PRO-FRAIL: Capturing and measuring what matters most to older people with frailty towards the end of life
Overview
In the coming decades older people with frailty will be one of the main recipients of palliative care. This change will significantly impact how health systems provide end-of-life services. Patient-reported outcome measures (PROMs) and Patient experience measures (PREMs) are increasingly used within healthcare. However, in the context of palliative care have been predominately developed with patients with single disease such as cancer. It is not clear how well PROMs and PREMs meet the expressed needs of older people with frailty, and their caregivers, or how they are used with this group towards the end of life.
Aim
- To identify how the needs, experiences, and priorities of those with severe frailty can most effectively be assessed with PROMs and PREMs
- Co-design a prototype adapted PREM/PROM which addresses the needs and priorities of this group.
Funder
PRO-FRAIL film
Please watch our 3-minute video explaining the project below, or for more information contact Faith Howard at f.howard@surrey.ac.uk.
Team
Study team
Professor Caroline Nicholson
Professor of Palliative Care and Ageing
Biography
Caroline is a Clinical Academic Nurse and her research forwards understanding and care for older people living with complex needs. She is particularly interested in the transitions that occurs in the last phase of life. Caroline qualified as a Registered Nurse at St Bartholomew’s Hospital London. She worked as a specialist Palliative Care Nurse before undertaking a combined BSc (Hons) in Community Nursing DN/HV Certs at King’s College London. She went on to an MSc in Medical Anthropology at Brunel University London before completing her PhD at City University, London in 2009. She is a FHEA from the Institute of Education and holds a diploma in psycho-dynamic approaches to old age from the Tavistock and Portman NHS Foundation Trust, London
Caroline is a HEE/NIHR Senior Clinical Academic Lecturer, working between the School of Health Sciences at Surrey University and St Christopher’s Hospice, London. She is passionate in her belief that everyone should have access to the best care and support in the final years of their life. She has a long-held interest in the experiences and palliative care needs of older people and their families and is co-lead in End of life Care for the British Geriatrics Society.
Caroline studies the experiences and care of older people living with complex needs across care settings, to develop interventions which equally value quality of life with quantity of years in old age. She has a long-held interest in the experience of older people living with frailty, and their capabilities as well as their current and future vulnerabilities. Her work also includes the development of care services and a workforce that can recognize, facilitate and enhance the processes and outcomes of high-quality palliative and supportive care. Caroline is committed to building the next generation of clinical academics and is an NIHR Nurse Training Advocate . Research expertise includes participatory action research, narrative research, mixed method research and complex intervention development.
Dr Jenny Harris
Senior Lecturer in Cancer Care and Health Statistics
Biography
Jenny is a Senior Lecturer in Cancer Care and Health Statistics the School of Health Sciences at the University of Surrey. Her on-going programme of work focuses on optimising health care delivery and outcomes based on data-driven approaches often informed by psychological and behavioural insights.
Jenny has a particular interest in psychosocial care for people living with cancer and using data driven insights to improve multidisciplinary teamworking and quality of care, patient experience and clinical outcomes.
Her recent work has been focused on the intersection of cancer and maternity care, and exploring how insights from cancer health services research might be adapted and implemented for other conditions or areas of care, notably maternity and obstetric care (TEAM-QI), peripheral artery disease and veterinary medicine.
Methodological interests include predictive risk modelling incorporating questionnaires, surveys and questionnaire design and validation, mixed-methods evaluations of complex interventions (quasi-experimental designs, feasibility studies, RCTs) and real-world implementation of electronic Patient Reported Outcome and Experience Measures. Jenny is passionate about involving patients and the public in research including studies using advanced statistical methods.
Dr Richard Green
Surrey Future Fellow
Biography
Richard was awarded a prestigious Surrey Future Fellowship in April 2023 to work with interdisciplinary colleagues from the Surrey Institute for People-Centred AI and across the university to develop a programme of research on the use of 'carebots' (chatbots and other artificial technologies) to support the health and wellbeing of older adults. Prior to this role, Richard was working as a Research Fellow, project managing The PALLUP Study - Improving home based palliative care for frail elders and his current fellowship continues and extends his research on the health and wellbeing of older adults in later life.
Richard completed a BSc in Criminology and Sociology at Royal Holloway university and then an MSc in Social Research Methods at the University of Surrey, before completing his PhD in Sociology in partnership with both universities on an ESRC studentship. His PhD explored men's experiences following treatment for prostate cancer in a qualitative interviewing study. Before joining the PALLUP study, Richard worked at the Office for National Statistics as a Senior Research Officer, working on facilitating research access to secure data for research that serves the public good.
Dr Joy Ross
Consultant in Palliative Medicine, St Christopher’s
See profileResearch groups and centres
Our research is supported by research groups and centres of excellence.