform a future definitive trial, potential solutions to identified feasibility issues were generated using the ADePT process for decision-making after pilot and feasibility trials. Most elements of the study protocol were executed smoothly, and intervention implementation was successful. Patients (N=42) responses to the intervention were positive. The reporting framework and the ADePT process facilitated the identification of two overarching feasibility problems, as well as solutions to be implemented in a definitive trial: (1) a high level of patient attrition in the pilot study, to be addressed through the use of financial incentives, reducing the length of the patient questionnaire, and providing a telephone survey option; and (2) negative staff perceptions, to be addressed through an augmented staff intervention, reframing sexual counselling as sexual education and support to fit with professional role perceptions, and reviewing all intervention terminology with a CR staff member to ensure acceptability. This article reports the successful piloting of a novel sexual counselling implementation intervention in cardiac rehabilitation. The utilisation of an extended reporting framework and the ADePT process facilitated the identification of adaptations necessary to ensure the feasibility of a definitive trial, thereby maximising methodological transparency.
Original languageEnglish (Ireland)
Article number88
Number of pages88
JournalPilot and Feasibility Studies
Volume4
Issue number1
DOIs
Publication statusPublished - 1 Jan 2018

Keywords

  • Behaviour change
  • Cardiac rehabilitation
  • Cardiovascular disease
  • Complex intervention
  • Feasibility study
  • Implementation intervention
  • Pilot trial
  • Sexual counselling

Authors (Note for portal: view the doc link for the full list of authors)

  • Authors
  • Murphy, P.J. and Noone, C. and DâEath, M. and Casey, D. and Doherty, S. and Jaarsma, T. and Murphy, A.W. and OâDonnell, M. and Fallon, N. and Gillespie, P. and Jalali, A. and Sharry, J.M. and Newell, J. and Toomey, E. and Steinke, E.E. and Byrne, M.
  • Murphy PJ;Noone C;D'Eath M;Casey D;Doherty S;Jaarsma T;Murphy AW;O'Donnell M;Fallon N;Gillespie P;Jalali A;Sharry JM;Newell J;Toomey E;Steinke EE;Byrne M;
  • Murphy, P. J. and Noone, C. and D'Eath, M. and Casey, D. and Doherty, S. and Jaarsma, T. and Murphy, A. W. and O'Donnell, M. and Fallon, N. and Gillespie, P. and Jalali, A. and Sharry, J. M. and Newell, J. and Toomey, E. and Steinke, E. E. and Byrne, M.
  • Murphy, P. J., Noone, C., D'Eath, M., Casey, D., Doherty, S., Jaarsma, T. & Byrne, M.
  • Murphy, P. J., Noone, C., DEath, M., Casey, D., Doherty, S., Jaarsma, T., & Byrne, M.

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