ArticlePrimary health care research & development2020
'It's like trying to ice a cake that's not been baked': a qualitative exploration of the contextual factors associated with implementing an evidence-based information intervention for family carers at the end of life.
Article in Primary health care research & development, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
4 citing papers in PubMed.
- Understanding the Implementation of CareCoach-A Blended eHealth Intervention for Carers of People Living with Dementia: A Qualitative Process Evaluation Using Normalisation Process Theory.Behavioral sciences (Basel, Switzerland) · 2025Article
- Child death review: understanding variations in practice using normalisation process theory.BMJ paediatrics open · 2025Article
- Implementation of a hospice community service redesign: Qualitative research identifying lessons learned.Palliative care and social practice · 2025Article
- Bridging the gap: Identifying diverse stakeholder needs and barriers to accessing evidence and resources for children's pain.Canadian journal of pain = Revue canadienne de la douleur · 2022Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
aimTo explore the introduction of an evidence-based information intervention - the 'Caring for Someone with Cancer' booklet - within home care and end-of-life care, to inform future implementation and practice development within this setting.
backgroundFamily carers' contribution is crucial to enable care and death of people at home. The 'Caring for Someone with Cancer' booklet received positive responses from family carers and District Nurses and is an evidence-based intervention designed to support carers to deliver basic nursing tasks. Further feasibility work was required to establish how it should be implemented. Little is known about how to successfully translate interventions into practice, particularly within home care settings and end-of-life care.
methodsImplementation of the 'Caring for Someone with Cancer' booklet, utilising a qualitative case study approach, in four home care sites. Semi-structured interviews, informed by Normalization Process Theory (NPT), were undertaken at implementation sites in May 2016-June 2017. Participants were generalist and specialist nurses, managers, and Healthcare Assistants (HCAs). A framework approach to analysis was adopted.
findingsForty-five members of staff participated. Failed implementation was associated with organisational-level characteristics and conditions, including workforce composition and predictability of processes. Unstable work environments meant home care providers focused on short-term rather than long-term goals, precluding practice development. Staff's perceptions of the time available to engage with and implement the intervention inhibited adoption, as many participants were "just getting through the day". Implementation was successful in sites with explicit management support, including proactive implementation attempts by managers, which legitimatised the change process, and if all staff groups were engaged. To encourage uptake of evidence-based interventions in home care settings, practitioners should be given opportunities to critically reflect upon taken-for-granted practices. Future implementation should focus on work pertaining to the NPT construct 'Collective Action', including how staff interact and build confidence in new practices.
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Registered trials
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