Background: Carer of people with advanced cancer are critical in a person returning home from hospital at end of life. Support for these carers during this transition is sub-optimal; and there is little evidence detailing the best practice approach. The five stage, carer-led CSNAT- Intervention (CSNAT-I) has shown promise in assisting carers of people with palliative care needs at hospital discharge. This study aims to evaluate the acceptability of this intervention in an acute oncology setting.
Method: A convergent mixed methods design was used; and data mapped against the theoretical framework of acceptability. The CSNAT-I identifies carers needs and generates action plans. It was delivered by occupational therapists to carers of advanced cancer patients people with complex discharge needs across two hospitals. Prospective clinical, service and process data were collected and descriptively analysed; including adoption and participation rates; and clinical activity. Patient, carer and clinician interview data were also collected and thematic analysed. Purposive sampling occurred and data saturation reached.
Results: Of the 106 eligible carers, 69 (65%) accepted the CSNAT-I. Sixty-two (90%) carers completed pre-discharge stages; and 32 (46%) completed both pre and post-discharge stages. The most prioritised needs were (1) help with equipment, (2) knowing who to contact; and (3) knowing what to expect. These triggered more care from treating doctors, social workers, pharmacists and occupational therapists. Interview data revealed that both carers (n=10) and clinicians' (n=10) viewed the CSNAT-I as comprehensive and offering early and targeted support.
Conclusion:The CSNAT-I is an acceptable intervention that can be delivered by occupational therapists to address the medical and practical needs of caring. Behavioural and contextual factors influencing the acceptability will be reported elsewhere. These findings will inform development of a protocolised model that will ensure sustainability and optimal outcomes.