Development of a Carer Support Needs Assessment Tool (CSNAT) for end-of-life care practice at home: A qualitative study

2012 ◽  
Vol 27 (3) ◽  
pp. 244-256 ◽  
Author(s):  
Gail Ewing ◽  
Gunn Grande ◽  
Keyword(s):  
Qualitative Study ◽  
Needs Assessment ◽  
End Of Life ◽  
End Of Life Care ◽  
Assessment Tool ◽  
Care Practice ◽  
Support Needs ◽  
Life Care ◽  
Carer Support ◽  
At Home

12 Feasibility of an online implementation toolkit for palliative care services seeking to implement a carer-centred process of assessment and support

2018 ◽  
Vol 8 (3) ◽  
pp. 364.1-364
Author(s):  
Janet Diffin ◽  
Gail Ewing ◽  
Christine Rowland ◽  
Gunn Grande
Keyword(s):  
Online Learning ◽  
Needs Assessment ◽  
End Of Life Care ◽  
Assessment Tool ◽  
Support Needs ◽  
Life Care ◽  
Face To Face ◽  
Care Services ◽  
Carer Support ◽  
Palliative Care Services

IntroductionThe Carer Support Needs Assessment Tool (CSNAT) intervention requires a change in practice to a carer-centred process of assessment and support.1-3 An online toolkit was developed to guide palliative services through the process of implementing the CSNAT intervention.AimsExplore the feasibility and acceptability of delivering implementation training through an online toolkit format.MethodsThe online toolkit has two learning components: (1) Individual: knowledge for practitioners to use the intervention; (2) Organisational: to assist a project team to plan pilot and sustain implementation. Five UK palliative care services participated; 2–4 practitioners from each completed the toolkit. Online survey administered upon completion of each learning component for feedback on content followed by telephone interview.Results15 practitioners completed ‘Learning component 1’ survey 14 completed ‘Learning component 2’ survey and 13 were interviewed. Feedback on content was positive. Online learning suitability was influenced by resource availability the nature/size of the team and individual learning styles. Variation in location of completion (work/home or both) was partly explained by availability of IT equipment space and time within the organisation. Whilst the majority of participants saw the value of online learning some had a preference for face-to-face delivery and so blended learning to include group discussions was deemed appropriate.ConclusionsWhilst online learning is welcomed by practitioners organisations need to ensure sufficient resources are available to enable completion and that it is given the same priority as attendance at face-to-face workshops. Blended learning may help accommodate different learning preferences.FunderNIHR CLARHC Greater ManchesterReferences. Ewing G, Grande G. Development of a Carer Support Needs Assessment Tool (CSNAT) for end-of-life care practice at home: A qualitative study. Palliative Medicine2013;27(3):244–56.. Ewing G, Brundle C, Payne S, Grande G. The Carer Support Needs Assessment Tool (CSNAT) for use in palliative and end-of-life care at home: A validation study. Journal of Pain and Symptom Management2013;46(3):395–405.. Ewing G, Austin L, Diffin J, Grande G. Developing a person-centred approach to carer assessment and support. British Journal of Community Nursing2015;20(12):580–4.

scholarly journals A drive for structure: A longitudinal qualitative study of the implementation of the Carer Support Needs Assessment Tool (CSNAT) intervention during hospital discharge at end of life

2020 ◽  
Vol 34 (8) ◽  
pp. 1088-1096
Author(s):  
Alex Hall ◽  
Gail Ewing ◽  
Christine Rowland ◽  
Gunn Grande
Keyword(s):  
Qualitative Study ◽  
Needs Assessment ◽  
End Of Life ◽  
Hospital Discharge ◽  
Performance Metrics ◽  
Assessment Tool ◽  
Care Patient ◽  
Practical Implementation ◽  
Support Needs ◽  
Carer Support

Background: Informal carers are essential in enabling discharge home from hospital at end of life and supporting palliative patients at home, but are often ill-prepared for the role. Carers’ support needs are rarely considered at discharge. If carers are less able to cope with home care, patient care may suffer and readmission may become more likely. Aim: To investigate the implementation of an evidence-based Carer Support Needs Assessment Tool (CSNAT) intervention to support carers during hospital discharge at end of life. Design: Longitudinal qualitative study with thematic analysis. Setting/participants: One National Health Service Trust in England: 12 hospital practitioners, one hospital administrator and four community practitioners. We provided training in CSNAT intervention use and implementation. Practitioners delivered the intervention for 6 months. Data collection was conducted in three phases: (1) pre-implementation interviews exploring understandings, anticipated benefits and challenges of the intervention; (2) observations of team meetings and review of intervention procedures and (3) follow-up interviews exploring experiences of working with the intervention. Results: Despite efforts from practitioners, implementation was challenging. Three main themes captured facilitators and barriers to implementation: (1) structure and focus within carer support; (2) the ‘right’ people to implement the intervention and (3) practical implementation challenges. Conclusions: Structure and focus may facilitate implementation, but the dominance of outcomes measurement and performance metrics in health systems may powerfully frame perceptions of the intervention and implementation decisions. There is uncertainty over who is best-placed or responsible for supporting carers around hospital discharge, and challenges in connecting with carers prior to discharge.

scholarly journals Who cares for the carers at hospital discharge at the end of life? A qualitative study of current practice in discharge planning and the potential value of using The Carer Support Needs Assessment Tool (CSNAT) Approach

2018 ◽  
Vol 32 (5) ◽  
pp. 939-949 ◽  
Author(s):  
Gail Ewing ◽  
Lynn Austin ◽  
Debra Jones ◽  
Gunn Grande
Keyword(s):  
Needs Assessment ◽  
End Of Life ◽  
Hospital Discharge ◽  
Assessment Tool ◽  
Discharge Planning ◽  
Hospital Setting ◽  
Support Needs ◽  
Framework Analysis ◽  
Carer Support ◽  
At Home

Background: Carer factors prevent patients achieving timely and appropriate hospital discharge. There is a lack of research into interventions to support carers at hospital discharge. Aim: To explore whether and how family carers are currently supported during patient discharge at end of life; to assess perceived benefits, acceptability and feasibility of using The Carer Support Needs Assessment Tool (CSNAT) Approach in the hospital setting to support carers. Design: Qualitative. Setting/participants: Three National Health Service Trusts in England: focus groups with 40 hospital and community-based practitioners and 22 carer interviews about experiences of carer support during hospital discharge and views of The CSNAT Approach. Two workshops brought together 14 practitioners and five carers to discuss implementation issues. Framework analysis was conducted. Results: Current barriers to supporting carers at hospital discharge were an organisational focus on patients’ needs, what practitioners perceived as carers’ often ‘unrealistic expectations’ of end-of-life caregiving at home and lack of awareness of patients’ end-of-life situation. The CSNAT Approach was viewed as enabling carer support and addressing difficulties of discussing the realities of supporting someone at home towards end of life. Implementation in hospital required organisational considerations of practitioner workload and training. To enhance carer support, a two-stage process of assessment and support (hospital with community follow-up) was suggested using the CSNAT as a carer-held record to manage the transition. Conclusion: This study identifies a novel intervention, which expands the focus of discharge planning to include assessment of carers’ support needs at transition, potentially preventing breakdown of care at home and patient readmissions to hospital.

Future provision of home end-of-life care: Family carers’ willingness for caregiving and needs for support

2020 ◽  
pp. 1-7
Author(s):  
Wallace Chi Ho Chan
Keyword(s):  
Psychological Distress ◽  
End Of Life ◽  
End Of Life Care ◽  
Assessment Tool ◽  
Family Members ◽  
Depression Scale ◽  
Support Needs ◽  
Life Care ◽  
Family Carers ◽  
Additional Support

Abstract Objective This study aimed to examine family carers’ willingness, perceived difficulties and confidence in providing home end-of-life care to family members in future and their needs for support for doing so. Specific focus was on whether significant differences were found between carers of low and high levels of psychological distress. Method Family carers who had been providing care to family members living in the community were recruited via a local elderly agency in Hong Kong. A survey was conducted. Carers were asked to complete a questionnaire which included self-developed items, the Hospital Anxiety and Depression Scale, and the Carers’ Support Need Assessment Tool. Results Of the 89 participants, 63.8% reported willingness to provide end-of-life care in future (increased to 78.5% if support needs were met), but most perceived it as difficult, and over half were not confident about doing so. The three greatest needs for support in end-of-life care are understanding the relative's illness, knowing what to expect in future, and knowing who to contact if concerned. Participants of the high psychological distress group experienced a significantly greater need for support in “dealing with your feelings and worries” and “looking after your own health.” Significance of Results Current family carers may not be ready for future provision of home end-of-life care. Meeting their support needs in providing end-of-life care is crucial to ensure the continuity of care provision. Psychologically distressed carers may often ignore self-care and may need helping professionals’ additional support.

scholarly journals Families' experiences of end-of-life care at home for Iranian older adults: A qualitative study

2020 ◽  
Vol 26 (4) ◽  
pp. 468
Author(s):  
Kian Norouzi ◽  
ManijehDehi Aroogh ◽  
FarahnazMohammadi Shahboulaghi ◽  
Reza Negarandeh
Keyword(s):  
Older Adults ◽  
Qualitative Study ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Care At Home ◽  
At Home
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