ArticlePalliative medicine2020
A drive for structure: A longitudinal qualitative study of the implementation of the Carer Support Needs Assessment Tool (CSNAT) intervention during hospital discharge at end of life.
Article in Palliative medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Implementing patient-centred outcome measures in palliative care clinical practice. An updated systematic review of facilitators and barriers.BMC palliative care · 2026Pooled it
- Considerations of equity in the development of tools that identify and respond to end-of-life carer support needs: a scoping review.BMJ open · 2026Article
- Mapping Caregiver Needs' Assessment Tools for Family and Friend Caregivers: A Rapid Scoping Review.International journal of environmental research and public health · 2026Article
- Attitudes and experiences of nurses and carers with the carer support needs assessment tool intervention (CSNAT-I).BMC nursing · 2025Article
- Caring for carers of people with advanced cancer at hospital discharge (CARENET): A single-arm open label feasibility trial.Palliative & supportive care · 2025Article
- A short form tool for clinical assessment of caregivers' reaction.BMC palliative care · 2025Article
- The NASSS (Non-Adoption, Abandonment, Scale-Up, Spread and Sustainability) framework use over time: A scoping review.PLOS digital health · 2025Article
- Article
- Implementation Strategies for Quality Improvement in Palliative Care: A Scoping Review.Health expectations : an international journal of public participation in health care and health policy · 2024Article
- POMSNAME: an aide-mémoire to improve the assessment and documentation of palliative care - a longitudinal project.BMC palliative care · 2023Article
- A person-centred intervention remotely targeting family caregivers' support needs in the context of allogeneic hematopoietic stem cell transplantation-a feasibility study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2022Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
backgroundInformal carers are essential in enabling discharge home from hospital at end of life and supporting palliative patients at home, but are often ill-prepared for the role. Carers' support needs are rarely considered at discharge. If carers are less able to cope with home care, patient care may suffer and readmission may become more likely.
aimTo investigate the implementation of an evidence-based Carer Support Needs Assessment Tool (CSNAT) intervention to support carers during hospital discharge at end of life.
designLongitudinal qualitative study with thematic analysis. SETTING/
participantsOne National Health Service Trust in England: 12 hospital practitioners, one hospital administrator and four community practitioners. We provided training in CSNAT intervention use and implementation. Practitioners delivered the intervention for 6 months. Data collection was conducted in three phases: (1) pre-implementation interviews exploring understandings, anticipated benefits and challenges of the intervention; (2) observations of team meetings and review of intervention procedures and (3) follow-up interviews exploring experiences of working with the intervention.
resultsDespite efforts from practitioners, implementation was challenging. Three main themes captured facilitators and barriers to implementation: (1) structure and focus within carer support; (2) the 'right' people to implement the intervention and (3) practical implementation challenges.
conclusionsStructure and focus may facilitate implementation, but the dominance of outcomes measurement and performance metrics in health systems may powerfully frame perceptions of the intervention and implementation decisions. There is uncertainty over who is best-placed or responsible for supporting carers around hospital discharge, and challenges in connecting with carers prior to discharge.
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