Using the Person-based Approach to plan and develop an intervention for healthcare professionals to facilitate family-centred conversations when an adult patient has a serious illness

Background
Everyday thousands of adults across the world are diagnosed with serious health conditions. Many will have important relationships with children in their role as parents or grandparents. Communicating effectively with children about parental illness is associated with better psychological outcomes for children and family functioning. Adult patients report wanting help from healthcare professionals (HCPs) to think about sharing their diagnosis with children. HCPs describe feeling uncertain and unskilled in asking patients about their relationships with children; consequently support for patients is often absent.

Aims
Plan and develop an intervention to enhance HCPs’ knowledge, skills and confidence about initiating family-centred conversations when an adult patient has a serious illness.

Methods
The research used the Person-based Approach. Phase one: (1) Focus groups with adults with experience of their own or a partner’s illness and have a relationship with children (n = 12); (2) Focus groups with adults with lived-childhood experience of an adult’s illness (n = 6); (3) Individual interviews with professionals with a role in HCP training in a UK NHS setting (n = 9); (4) Focus groups with HCPs with experience of working in a UK NHS setting with adult patients who have an illness (n = 10). Phase two: ‘Think-aloud’ individual interviews with (1) adults with experience of their own or a partner’s illness (n = 2); (2) adults with lived-childhood experience (n = 2); (3) child with lived-experience (n = 1); (4) HCPs (n = 4). Focus groups and interviews were audio-recorded and transcribed.

Results
Phase one: data were analysed using reflexive thematic analysis to identify the content for the intervention. Findings were triangulated and used to develop guiding principles and logic model to inform development of the draft intervention. The format selected was an animation. Phase two: Data were collected through 3 cycles with changes made to the audio, speed and visuals of the draft animation.

Conclusions
The Person-based Approach facilitated the inclusion of multiple perspectives from different stakeholders. This extensive and rigorous process resulted in the development of an intervention in the form of an animation; evaluation is now required to assess the extent to which the animation increases HCPs’ knowledge, skills and confidence to initiate family-centred conversations with adult patients.

Clinical trial number
Not applicable.