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To co-design a nurse-led family support intervention for patients with cancer and their family members.
An intervention co-design process.
The Experience-Based Co-Design method was conducted in a hospital in northern Spain from January 2024 to February 2025 with nurses, patients and family members, following The Point of Care Foundation's eight steps: observations, individual interviews, editing the trigger film, feedback events, co-design and validation events and celebration event.
Four themes emerged from the integrated dataset. (1) Cancer: a family affair, (2) Needs of patients with cancer and their families, (3) The importance of establishing a trust-based nurse-family relationship and (4) Barriers and facilitators for a family-oriented approach in care. These findings informed feedback events where stakeholders identified critical intervention areas, including family support, illness communication, emotional expression and the importance of trust. Based on these results, the Family CARE-ON intervention was structured around three core components: Engaging, Supporting and Empowering.
This study highlights the value of the Experience-Based Co-Design methodology, with active engagement from stakeholders, to develop a family support intervention in oncology care. Further research is needed to evaluate the feasibility and effectiveness, as well as to explore the implementation and scalability of the intervention in oncological settings.
Co-designing a family support intervention together with stakeholders ensures alignment with their needs and expectations, while also fostering the feasibility of the intervention in clinical practice.
The results show how stakeholders co-designed a family support intervention, drawing from their own experiences and perspectives on the impact of cancer on the family.
Guidance for reporting intervention development studies in health research (GUIDED) and Template for Intervention Description and Replication (TIDieR).
Nurses, patients and family members were involved in designing the family support intervention.
Research and evidence-based practice in nursing have a direct impact on the quality of care to patients. Its enactment in daily practice remains challenging, with nurses' insufficient research capacity and capability being one challenge, and the limited current state of knowledge another.
To map the knowledge landscape around capacity-building programmes aiming to increase evidence-based nursing practice and research activity in acutecare hospitals.
Scoping review using Joanna Briggs Institute methodology and PRISMA-ScR reporting guidelines.
Articles from 2013 to 2023 were searched on PubMed, CINAHL, Medline/OVID, Cochrane Library, PsycINFO, Scopus and Web of Science. Two researchers screened their eligibility independently. To be eligible, studies needed to focus on nursing/midwifery in acute care settings, address research capacity-building practices and be either an empirical, review or theoretical publication. Data were extracted in a structured format and synthesised narratively.
Twenty-four articles were included, consisting of 12 empirical, 6 reviews and 6 non-data-based articles. Our analysis identified two dimensions of research capacity: (1) individual research capability and (2) organisational research capacity, each influenced by various determinants. Findings suggest that four key elements are required to build a research capacity programme: (1) context assessment, (2) multilevel leadership and management engagement, (3) programme tailored to context and (4) clear outcome indicators. We found nursing research capacity programmes lacked clear definitions and a consensus on a conceptual framework.
This review systematically synthesised the knowledge landscape on nursing research capacity building programmes in acute care hospitals, bringing clarity regarding concepts, dimensions, determinants and structural key elements.
The conceptual model developed through this review encourages comprehensive and comparable research capacity-building programmes, which can accelerate enhancement of research skills, literacy, activities and evidence-based practice among nurses, thereby improving quality of care and patient outcomes.
No patient or public contribution.
To investigate the experience with and progress of the implementation of a Family Support Intervention (FSI) into adult intensive care units (ICUs) as part of the cluster-randomised FICUS trial.
A mixed-methods process evaluation using a multiple case study approach guided by the normalisation process theory.
This study took place between June 2022 and July 2023 in eight Swiss ICUs randomised to the intervention arm. A tailored implementation strategy was used to introduce the multicomponent FSI, consisting of a new family nursing role and a family care pathway, into interprofessional ICU teams. Participants were 40 ICU key clinical partners. Qualitative data were collected twice, early (3–6 months) and mid-implementation (9–12 months), using small group interviews. A questionnaire with psychometric measures (Acceptability of Intervention Measure, Feasibility of Intervention Measure, Intervention Appropriateness Measure, Normalisation Measure Development Questionnaire) was administered at mid-implementation. RITA pragmatic rapid thematic analysis and descriptive statistics were used to analyse the data. Qualitative and quantitative results were then compared across ICUs (cases).
Findings indicated the desired progress of the FSI integration overall and across cases, with high acceptability and appropriateness ratings but only moderate to high feasibility scores. Study-related barriers were noted in all ICUs (i.e., FSI delivery as part of a clinical trial). Implementation barriers included family nurses' limited capacity and clinician's attitudes towards the FSI. Leadership support and interprofessional collaboration were identified as facilitators. Case-based, integrated findings yielded two implementation pathways, namely early and protracted adopters.
Implementation barriers were related to the feasibility of FSI delivery within the study context that required a high degree of standardisation and protocol adherence. Implementation progress was shaped by an interprofessional culture of family care, sufficient staff and time resources, and leadership support. The study's findings will inform future implementation of complex health interventions in ICUs.
Good reporting of a Mixed-Methods Study (GRAMMS).
Within the FICUS trial, a patient and family advisory board with a patient expert, three family members and a patient with own lived experience of critical care collaborate with the research team.
To synthesise evidence on the impact of pre- and post-loss family support interventions on bereavement outcomes and families' perceptions of their usefulness and benefits in specialist palliative care.
A rapid mixed-methods systematic review drawing on JBI and Cochrane guidance. Study quality was appraised using the Mixed-Methods Appraisal Tool. Qualitative and quantitative data were analysed using a meta-aggregation and narrative analysis approach combined with narrative synthesis.
We searched Medline, CINAHL, PsycINFO, Embase and Cochrane Library and included articles published between 2004 and 2024 that evaluated pre- and post-loss family support in specialist adult palliative care and assessed bereavement outcomes.
The search yielded 3682 records. We included thirty-nine mostly moderate to high-quality studies (57% quantitative). Results suggest that pre-loss support, like family-focused interventions and communication during dying, may mitigate post-loss anxiety, depression and grief. Individual and group post-loss support interventions may reduce anxiety, distress and grief while improving well-being. Families desire individualised and comprehensive pre- and post-loss support, with few not needing or accepting it. Stigma associated with bereavement, support and barriers can hinder access.
Included studies demonstrated mixed effects of pre- and post-loss family support interventions, suggesting they are beneficial when accessible and tailored to family needs. High-quality intervention research assessing a broader range of family bereavement outcomes is needed.
Palliative care nurses and other health professionals should tailor their care to family needs, start family support before patient death and ensure equitable access to bereavement services. Our results may guide palliative care professionals in designing effective, personalised and accessible services and policymakers in allocating resources for bereavement care. Findings highlight research needs, including investigating barriers to care and accessibility of services. High-quality research is needed to understand who benefits the most from health-promoting bereavement support and why.
We adhered to the PRISMA guideline.
No Patient and Public Contribution.
Open Science Framework https://osf.io/36jeu
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