Palliative Care Research Unit, Department of Geriatrics and Palliative Medicine GP, Bispebjerg and Frederiksberg Hospitals, University of Copenhagen, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark.
Department of Oncology and Palliative Care, Zealand University Hospital, Roskilde, Denmark.
Support Care Cancer. 2022 Jan;30(1):377-387. doi: 10.1007/s00520-021-06432-1. Epub 2021 Jul 23.
The Carer Support Needs Assessment Tool Intervention (CSNAT-I) has shown positive effects in the Danish specialised palliative care (SPC) setting. Here, we explore the process, content, and experiences of delivering the CSNAT-I.
Data were collected during a stepped wedge cluster randomised controlled trial investigating the impact of the CSNAT-I in the Danish SPC setting in 2018-2019. Data were obtained from the CSNAT (tool) completed by caregivers, from health care professionals' (HCPs') written documentation of the CSNAT-I, and from semi-structured interviews with HCPs.
The study population consisted of the 130 caregivers receiving a first CSNAT-I within 13 days of study enrolment, the 93 caregivers receiving a second CSNAT-I 15-27 days after enrolment, and the 44 HCPs delivering the intervention. Top three domains of unmet caregiver support needs reported in the CSNAT-I were: "knowing what to expect in the future," "dealing with feelings and worries," and "understanding the illness." These domains together with "knowing who to contact if concerned" and "talking to the patient about the illness" were also the domains most frequently prioritised for discussion with HCPs. According to HCPs, most often support delivered directly by HCPs themselves during the actual contact (e.g., listening, advice, information) was sufficient. Overall, HCPs experienced the CSNAT-I as constructive and meaningful, and difficulties in delivering the intervention were rarely an issue.
The support needs reported by caregivers confirm the relevance of the CSNAT-I. HCPs' overall experiences of the clinical feasibility and relevance of the CSNAT-I were very positive. ClinicalTrials.gov ID: NCT03466580. Date of registration: March 1, 2018.
照顾者支持需求评估工具干预(CSNAT-I)在丹麦专业姑息治疗(SPC)环境中显示出积极的效果。在这里,我们探讨了提供 CSNAT-I 的过程、内容和经验。
数据是在 2018-2019 年期间进行的一项关于 CSNAT-I 对丹麦 SPC 环境影响的阶段性楔形集群随机对照试验中收集的。数据来自照顾者完成的 CSNAT(工具)、卫生保健专业人员(HCPs)关于 CSNAT-I 的书面记录以及 HCPs 的半结构化访谈。
研究人群包括 130 名在研究登记后 13 天内首次接受 CSNAT-I 的照顾者、130 名在登记后 15-27 天接受第二次 CSNAT-I 的照顾者和 44 名提供干预措施的 HCPs。在 CSNAT-I 中报告的未满足的照顾者支持需求的前三个领域是:“了解未来会发生什么”、“处理感受和担忧”和“了解疾病”。这些领域与“了解如果有问题应联系谁”和“与患者谈论疾病”一起也是与 HCPs 讨论最多的领域。根据 HCPs 的说法,在实际接触期间,HCPs 自己直接提供的支持(例如倾听、建议、信息)通常就足够了。总体而言,HCPs 认为 CSNAT-I 具有建设性和意义,而且很少出现提供干预措施的困难。
照顾者报告的支持需求证实了 CSNAT-I 的相关性。HCPs 对 CSNAT-I 的临床可行性和相关性的总体体验非常积极。ClinicalTrials.gov ID:NCT03466580。注册日期:2018 年 3 月 1 日。