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Gunn Grande - One of the best experts on this subject based on the ideXlab platform.
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the influence of organisational context and practitioner attitudes on implementation of the carer support Needs Assessment tool csnat intervention
BMJ, 2016Co-Authors: Janet Diffin, Gail Ewing, Gunn GrandeAbstract:Background The Carer Support Needs Assessment Tool (CSNAT) intervention identifies and addresses family carer support Needs towards end of life. 1–3 A paucity of studies has investigated how to successfully implement evidence based interventions within palliative care. Aim Investigate how staff attitudes and organisational context affect implementation of the CSNAT intervention in palliative care. Methods 36 UK palliative care services participated. Staff surveys measured attitudes and context prior to, and six months after the implementation began including (i) a questionnaire assessing staff attitudes to the CSNAT; (ii) The Alberta Context Tool (ACT) assessing organisational context. Data on use of the CSNAT intervention were collected over six months; services were classified as ‘high’ or ‘low’ adopters on this basis. Relationships between service characteristics, aggregate data on staff attitudes and organisational context, and level of adoption were analysed. Results 157/462 surveys were returned at baseline and 69/462 at six months. Level of adoption depended on service type. ‘High’ adopters had a higher ratio of intervention ‘champions’ to total staff numbers and higher scores for ACT ‘informal interactions’ (e.g. more discussions with colleagues about patient care), compared to ‘low’ adopters. Both groups had similarly positive attitudes to the CSNAT intervention pre-implementation. By six months attitudes for ‘low’ adopters were significantly more negative, but remained similar or improved for ‘high’ adopters. Conclusions Ensuring successful implementation of complex interventions within palliative care requires consideration of the organisational context, service type, strategies for maintaining positive staff attitudes over time, and the use of intervention ‘champions’. References 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. J Pain Symptom Manage 2013; 46 (3):395–405 Ewing G, Grande G. Development of a Carer Support Needs Assessment Tool (CSNAT) for end-of-life care practice at home: a qualitative study. Palliat Med 2013; 27 (3):244–256 Ewing G, Austin L, Diffin J, Grande G. The Carer Support Needs Assessment Tool: A person centred approach to carer Assessment and support. Br J Community Nurs 2015; 20 (12):580–584
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facilitating successful implementation of the carer support Needs Assessment tool csnat intervention within palliative care
BMJ, 2016Co-Authors: Janet Diffin, Gail Ewing, Gunn GrandeAbstract:Background The Carer Support Needs Assessment Tool (CSNAT) intervention identifies and addresses family carer support Needs towards end of life.1–3 This person-centred approach involves a change in practice from a practitioner- to carer-led Assessment process. Numerous policies recommend carers’ Needs should be addressed yet there is little guidance on how to achieve this within palliative care. To address this gap and assist a change to a carer-led process, an implementation strategy for the CSNAT intervention was developed, of which facilitation is key. Aims investigate components of facilitation associated with successful implementation of the CSNAT intervention across 36 palliative care services. Methods Qualitative: Interviews three and six months post-CSNAT implementation with 38 practitioners acting as CSNAT ‘champion’ (internal facilitation) in 32 services. Researcher field notes collected from teleconference support sessions with ‘champions’ (external facilitation). Results Successful implementation of the CSNAT intervention was associated with: a teamwork approach to facilitation; the ‘lead champion’ having a leadership role in the service e.g. team manager; presenting a clear rationale why a change in practice was needed; reviewing progress and making changes to overcome identified barriers; ‘champions’ having good communication skills and authority to make changes. Aspects of context which constrained facilitation included the need to establish a new carer record, and organisational changes e.g. budget cuts, and a culture focused on the patient. Management support assisted with facilitation efforts. Conclusions Establishing a team of practitioners to lead facilitation of the CSNAT intervention and regularly review implementation progress, is recommended to help ensure implementation success. References 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. J Pain Symptom Manage 2013;46(3):395–405 Ewing G, Grande G. Development of a Carer Support Needs Assessment Tool (CSNAT) for end-of-life care practice at home: A qualitative study. Palliat Med 2013;27(3):244–256 Ewing G, Austin L, Diffin J, Grande G. The Carer Support Needs Assessment Tool: A person centred approach to carer Assessment and support. Br J Community Nurs 2015;20(12):580–584
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the adaptation face and content validation of a Needs Assessment tool progressive disease for people with interstitial lung disease
Journal of Palliative Medicine, 2016Co-Authors: Jason W Boland, Carla Reigada, Janelle Yorke, Simon P Hart, Sabrina Bajwah, Joy R Ross, Athol U Wells, Athanasios Papadopoulos, David C Currow, Gunn GrandeAbstract:Abstract Background: Irrreversible interstitial lung disease (ILD) is associated with high morbidity and mortality. Palliative care Needs of patients and caregivers are not routinely assessed; there is no tool to identify Needs and triage support in clinical practice. Objective: The study objective was to adapt and face/content validate a palliative Needs Assessment tool for people with ILD. Methods: The Needs Assessment Tool: Progressive Disease-Cancer (NAT:PD-C) was adapted to reflect the palliative care Needs identified from the ILD literature and patient/caregiver interviews. Face and content validity of the NAT:PD-ILD was tested using patient/caregiver focus groups and an expert consensus group. Participants in the study were two English tertiary health care trusts' outpatients clinics. There were four focus groups: two patient (n = 7; n = 4); one caregiver (n = 3); and one clinician (n = 8). There was a single caregiver interview, and an expert consensus group—academics (n = 3), clinicians (n = 9), ...
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the role of the carer support Needs Assessment tool in palliative home care a qualitative study of practitioners perspectives of its impact and mechanisms of action
Palliative Medicine, 2016Co-Authors: Gail Ewing, Lynn Austin, Gunn GrandeAbstract:Background:The importance of supporting family carers is well recognised in healthcare policy. The Carer Support Needs Assessment Tool is an evidence-based, comprehensive measure of carer support n...
Gail Ewing - One of the best experts on this subject based on the ideXlab platform.
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the influence of organisational context and practitioner attitudes on implementation of the carer support Needs Assessment tool csnat intervention
BMJ, 2016Co-Authors: Janet Diffin, Gail Ewing, Gunn GrandeAbstract:Background The Carer Support Needs Assessment Tool (CSNAT) intervention identifies and addresses family carer support Needs towards end of life. 1–3 A paucity of studies has investigated how to successfully implement evidence based interventions within palliative care. Aim Investigate how staff attitudes and organisational context affect implementation of the CSNAT intervention in palliative care. Methods 36 UK palliative care services participated. Staff surveys measured attitudes and context prior to, and six months after the implementation began including (i) a questionnaire assessing staff attitudes to the CSNAT; (ii) The Alberta Context Tool (ACT) assessing organisational context. Data on use of the CSNAT intervention were collected over six months; services were classified as ‘high’ or ‘low’ adopters on this basis. Relationships between service characteristics, aggregate data on staff attitudes and organisational context, and level of adoption were analysed. Results 157/462 surveys were returned at baseline and 69/462 at six months. Level of adoption depended on service type. ‘High’ adopters had a higher ratio of intervention ‘champions’ to total staff numbers and higher scores for ACT ‘informal interactions’ (e.g. more discussions with colleagues about patient care), compared to ‘low’ adopters. Both groups had similarly positive attitudes to the CSNAT intervention pre-implementation. By six months attitudes for ‘low’ adopters were significantly more negative, but remained similar or improved for ‘high’ adopters. Conclusions Ensuring successful implementation of complex interventions within palliative care requires consideration of the organisational context, service type, strategies for maintaining positive staff attitudes over time, and the use of intervention ‘champions’. References 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. J Pain Symptom Manage 2013; 46 (3):395–405 Ewing G, Grande G. Development of a Carer Support Needs Assessment Tool (CSNAT) for end-of-life care practice at home: a qualitative study. Palliat Med 2013; 27 (3):244–256 Ewing G, Austin L, Diffin J, Grande G. The Carer Support Needs Assessment Tool: A person centred approach to carer Assessment and support. Br J Community Nurs 2015; 20 (12):580–584
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facilitating successful implementation of the carer support Needs Assessment tool csnat intervention within palliative care
BMJ, 2016Co-Authors: Janet Diffin, Gail Ewing, Gunn GrandeAbstract:Background The Carer Support Needs Assessment Tool (CSNAT) intervention identifies and addresses family carer support Needs towards end of life.1–3 This person-centred approach involves a change in practice from a practitioner- to carer-led Assessment process. Numerous policies recommend carers’ Needs should be addressed yet there is little guidance on how to achieve this within palliative care. To address this gap and assist a change to a carer-led process, an implementation strategy for the CSNAT intervention was developed, of which facilitation is key. Aims investigate components of facilitation associated with successful implementation of the CSNAT intervention across 36 palliative care services. Methods Qualitative: Interviews three and six months post-CSNAT implementation with 38 practitioners acting as CSNAT ‘champion’ (internal facilitation) in 32 services. Researcher field notes collected from teleconference support sessions with ‘champions’ (external facilitation). Results Successful implementation of the CSNAT intervention was associated with: a teamwork approach to facilitation; the ‘lead champion’ having a leadership role in the service e.g. team manager; presenting a clear rationale why a change in practice was needed; reviewing progress and making changes to overcome identified barriers; ‘champions’ having good communication skills and authority to make changes. Aspects of context which constrained facilitation included the need to establish a new carer record, and organisational changes e.g. budget cuts, and a culture focused on the patient. Management support assisted with facilitation efforts. Conclusions Establishing a team of practitioners to lead facilitation of the CSNAT intervention and regularly review implementation progress, is recommended to help ensure implementation success. References 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. J Pain Symptom Manage 2013;46(3):395–405 Ewing G, Grande G. Development of a Carer Support Needs Assessment Tool (CSNAT) for end-of-life care practice at home: A qualitative study. Palliat Med 2013;27(3):244–256 Ewing G, Austin L, Diffin J, Grande G. The Carer Support Needs Assessment Tool: A person centred approach to carer Assessment and support. Br J Community Nurs 2015;20(12):580–584
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the role of the carer support Needs Assessment tool in palliative home care a qualitative study of practitioners perspectives of its impact and mechanisms of action
Palliative Medicine, 2016Co-Authors: Gail Ewing, Lynn Austin, Gunn GrandeAbstract:Background:The importance of supporting family carers is well recognised in healthcare policy. The Carer Support Needs Assessment Tool is an evidence-based, comprehensive measure of carer support n...
Hans Rosling - One of the best experts on this subject based on the ideXlab platform.
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are donor allocations for humanitarian health assistance based on Needs Assessment data
Global Public Health, 2008Co-Authors: J Von Schreeb, C Unge, R Brittainlong, Hans RoslingAbstract:Abstract Donors have agreed to fund humanitarian assistance according to Needs. We studied if project applications to a major donor, and the subsequent funding decisions for humanitarian health projects contained Needs Assessment data. In 2003, a total of 258 million SEK (37 million USD) was allocated by Swedish International Development Cooperation Agency (Sida) to 38 humanitarian health projects. Only 14 applications (37%) had data on the size of the target population while reference to any quantified health Needs was found in less than 30% of the funding decisions. In contrast to stated policy, interviews with staff at Sida revealed that Needs Assessment data had a limited role in the funding decisions, whereas the implementing capacity of the applying agency was of great importance. Our findings suggest that Needs Assessment data has a very limited role in the decision to fund while other, not clearly defined factors are more important.
David H Gustafson - One of the best experts on this subject based on the ideXlab platform.
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Needs Assessment for cancer patients and their families
Health and Quality of Life Outcomes, 2004Co-Authors: Kuangyi Wen, David H GustafsonAbstract:The Assessment of Needs for cancer care is a critical step in providing high quality care and achieving cancer patients' and families' satisfaction. Instruments can be used to assess Needs and guide cancer care planning. This study discusses the importance of the Needs Assessment, relationships between Needs, satisfaction and quality of life; and reviews the Assessment instruments of Needs experienced by cancer patients and their families. A systematic search was conducted in MEDLINE and CANCERLIT data bases. Instruments were evaluated based on their conceptual and measurement models as well as their demonstrated reliability and validity. The authors also sought information pertaining to instruments' burden of administration and responsiveness. Measures compromised by a lack of published psychometric description were not included. This search identified 17 patient Needs Assessment instruments and seven family Needs Assessment instruments. The development and psychometric proprieties of most of these instruments were well documented. However, data on their responsiveness and burden of administration were scarce. Each selected instrument meets some but not all of our criteria for validity, reliability, responsiveness and burden. It is questionable whether any instrument can be developed meeting all the requirements. However, there is still a need to continue researching and developing Needs Assessment instruments leading to effective intervention and improving quality of cancer care.
Johan Von Schreeb - One of the best experts on this subject based on the ideXlab platform.
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funding based on Needs a study on the use of Needs Assessment data by a major humanitarian health assistance donor in its decisions to allocate funds
PLOS Currents, 2014Co-Authors: Emma Olin, Johan Von SchreebAbstract:BACKGROUND International humanitarian assistance is essential for disaster-affected populations, particularly in resource scarce settings. To target such assistance, Needs Assessments are required. According to internationally endorsed principles, donor governments should provide funding for humanitarian assistance based on need. AIM The aim of this study is to explore a major donor's use of Needs Assessment data in decision-making for allocations of funds for health-related humanitarian assistance contributions. SETTING This is a case study of the Swedish International Development Cooperation Agency (Sida), a major and respected international donor of humanitarian assistance. METHODS To explore Sida's use of Needs Assessment data in practice for Needs-based allocations, we reviewed all decision documents and Assessment memoranda for humanitarian assistance contributions for 2012 using content analysis; this was followed by interviews with key personnel at Sida. RESULTS Our document analysis found that Needs Assessment data was not systematically included in Sida's Assessment memoranda and decision documents. In the interviews, we observed various descriptions of the concept of Needs Assessments, the importance of contextual influences as well as previous collaborations with implementing humanitarian assistance organizations. Our findings indicate that policies guiding funding decisions on humanitarian assistance need to be matched with available Needs Assessment data and that terminologies and concepts have to be clearly defined. CONCLUSION Based on the document analysis and the interviews, it is unclear how well Sida used Needs Assessment data for decisions to allocate funds. However, although our observations show that Needs Assessments are seldom used in decision making, Sida's use of Needs Assessments has improved compared to a previous study. To improve project funds allocations based on Needs Assessment data, it will be critical to develop distinct frameworks for allocation distributions based on Needs Assessment and clear definitions, measurements and interpretations of Needs. Key words: Needs Assessment, humanitarian assistance, disasters, donor decision-making.
