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Implementing the Family Talk Intervention among families with a severely ill parent or child with palliative care needs: A longitudinal study of the perspectives of hospital social workers
Marie Cederschiöld University, Department of Health Care Sciences.ORCID iD: 0000-0002-6402-7304
Sophiahemmet University, Sweden.ORCID iD: 0000-0003-2074-5985
Linnaeus University, Sweden.
Dalarna University, Sweden.
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2025 (English)In: Frontiers in Health Services, E-ISSN 2813-0146, Vol. 5, article id 1527431Article in journal (Refereed) Published
Abstract [en]

Background: The Family Talk Intervention (FTI) is a psychosocial intervention supporting families where a family member has palliative care needs. This study aimed to evaluate how the Family Talk Intervention (FTI) was implemented over time from the perspective of hospital social workers (HSWs) in their everyday clinical practice among families with a severely ill parent or child in need of palliative care.

Methods: HSWs (n=21) working in adult and children’s care completed a 10-day education where they were trained to use FTI. The education was part of a multifaced implementation strategy involving educational outreach visits, facilitation, clinical implementation meetings, and audit and feedback. The HSWs were then expected to use FTI in their clinical practice to support families with dependent children. To assess if and how FTI was integrated into their daily practice, they were also asked to complete the Swedish version of the Normalization Process Theory Measure (S-NoMAD) on three occasions: on completion of the FTI-education, six months later, and one year later. For the longitudinal analysis of data, Friedman’s test was used.

Results: The HSWs rated the use of FTI high after completing the FTI-education, indicating a positive attitude towards FTI. In the longitudinal analysis, statistically significant changes were seen for two questions in S-NoMAD, where the HSWs’ ratings showed that the FTI became more familiar and normalized over time. Generally, the HSWs’ ratings of S-NoMAD’s main constructs were high and stable over time, indicating a positive view of FTI and its implementation. However, for the single questions, the ratings were slightly more negative to some contextual aspects, such as managerial support and resources.

Conclusion: As results showed, HSW mainly rated different aspects of the implementation process as positive, both from the beginning, but also over time. Therefore, the intervention could be judged to have been implemented as a tool to support families when a parent or a child is severely ill. Contextual factors, involving managerial support and resources were rated lower, indicating the importance of those aspects when introducing interventions into healthcare. The result also indicates that the multifaced implementation strategy supported the HSW’s everyday clinical practice.

Place, publisher, year, edition, pages
2025. Vol. 5, article id 1527431
Keywords [en]
Implementation, Normalization Process Theory, Psychosocial support, Hospital social worker, Family based intervention
National Category
Nursing Palliative Medicine and Palliative Care
Research subject
The Individual in the Welfare Society, Palliative Care
Identifiers
URN: urn:nbn:se:esh:diva-11299DOI: 10.3389/frhs.2025.1527431ISI: 001518141000001PubMedID: 40584244OAI: oai:DiVA.org:esh-11299DiVA, id: diva2:1943289
Part of project
The Family Talk Intervention in clinical practice when a parent with dependent children or a child is severely ill: An effectiveness-implementation study, Swedish Research Council, Forte, Swedish Research Council for Health, Working Life and Welfare, Swedish Cancer Society, Swedish Childhood Cancer Foundation
Note

Publication status in dissertation: Submitted

Available from: 2025-12-01 Created: 2025-03-10 Last updated: 2025-12-01Bibliographically approved
In thesis
1. Implementering av familjeinterventionen The Family Talk Intervention när ett barn eller en förälder har en svår sjukdom: Hälso- och sjukvårdskuratorers perspektiv
Open this publication in new window or tab >>Implementering av familjeinterventionen The Family Talk Intervention när ett barn eller en förälder har en svår sjukdom: Hälso- och sjukvårdskuratorers perspektiv
2025 (Swedish)Licentiate thesis, comprehensive summary (Other academic)
Abstract [sv]

När ett barn eller en förälder i en familj får en svår sjukdom innebär det en psykosocial stress för alla familjemedlemmar. Trots kunskap om att välmående och livskvalitet kan främjas om psykosocialt stöd ges till varje individ samt familjen som helhet finns få utvärderade psykosociala interventioner för dessa familjer. Genom sin psykosociala expertis, har hälso och sjukvårdskuratorn (HSK) en betydande roll vad gäller stödet till dessa familjer. I arbetet utgår HSK främst från erfarenhetsbaserad kunskap samt teorier, snarare än evidensbaserad praktik. Det råder brist på kunskap kring implementering av evidensbaserade interventioner inom det psykosociala arbetet. The Family Talk Intervention (FTI) är en psykosocial familjebaserad intervention som är effektiv i att stödja familjer med svår sjukdom. FTI implementerades under 2021–2024 inom palliativ vård där antingen ett barn eller förälder har svår sjukdom. Det övergripande syftet med avhandlingen var att undersöka implementeringen av FTI både initialt och över tid utifrån HSK perspektiv inom olika vårdkontexter när ett barn eller en förälder har en svår sjukdom. Avhandlingens resultat visar att HSK tidigare erfarenhet av psykosocialt arbete var av betydelse både initialt och över tid. Användandet av interventionen underlättades genom att FTI matchade familjernas behov och uppmärksammade barnen. Kontextuella faktorer, såsom bristande chefsstöd, begränsande resurser samt faktorer relaterade till vårdens organisering visade sig försvåra det initiala användandet av FTI samt den fortsatta integreringen. Det faktum att FTI utfördes inom ramen för ett forskningsprojekt både hindrade och underlättande användandet. Trots implementeringssvårigheter rapporterade HSK en hög tilltro till FTI, samt att de fortsatt kommer att stödja interventionen.

Place, publisher, year, edition, pages
Stockholm: Marie Cederschiöld högskola, 2025. p. 78
Series
Avhandlingsserie inom området Människan i välfärdssamhället, ISSN 2003-3699 ; 21
Keywords
Implementering, Hälso- och sjukvårdskurator, Psykosocial familjebaserad intervention, Palliativ vård, The Family Talk Intervention
National Category
Nursing Palliative Medicine and Palliative Care
Research subject
The Individual in the Welfare Society, Palliative Care
Identifiers
urn:nbn:se:esh:diva-11302 (URN)978-91-985807-0-9 (ISBN)
Presentation
2025-04-03, Aulan, Marie Cederschiöld högskola, Stigbergsgatan 30, Stockholm, 13:00 (Swedish)
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Supervisors
Available from: 2025-04-09 Created: 2025-04-09 Last updated: 2025-09-22Bibliographically approved

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Thermaenius, IngridHolm, MajaAlvariza, AnetteLundberg, TinaLövgren, Malin

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