Development of a "Changes Toolkit" for Rural Older Palliative Patients and Their Family Caregivers

Abstract

A Changes Toolkit was developed to help rural older palliative care patients and their caregivers deal with multiple concurrent transitions that cause disruption in their lives. The purpose of this article is to describe the development of the Changes Toolkit to support rural palliative patients and their families with transitions using the Medical Research Council (UK) guidelines for complex intervention development The first step was to develop a theoretical understanding of the likely process of change, by drawing on existing evidence and theory, supplemented by new primary research. The intervention was then developed based on this first step by multidisciplinary experts (step 2), followed by conceptual mapping of the critical inputs of the intervention with the theoretical understanding (step 3). Then an assessment of the feasibility of the intervention was completed (step 4). The preliminary findings of a feasibility pilot study of this toolkit were positive with the majority of participants describing it as acceptable, easy to use, and having potential to help deal with transitions.