{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:31:45Z","timestamp":1777926705407,"version":"3.51.4"},"reference-count":41,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"unspecified","delay-in-days":28,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Pall Supp Care"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1478951525101582_sec1a\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the impact of a tailored organizational intervention on the support for family caregivers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1478951525101582_sec2b\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A convergent mixed-methods study was conducted in 17 organizations (6 hospices, 5 home care organizations, 3 nursing homes, 2 hospitals, 1 transmural organization) between November 2021 and August 2023. The intervention comprised a structured practice improvement trajectory during which each organization conducted a structured workshop to define organization-specific goals to improve their support for family caregivers and to develop an action plan to achieve those goals. The action plan was implemented over 1 year with intermittent evaluations. Pre- and post-intervention surveys were distributed among healthcare professionals (paired) and bereaved family caregivers (non-paired) to assess provided and received support. Data were analyzed with mixed models and regression analyses. Post-intervention focus groups with project team members and final evaluation reports were analyzed with qualitative content analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1478951525101582_sec3c\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Survey respondents were 97 healthcare professionals (83% nursing staff), 123 family caregivers pre-intervention, and 99 family caregivers post-intervention. Only healthcare professionals of home care organizations reported a significant increase in attending to family caregivers\u2019 wellbeing and needs (scale 0\u201320; \u03b2 = 3.65; 95%CI: 1.33\u20135.97). Family caregivers\u2019 reports of healthcare professionals attending to their wellbeing and needs did not change (scale 0\u20132; \u03b2 = 0.17; 95%CI: \u22120.04\u20130.38). Across settings, healthcare professionals evaluated the care they provided more positively post-intervention (scale 0\u20138; \u03b2 = 0.65, 95%CI: 0.38\u20130.97). In home care, family caregivers also evaluated care more positively (scale 0\u20138; \u03b2 = 2.12; 95%CI: 0.89\u20133.34). Four focus groups and 17 evaluation reports indicated improvements at 3 levels: the support for family caregivers (increased awareness of healthcare professionals, changes in work processes, more structured support), the healthcare team (more skills, confidence, available tools), and the organization (fostering sustainability).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1478951525101582_sec4d\">\n                    <jats:title>Significance of results<\/jats:title>\n                    <jats:p>A tailored organizational intervention can strengthen the support of family caregivers in healthcare organizations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1478951525101582","type":"journal-article","created":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T01:02:41Z","timestamp":1769648561000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["Improving support for family caregivers: A mixed-methods effect evaluation of an organizational intervention"],"prefix":"10.1017","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5985-6397","authenticated-orcid":false,"given":"Hinke E.","family":"Hoffst\u00e4dt","sequence":"first","affiliation":[{"name":"Leiden University Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arianne","family":"Stoppelenburg","sequence":"additional","affiliation":[{"name":"Leiden University Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcella C.","family":"Tam","sequence":"additional","affiliation":[{"name":"Leiden University Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iris D.","family":"Hartog","sequence":"additional","affiliation":[{"name":"Leiden University Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leti","family":"van Bodegom-Vos","sequence":"additional","affiliation":[{"name":"Leiden University Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bart J.A.","family":"Mertens","sequence":"additional","affiliation":[{"name":"Leiden University Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9063-7501","authenticated-orcid":false,"given":"Jenny T.","family":"van der Steen","sequence":"additional","affiliation":[{"name":"Leiden University Medical Center"},{"name":"Radboud university medical center"},{"name":"Cicely Saunders Institute, King\u2019s College London, London"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yvette M.","family":"van der Linden","sequence":"additional","affiliation":[{"name":"Leiden University Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2026,1,29]]},"reference":[{"key":"S1478951525101582_ref40","doi-asserted-by":"publisher","DOI":"10.35680\/2372-0247.1594"},{"key":"S1478951525101582_ref15","volume-title":"Designing and Conducting Mixed Methods Research","author":"Creswell","year":"2017"},{"key":"S1478951525101582_ref22","doi-asserted-by":"publisher","DOI":"10.1089\/pmr.2024.0088"},{"key":"S1478951525101582_ref31","unstructured":"PZNL, AHzN, KWF and VPTZ (2020) Rapport Trendanalyse Palliatieve Zorg [Report Trend Analysis Palliative Care]. Available at: Rapport-Trendanalyse-Palliatieve-Zorg-D1-0_incl-links.pdf (Accessed date 17 July 2025)."},{"key":"S1478951525101582_ref29","doi-asserted-by":"publisher","DOI":"10.1111\/hsc.13578"},{"key":"S1478951525101582_ref41","unstructured":"World Health Organization (2020) Palliative care - key facts. Available at https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/palliative-care (accessed 17 July 2025 )."},{"key":"S1478951525101582_ref28","doi-asserted-by":"publisher","DOI":"10.1177\/15271544241286083"},{"key":"S1478951525101582_ref35","unstructured":"Stoppelenburg, A , van der Steen, JT , van der Linden, YM , et al. (2021) Supporting family caregivers during the illness and after the death of their loved one, with special attention for individual needs, health skills and culturally sensitive communication. Available at https:\/\/osf.io\/57wm9 (accessed 17 July 2025 )."},{"key":"S1478951525101582_ref26","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-6-160"},{"key":"S1478951525101582_ref7","doi-asserted-by":"publisher","DOI":"10.1177\/0269216319899025"},{"key":"S1478951525101582_ref37","doi-asserted-by":"publisher","DOI":"10.1097\/WAD.0b013e318293b380"},{"key":"S1478951525101582_ref19","doi-asserted-by":"publisher","DOI":"10.1177\/02692163211066733"},{"key":"S1478951525101582_ref8","unstructured":"Boere, W (2021) Implementation of the Oog voor Naasten en Nabestaanden method: Inspiring healthcare professionals to create and reflect on the journey of the family caregiver. Master thesis, Faculty of Industrial Design Engineering, Delft University of Technology."},{"key":"S1478951525101582_ref24","doi-asserted-by":"publisher","DOI":"10.1177\/1049732305276687"},{"key":"S1478951525101582_ref21","doi-asserted-by":"publisher","DOI":"10.1177\/10499091221123006"},{"key":"S1478951525101582_ref36","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-024-01428-0"},{"key":"S1478951525101582_ref10","unstructured":"Castor EDC (2019) Castor electronic data capture. 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IBM SPSS Statistics for Windows ver 29 [computer software]."}],"container-title":["Palliative and Supportive Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1478951525101582","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T01:02:43Z","timestamp":1769648563000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1478951525101582\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":41,"alternative-id":["S1478951525101582"],"URL":"https:\/\/doi.org\/10.1017\/s1478951525101582","relation":{},"ISSN":["1478-9515","1478-9523"],"issn-type":[{"value":"1478-9515","type":"print"},{"value":"1478-9523","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press.","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e39"}}