Gaining consensus on family carer needs when caring for someone dying at home to develop the Carers' Alert Thermometer (CAT): a modified Delphi study.
OBJECTIVE
To report a multi-phase modified Delphi study conducted with carers and professionals to identify the priority areas for inclusion in an alert screening tool for carers providing support to someone dying at home.


BACKGROUND
Internationally, there is a growing emphasis on increasing choice for patients who wish to die at home which relies heavily on care provided by the unpaid family carers. Family carers can have high levels of unmet needs comprising their psychological and physical health and their ability to provide effective care and support. Development of an alert tool to identify carers' needs in everyday practice required identification and consensus of the priority areas of need for inclusion.


METHODS
Multi-phase modified Delphi study and instrument development.


METHODS
Qualitative and quantitative data collection took place between 2011-2013 with 111 carers and 93 professionals to identify carers' needs and gain consensus on the priority areas for inclusion in the alert tool. An expert panel stage and final evidence review post-Delphi were used.


RESULTS
The Delphi panels had high levels of agreement and consensus. Ten areas of carer need across two themes of 'the current caring situation' and 'the carer's own health and well-being' were prioritized for inclusion in the alert tool. An optional end-of-life planning question was included following the final stages.


CONCLUSIONS
The results provide evidence of carers' needs to be assessed, areas for consideration in the education of those who support carers and someone dying at home and targeting of services, while demonstrating the usefulness and adaptability of the Delphi method.
Evidence-Based Practice Research Centre, Edge Hill University, Faculty of Health & Social Care, Ormskirk, UK.
Katherine
K
Knighting
Evidence-Based Practice Research Centre, Edge Hill University, UK.
Mary R
http://orcid.org/0000-0002-8509-3650
MR
O'Brien
Evidence-Based Practice Research Centre, Edge Hill University, UK.
Brenda
http://orcid.org/0000-0001-8227-0116
B
Roe
Liverpool Business School, Liverpool John Moores University, UK.
Rob
R
Gandy
Academic Palliative and Supportive Care Studies Group, Institute of Psychology, Health and Society, University of Liverpool, UK.
Mari
M
Lloyd-Williams
The School of Nursing & Midwifery, University of Sheffield, UK.
Mike
M
Nolan
Evidence-Based Practice Research Centre, Edge Hill University, UK.
Barbara A
BA
Jack
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D056902:Clinical Alarms; D003697:Delphi Technique; D005190:Family / Q000523:psychology*; D005260:Female; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D012944:Social Support; D013727:Terminal Care / Q000523:psychology*
Delphi; caregivers; carers; end-of-life care; expert panel; home care; needs assessment; nursing; palliative care