Research project – Adapting CSNAT-I for parent-carers of children with life-limiting conditions

A Person Based Approach to adaptation and programme theory development

The Carer Support Needs Assessment Tool Intervention (CSNAT-I) is a person-centred intervention, facilitated by practitioners, enabling family carers themselves to identify the domains in which they need more support, prioritise those for discussion with a practitioner where their specific support needs are explored and an appropriate action plan is agreed to address their individual needs.

CSNAT-I was initially developed as an intervention to support carers of adults with life-limiting conditions. The intervention is delivered using a five-stage person-centred process.

Whilst the benefits and principles of CSNAT-I have been established across national and international care settings for carers of adults, some adaptation is likely to be needed for the circumstances of parent-carers of children with palliative care needs.

Some initial work has been conducted with parent-carers in Australia and the US which both showed that the parents valued using the CSNAT-I approach to assessing and supporting their needs.

However, further development work is required in a UK context that draws upon the perspectives of a wide range of stakeholders and to ensure that appropriate consideration has been given to the suitability of the intervention (both the tool itself and the five stage process used for delivery) for use with parents and in children’s hospices.

Furthermore, to ensure that its use is feasible and implementable in this setting, it is important that we develop a programme theory to explore the mechanisms of action that underpin the intervention in this context.

Not only will this help us to identify implementation barriers and facilitators, but it will demonstrate whether, how and why this intervention is useful for parent-carers or why it may not be.

Project Lead: Professor Lorna Fraser, Kings College London

Local Lead: Dr Joanna Elverson, Consultant in Palliative Medicine, St Oswald’s Hospice

August 2025

Aims:

  1. Assess the suitability of the CSNAT-I (Paediatric) for use with parent-carers from the perspectives of parents and professionals in children’s hospices, and adapt it as appropriate in preparation for feasibility and effectiveness studies;
  2. Develop a programme theory (including Theory of Change) for the CSNAT-I (Paediatric). This will be developed through engagement with existing literature, stakeholder (including PPI) input and the results of these workshops.

Person-based approach to intervention planning, development and optimisation of the CSNAT-I (Paediatric), incorporating the Theory of Change and Normalisation Process Theory.