A process evaluation of systematic risk and needs assessment for caregivers in specialised palliative care
Open Access
- 8 April 2017
- journal article
- research article
- Published by Springer Science and Business Media LLC in BMC Palliative Care
- Vol. 16 (1), 1-8
- https://doi.org/10.1186/s12904-017-0196-x
Abstract
Caregiving is strenuous and it may be associated with adverse psychological outcomes. During the palliative care trajectory, there are unique opportunities for providing support and preventing poor bereavement outcome. However, the tasks of palliative care staff in relation to caregivers are often unclear in the daily practice. Assessment is recommended to establish risk and needs and standards for caregiver support are available. Still, the feasibility of applying these standards among caregivers in everyday clinical practice has not been tested so far. This study tested the feasibility of an intervention based on key elements of the “Bereavement support standards for specialist palliative care services” in a Danish specialised palliative home care team. We followed the UK Medical Research Council’s guidelines for the process evaluation of complex interventions. The intervention consisted of: 1. Systematic risk and needs assessment for caregivers at care entry; 2. Interdisciplinary conference to prepare a support plan; 3. Targeted support; 4. The establishment of an electronic medical record for caregivers to document targeted support. Outcomes included the reach, fidelity and acceptability of the intervention as well as the assessment of contextual factors. The intervention reached 76 of 164 caregivers (46%). The interdisciplinary risk assessment and documentation of a support plan was conducted in 57 (75%) of the enrolled caregivers. Finally, a separate medical record was established according to the intervention blueprint for 62% of caregivers receiving targeted support. After managing initial challenges, palliative care staff reported that the intervention was useful and acceptable. The intervention proved feasible and useful. Still, we identified barriers to the implementation which should be taken into consideration when planning implementation of a systematic risk and needs assessment and in the establishment of medical records for caregivers.Funding Information
- TrygFonden
- Kræftens Bekæmpelse
- Health Research Fund of Central Denmark Region
This publication has 21 references indexed in Scilit:
- The Carer Support Needs Assessment Tool (CSNAT) for Use in Palliative and End-of-life Care at Home: A Validation StudyJournal of Pain and Symptom Management, 2013
- The Melbourne Family Support Program: evidence-based strategies that prepare family caregivers for supporting palliative care patients: Table 1BMJ Supportive & Palliative Care, 2013
- Development of a Carer Support Needs Assessment Tool (CSNAT) for end-of-life care practice at home: A qualitative studyPalliative Medicine, 2012
- Supporting family caregivers of hospitalised palliative care patients: a psychoeducational group interventionBMJ Supportive & Palliative Care, 2012
- Complicated grief and need for professional support in family caregivers of cancer patients in palliative care: a longitudinal cohort studySupportive Care in Cancer, 2011
- Predictors of Complicated Grief: A Systematic Review of Empirical StudiesDeath Studies, 2010
- A systematic review of psychosocial interventions for family carers of palliative care patientsBMC Palliative Care, 2010
- A systematic review of instruments related to family caregivers of palliative care patientsPalliative Medicine, 2010
- Bereavement Assessment Practice in Hospice Settings: Challenges for Palliative Care Social WorkersThe British Journal of Social Work, 2010
- Review of the literature on the effects of caring for a patient with cancerPsycho‐Oncology, 2009