JMIR Publications

ABSTRACT

Background:

Families are often unsure how best to prepare dependent children for the death of a significant caregiver with a poor cancer prognosis, seeking guidance and support from their healthcare team. Health and social care professionals (professionals) often lack educational opportunities to gain the desired knowledge, skills, and confidence to provide family-centred supportive cancer care. To improve educational opportunities in healthcare, eLearning has positively impacted access and reach of effective evidence-based interventions.

Objective:

To evaluate the acceptability, useability, effectiveness and outome of an evidence-based and theory-driven eLearning intervention to equip and promote professionals’ self-efficacy to deliver family-centred supportive cancer care, when an adult with significant caregiving responsibilities for dependent children is at end of life.

Methods:

Guided by the ‘Person-based Approach’, a mixed-methods outcome evaluation was utilised. A validated pre-test post-test survy was used to determine self-efficacy and one-to-one remote semi-structured interviews, alongside single-item questions explore professionals’ experience and perceived learning onto clinical practice. To generate enhanced insights, the quantitative and qualitative data was integrated through a four stage modified pillar integration process.

Results:

One-hundred and fifty eight participants completed the pre-test survey prior to engaging with the eLearning resource, with a total of 99 participants completing the post-test survey. Semi-structured qualitative interviews were conducted with 12 professionals at least one month post-intervention. Findings highlighted a statistically significant improvement in professionals’ post-test self-efficacy (n = 99, p = <0.001). Professionals reported a preparedness to engage in supportive adult-professional end of life cancer care conversations, when an adult with significant caregiving responsibilities is dying. Findings demonstrated transferable learning to additional contexts such as other close adult-child relational bonds (grandparents) and to life-limiting conditions. Usability of the eLearning resource was reported positively, focusing on look and feel, length and integration of multimedia elements.

Conclusions:

The systematic and iterative “Person-based Approach’ optimised the acceptability of a novel eLearning intervention, having the potential to promote family-centred supportive end of life cancer care. This accessible eLearning intervention makes an important contribution to the recognised global gap of educational interventions in this field. Equipping professionals on family-centred supportive end of life care improves self-efficacy and preparedness to engage in challenging parent-professional communication, with the potential to promote better outcomes for affected adults and children and mediate for adverse outcomes for adults and children pre-and post-bereavement.