The National Palliative Care Research Center

Curing suffering through palliative care research.

Cauley,

Christy E. Cauley, MD, MPH

Assistant Professor

Massachusetts General Hospital

Grant Year
2022
Grant Term
2 years
Grant Type
Kornfeld Scholars Program

Project Description
Improving Surgical Communication Quality for Locally Advanced and Metastatic Cancer Patients with Fecal Ostomy

This proposal outlines a training and research program to support my transition to independence through development and testing of a communication intervention to improve surgical care of patients with locally advanced or metastatic colorectal cancer (LAMCRC) and their families. Background: Surgeons discuss options for fecal ostomy surgery for patients with LAMCRC experiencing severe symptoms including intestinal obstruction, intestinal perforation, and fecal incontinence. However, surgeons are not trained to address communication needs of patients and families facing these difficult treatment decisions, specifically tradeoffs in functional outcomes and caregiver burden with and without surgical intervention. Specific aims and research design: I aim to evaluate the unmet communication needs of this patient and family population and develop the first version of the Communication Guide for elective fecal ostomy Surgery (CG-oSurg) intervention through 1) interviews with adults with LAMCRC undergoing elective fecal ostomy surgery and their family (up to N=20) (Aim 1) and 2) focus groups of key clinical stakeholders (surgeons, nurse practitioners, and wound ostomy nurses) (N=4, <24) (Aim 2).  After CG-oSurg development, I will examine preliminary feasibility and acceptability of utilizing CG-oSurg in the surgical clinic via an open pilot (N=12 patients, N=2 surgeons) with exit interviews (Aim 3) to refine the intervention and methodology. In future work, I will compare CG-oSurg versus usual surgical care (N=48 patients; 24 patients and 2 surgeons per arm) in a RCT. Training: My training goals align with my research aims to develop expertise in: 1) clinical palliative care focusing on communication interventions; 2) mixed-methods assessment to inform intervention development; and 3) clinical trial methodology. Impact: As a colorectal surgeon with expertise in fecal ostomy surgery in patients with colorectal cancer I recognize the critical need to improve surgical care communication quality among patients with serious illness, families, and the surgical care team. 
Bio

Christy Cauley, MD, MPH, received her undergraduate degree from Purdue University, Medical Degree from Indiana University School of Medicine and her Master’s in Public Health degree from Harvard University. She completed general surgery residency at Massachusetts General Hospital and a colorectal surgery fellowship at Cleveland Clinic.  During her surgical residency she completed the two year NIH funded Program for Cancer Outcomes Research Fellowship at Ariadne Labs where she gained experience in health systems change. She is a colorectal surgeon at Massachusetts General Hospital, an Assistant Professor of Surgery at Harvard Medical School, and Faculty Researcher at Ariadne Labs. Her research focuses on improving care for surgical patients with serious illness across the aging spectrum and their families through interventions that support high quality communication and psychosocial well-being.


Email: CCAULEY@PARTNERS.ORG