Improving support for family caregivers: A mixed-methods effect evaluation of an organizational intervention

To evaluate the impact of a tailored organizational intervention on the support for family caregivers.

A convergent mixed-methods study was conducted in 17 organizations (6 hospices, 5 home care organizations, 3 nursing homes, 2 hospitals, 1 transmural organization) between November 2021 and August 2023. The intervention comprised a structured practice improvement trajectory during which each organization conducted a structured workshop to define organization-specific goals to improve their support for family caregivers and to develop an action plan to achieve those goals. The action plan was implemented over 1 year with intermittent evaluations. Pre- and post-intervention surveys were distributed among healthcare professionals (paired) and bereaved family caregivers (non-paired) to assess provided and received support. Data were analyzed with mixed models and regression analyses. Post-intervention focus groups with project team members and final evaluation reports were analyzed with qualitative content analysis.

Survey respondents were 97 healthcare professionals (83% nursing staff), 123 family caregivers pre-intervention, and 99 family caregivers post-intervention. Only healthcare professionals of home care organizations reported a significant increase in attending to family caregivers' wellbeing and needs (scale 0-20; β = 3.65; 95%CI: 1.33-5.97). Family caregivers' reports of healthcare professionals attending to their wellbeing and needs did not change (scale 0-2; β = 0.17; 95%CI: -0.04-0.38). Across settings, healthcare professionals evaluated the care they provided more positively post-intervention (scale 0-8; β = 0.65, 95%CI: 0.38-0.97). In home care, family caregivers also evaluated care more positively (scale 0-8; β = 2.12; 95%CI: 0.89-3.34). Four focus groups and 17 evaluation reports indicated improvements at 3 levels: the support for family caregivers (increased awareness of healthcare professionals, changes in work processes, more structured support), the healthcare team (more skills, confidence, available tools), and the organization (fostering sustainability).

A tailored organizational intervention can strengthen the support of family caregivers in healthcare organizations.