Abstract

Family carers are crucial in enabling patients to be cared for at home towards end-of-life. This can entail considerable psychological and physical cost for carers, but caregiving context, role norms and a focus on the patient often make it difficult for carers to express their own support needs. We have developed an evidence-based Carer Support Needs Assessment Tool (CSNAT) suitable for use within palliative home care practice to elicit and facilitate communication about carer needs. Before this is tested in a full trial preliminary work is required to optimise the intervention and its evaluation as recommended through the MRC Guidance for interventions[1]. Use of the CSNAT will be piloted within one hospice at home (H@H) with 20 carers to identify challenges in implementation and use, perceived "active components" of the intervention, their likely impact and factors affecting impact. We will explore these issues through stakeholder interviews and focus groups with H@H staff before and after piloting and through reflective audio diaries by H@H staff and telephone interviews with carers during piloting. Data will undergo qualitative analysis to inform implementation strategies and guidelines to maximise the effectiveness of the future intervention and devise appropriate outcome measures for the future trial.