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Category: Project

Description: Background: Family caregiving followed by the loss of the close other are stressful, incisive experiences that may impact negatively on physical and mental health. Evidence-based, health-promoting bereavement care is insufficiently adopted and inconsistently delivered in Swiss palliative care services. Objectives: The aims of this implementation research project are first, to adopt the evidence to local conditions and tailor implementation to barriers / enablers, and second, to evaluate the ability to ensure full integration of this evidence-based BEreavement SupporT services for families (= BEST for Family) through a set of co-developed implementation strategies in palliative care by investigating implementation, service, and health outcomes from health professionals’ and bereaved families’ perspectives. Setting and Participants: Implementation and evaluation of BEST for Family will be carried out in two specialized palliative care inpatient services in two large Swiss hospitals. Health professionals, namely, nurses, physicians, chaplains, social workers, psychologists, and other palliative staff members working in the services, and bereaved family members receiving the support will be included. Methods: The study includes a preparation, implementation and evaluation phase with five work packages. First, evidence-based recommendations will be identified through a literature review and adapted to the Swiss context through practice partner workshops, resulting in the BEST for Family service. Second, implementation strategies will be developed in collaboration with practice partners through contextual analysis focus groups guided by the Updated Consolidated Framework for Implementation Research (CFIR 2.0). Third, BEST for Family will be implemented and delivered. Fourth, using a pre-mid-post survey study with embedded qualitative interviews, implementation process and outcomes will be evaluated with health professionals. Fifth, using mixed-methods, service and health outcomes will also be assessed with families. Expected outcomes: The evidence available on how to best support bereaved families according to their individual needs and risks requires better translation into specialized palliative care in Switzerland. Therefore, this study addresses a significant know-do gap in palliative care by using implementation science knowledge and methods. Study findings will provide important knowledge on implementation processes and outcomes of family care, which will inform scalability to other palliative care services and settings in Switzerland and ensure improved and equitable access to evidence-informed, health-promoting engagement and support to families at the end-of-life and in bereavement.