Terminal Illness
Conditions
Keywords
Specialised palliative care, Communication, Family Intervention
Brief summary
This intervention study aims to evaluate a psychosocial family based intervention in clinical practice, the Family Talk Intervention (FTI), for families with dependent children affected by life-threatening/life-limiting illness, when a parent is ill. The study has an effectiveness implementation hybrid design where both the effects of FTI and the implementation process in clinical practice are examined.
Detailed description
When a family with dependent children is affected by severe illness this affects the entire family. Still, there is little research evaluating support to such families. This intervention study aims to evaluate a psychosocial family based intervention in clinical practice, the Family Talk Intervention (FTI), for families with dependent children affected by life-threatening/life-limiting illness, when a parent is ill. The study has an effectiveness implementation hybrid design where both the effects of FTI and the implementation process in clinical practice are examined. FTI will be carried out as a cluster randomized trial at 12 clinics in specialized palliative homecare (6 units=intervention, 6 units=control). All social workers at these clinics will receive education and training in FTI in 2021. From 2022, FTI will be offered to families cared for at these care contexts. FTI is manual-based and consists of 6 meetings with the families (together and individually) and is led by the FTI-educated social workers. The aim of FTI are to support the family in talking about illness-related subjects (e.g. prognosis, stress), support parenting, and support the family in identifying their strengths and how to best use them. FTI will be evaluated through surveys and interviews with families before FTI/baseline and after completed intervention (3 and 6 months after baseline). Further, social workers will be invited to compete questionnaires and take part in focus groups about their experiences of FTI. The research group has conducted pilot-studies on FTI in these contexts with positive results. The present study allows us to take a further step in the evaluation of FTI- evaluate FTI under real conditions.
Interventions
FTI entails six meetings, with intervals of 1-2 weeks between meetings. Meetings 1-2 include only the parent(s) and focus on their experiences of the situation, as well as the consequences of the diagnosis for each family member. The parent(s) will formulate the goal of the intervention. Meeting 3: Interviews will be held with each child and includes the child's life situation. Meeting 4 includes the parent(s) and focuses on planning the family meeting. The children's thoughts and questions serve as a guide for the upcoming family meeting. Meeting 5 is a family meeting and consists of questions and issues raised earlier by the family members. Meeting 6 is a follow-up with all family members. The meeting is guided by the family members' needs, e.g., regarding communication and parenting. If the intervention is interrupted unexpectedly and cannot be finished as scheduled due to extraordinary circumstances, extra meetings are available (Meetings 7-11).
Sponsors
Forte
Ersta Sköndal University College
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Intervention model description
A cluster-randomized trial will be conducted at 12 homecare services (6 services=intervention, 6 services=control).
Eligibility
Sex/Gender
ALL
Age
6 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Families affected by a life-threatening or life-limiting illness and have dependent children, ill or health aged 0-19 years and * Enrolled in specialized palliative home care * At least two family members have accepted to participate
Exclusion criteria
\-
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Changes in family Communication over time. Family Adaptability and Cohesion Scale IV | Six months | Measures in self-rated family communication which is the primary outcome of the intervention |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Changes in self-rated grief. Prolonged Grief Disorder (PG-12/PG-13). | Six months | An instrument to screen for pathologic forms of grief before and after an expected death |
| Changes in self-rated anxiety. Generalized Anxiety Disorder (GAD) | Six months | Measures symptoms of anxiety |
| Changes in The Strengths and Difficulties Questionnaire (SDQ) | Six months | Measures self-rated strengths and difficulties. Has a proxy version for children |
| Changes in self-rated resilience. Resilience Scale (RS-14) ((Resilience Scale for Children (RS-10)). | Six months | Measures self-rated resilience in adults and children |
| Changes in factors needed for successful implementation.The Swedish Normalization Process Theory Measure (S-NoMAD) | Six months | For the implementation research. Characterizes and explains key mechanisms that promote and inhibit the implementation, embedding and integration of new health techniques, technologies and other complex interventions. |
| Changes in perception of organizational context. Alberta Context Tool (ACT) | Six months | For the implementation research. Measures organizational context for use in complex healthcare settings. |
| Changes in self-perceived parenting skill. Parental Skills Checklist (PSC) | Six months | Measures self-rated parenting abilities |
Countries
Sweden
Contacts
Primary ContactMalin Lövgren, PhD
Backup ContactAnette Alvariza, PhD
Outcome results
None listed