title: Development of a Carer Support Needs Assessment Tool (CSNAT) for end-of-life care practice at home: a qualitative study.
abstract: BACKGROUND
  Current end-of-life care policy and guidance recognises the important contribution of family carers, recommending that their needs should be assessed to support them in their caring role. How regular carer assessment is to be achieved is unclear, particularly because there is no evidence-based tool for directly assessing carers' support needs that is suitable for use in end-of-life home care practice.
  
  
  OBJECTIVE
  To obtain carers' perspectives of key aspects of support needed during provision of end-of-life care at home and to develop a carer support needs assessment tool suitable for use in everyday practice.
  
  
  METHODS
  Qualitative using focus groups and telephone interviews. Thematic analysis uses a framework approach.
  
  
  METHODS
  75 adult bereaved carers who were family members/friends of patients referred to five Hospice at Home services in the UK.
  
  
  RESULTS
  Carers' needs fell into two distinct groupings of key support areas or 'domains': support to enable them to provide care for their relative and more direct personal support for themselves. Many aspects of supportive input were common across domains, for example, anticipatory information, explanations or being included in the care process. Therefore, the tool was designed as a screening measure, to identify support needs requiring further detailed assessment.
  
  
  CONCLUSIONS
  The Carer Support Needs Assessment Tool (CSNAT) is an evidence-based direct measure of carers' support needs in 14 domains. It is short but comprehensive in approach and thus suitable for both end-of-life care research and practice. Further work has been undertaken to test its psychometric properties.
authors.affiliation: Centre for Family Research, University of Cambridge, Cambridge, UK. ge200@cam.ac.uk
authors.forename: Gail
authors.initials: G
authors.lastname: Ewing
authors.forename: Gunn
authors.initials: G
authors.lastname: Grande
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D006301:Health Services Needs and Demand; D006699:Home Care Services; D017051:Hospice Care; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D036301:Qualitative Research; D012944:Social Support; D013727:Terminal Care; D006113:United Kingdom