Mixed-Methods outcome evaluation of a face-to-face educational intervention to promote family-centred end-of-life cancer care for professionals at a specialist palliative care unit

Background: Families often feel unsure about how best to prepare children
for the death of a significant adult caregiver with a poor cancer
prognosis, necessitating guidance and support from health and social
care professionals (professionals). Globally, professionals report a lack of
knowledge, skill and confidence to provide this important aspect of supportive
care, highlighting a need for educational opportunities.
Aim/Research question or hypothesis: To evaluate the acceptability and
long-term effectiveness of an educational intervention to promote professionals’
self-efficacy to providing family-centred cancer care in a specialist
palliative care unit.
Methods: A two-hour, evidence-based and theory-driven educational
intervention was co-delivered to 98% (54/55) of clinical staff within a
specialist palliative care unit in February 2024. Guided by three levels of
Kirkpatrick’s Model of Evaluation (reactions, learning, behaviour), a
mixed-methods outcome evaluation was utilised and data analysed
using pillar integration. Pre-test, initial post-test, three-month and eighteen-
month follow-up surveys were used to determine self-efficacy, with
focus groups exploring perceived impact of the intervention to clinical
practice.
Results: A total of 54 professionals completed the pre-test, post-testsurvey,
with 39 and 45 completing the three-month and eighteen-month
follow-up survey. Eight professionals participated in one of two focus
groups three-months post-intervention. Findings identified statistically
significant increases in scores of self-efficacy, with marked and sustained
increases at all time points (p<.001). Professionals reported feeling better
equipped to starting conversations with adults at end-of-life in relation
to children. As a consequence of the educational intervention, the
specialist palliative care unit introduced questions regarding children to
the admission process.
Discussion: Equipping professionals to provide family-centred cancer
supportive care at end-of-life care improves and sustains clinicians perceived
self-efficacy to the provision of supportive care to adults at endof-
life. Globally, starting important conversations about the children at
the time of admission has the potential to promote better outcomes for
the family, pre-and-post bereavement.