The impact of the carer support needs assessment tool (CSNAT) in community palliative care using a stepped wedge cluster trial
MetadataShow full item record
Family caregiving towards the end-of-life entails considerable emotional, social, financial and physical costs for caregivers. Evidence suggests that good support can improve caregiver psychological outcomes. The primary aim of this study was to investigate the impact of using the carer support needs assessment tool (CSNAT), as an intervention to identify and address support needs in end of life home care, on family caregiver outcomes. A stepped wedge design was used to trial the CSNAT intervention in three bases of Silver Chain Hospice Care in Western Australia, 2012-14. The intervention consisted of at least two visits from nurses (2-3 weeks apart) to identify, review and address caregivers' needs. The outcome measures for the intervention and control groups were caregiver strain and distress as measured by the Family Appraisal of Caregiving Questionnaire (FACQ-PC), caregiver mental and physical health as measured by SF-12v2, and caregiver workload as measured by extent of caregiver assistance with activities of daily living, at baseline and follow up. Total recruitment was 620. There was 45% attrition for each group between baseline and follow-up mainly due to patient deaths resulting in 322 caregivers completing the study (233 in the intervention group and 89 in the control group). At follow-up, the intervention group showed significant reduction in caregiver strain relative to controls, p=0.018, d=0.348 (95% CI 0.25 to 0.41). Priority support needs identified by caregivers included knowing what to expect in the future, having time for yourself in the day and dealing with your feelings and worries. Despite the challenges at the clinician, organisational and trial levels, the CSNAT intervention led to an improvement in caregiver strain. Effective implementation of an evidence-informed and caregiver-led tool represents a necessary step towards helping palliative care providers better assess and address caregiver needs, ensuring adequate family caregiver support and reduction in caregiver strain.
This open access article is distributed under the Creative Commons license http://creativecommons.org/licenses/by/4.0/
Showing items related by title, author, creator and subject.
Outcomes for family carers of a nurse-delivered hospital discharge intervention for older people (the Further Enabling Care at Home Program): Single blind randomised controlled trialToye, Christine; Parsons, R.; Slatyer, Susan; Aoun, Samar; Moorin, Rachael; Osseiran-Moisson, R.; Hill, Keith (2016)Background: Hospital discharge of older people receiving care at home offers a salient opportunity to identify and address their family caregivers’ self-identified support needs. Objectives: This study tested the hypothesis ...
The Impact of Supporting Family Caregivers Before Bereavement on Outcomes After Bereavement: Adequacy of End-of-Life Support and Achievement of Preferred Place of Death.Aoun, Samar; Ewing, G.; Grande, G.; Toye, C.; Bear, N. (2017)CONTEXT: The investigation of the situation of bereaved family caregivers following caregiving during the end-of-life phase of illness has not received enough attention. OBJECTIVES: This study investigated the extent to ...
Evaluation of a psycho-educational group programme for family caregivers in home-based palliative careHudson, P.; Quinn, K.; Kristjanson, Linda; Thomas, T.; Braithwaite, M.; Fisher, J.; Cockayne, M. (2008)BACKGROUND: Family caregivers are often responsible for providing significant support to relatives who require palliative care at home. However, evidence suggests that family caregivers have limited information, resources ...