Implementation and acceptability of the Caregiver Care Model in general practice: a mixed-method feasibility study

Abstract

Abstract Background Being a caregiver can be demanding. Therefore, we developed the Caregiver Care Model for general practice. The model consists of a mandatory dialogue questionnaire, which is used to identify support needs in caregivers, grief-facilitating questions, and an overview of community-based caregiver initiatives for caregivers in need of support. We aimed to test the implementation and acceptability of the model in general practice. Methods We used a fixed, convergent, mixed-methods approach to test the model in five general practices in the Central Denmark Region among 40 caregivers. Quantitative data included monitoring data collected by health professionals in an online database at inclusion and after each consultation. Qualitative data were derived from five introductory meetings and semi-structured interviews with ten health professionals. The analysis focused on the implementation (delivery and process) and the health professionals' acceptability of the model. Results All 40 caregivers participated in the first consultation, and 29 (73%) had two or more consultations. Eight caregivers (20%) were referred to community-based initiatives or a private-practice psychologist. The mandatory dialogue questionnaire was completed by 30 (75%) caregivers prior to the first consultation, and it was rated useful by general practitioners (GPs) and staff in 26 (74%) of encounters. GPs and staff perceived the dialogue questionnaire to be useful to direct the first consultations towards the most relevant issues, whereas the usefulness of the facilitating questions was unclear due to the brief introduction to them. The list of community-based initiatives was considered useful in urban areas, but not in rural areas with long distance to initiatives. Here, support from general practice was needed to promote mental health in caregivers and avoid sick leave. Conclusion The Caregiver Care Model was in line with core values of general practice and the dialogue questionnaire targeted the consultations on relevant issues for the caregiver. Health professionals provided targeted support, including follow-up consultations and referred a group for community-based initiatives, especially caregivers in urban settings. The findings call for increased focus on caregivers and education of general practitioners and staff to facilitate caregiver reactions in connection with loss and grief.

Keywords

• General practice
• Primary care
• Caregivers
• Grief
• Mental health
• Palliative care