This integrative review offers important insight into the needs of informal caregivers, specifically for the elderly. The inclusive nature of integrative review method enabled us to provide a good understanding of underlying issues on the needs of informal caregivers. Challenges for the future are to broaden and enhance the scope of research in this area to provide effective support to intervention projects, services and care to informal caregivers.

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Background Family caregivers’ empowerment can assume strategic importance in palliative care. Healthcare professionals and volunteers have been showing significant gaps in this field. Hence, education has been advocated as an effective strategy to fill this gap. While several educational initiatives exist, a comprehensive evidence synthesis on the effectiveness of educational training on healthcare professionals and volunteers is lacking. Aims An integrative review was conducted to explore worldwide initiatives, aiming to improve healthcare professionals and volunteers’ competence in a palliative care setting especially in relation to the family caregiver. Method A scoping literature review was conducted with systematic searches in multiple databases – REDALYC, CINAHL, SCIELO, EBSCO, ERIC and MEDLINE since January 2012. Studies were selected based on programmes content and its impact evaluation. Four researchers assessed the studies regarding their eligibility with reference to the inclusion and exclusion criteria. Findings Twenty‐two studies met the eligibility criteria. Multi‐professional learning was reported, emphasising nurses and physician's enrolment. Only few studies showed participants’ learning outcomes. Inconsistencies in delivery mode and duration were identified. Impact evaluations were heterogeneous and relied on no validated instruments. Family caregiver's content was addressed only in three initiatives. Conclusions Further research is needed using a more reliable design, mode of delivery and impact measurement of educational training. In addition, more initiatives associated with cost‐effectiveness, shorter‐ and longer‐term clinical impact are needed. Despite the strides already made towards the establishment of an evidence base for healthcare professionals in the field of palliative care, either greater consideration is required for family care providers in the education of healthcare professionals and respect for the cultural diversity.

Background: Family caregivers play an important role supporting their relatives with advanced progressive disease to live at home. There is limited research to understand family caregiver needs over time, particularly outside of high-income settings. The aim of this study was to explore family caregivers' experiences of caring for a relative living with advanced progressive disease at home, and their perceptions of met and unmet care needs over time. Methods: An ethnographic study comprising observations and interviews. A purposive sample of 10 family caregivers and 10 relatives was recruited within a rural area in the north of Portugal. Data were collected between 2014 and 16 using serial participant observations (n = 33) and in-depth interviews (n = 11). Thematic content analysis was used to analyse the data. Results: Five overarching themes were yielded: (1) provision of care towards independence and prevention of complications; (2) perceived and (3) unknown caregiver needs; (4) caregivers' physical and emotional impairments; and (5) balancing limited time. An imbalance towards any one of these aspects may lead to reduced capability and performance of the family caregiver, with increased risk of complications for their relative. However, with balance, family caregivers embraced their role over time. Conclusions: These findings enhance understanding around the needs of family caregivers, which are optimally met when professionals and family caregivers work together with a collaborative approach over time. Patients and their families should be seen as equal partners. Family-focused care would enhance nursing practice in this context and this research can inform nursing training and educational programs.

Background: Nowadays, family caregivers play a critical role in the support of terminally ill at home. However, there are relatively few supervision models to help nurses in make decisions. Objectives: Contribute to a caregiver supervision model. Methodology: In a prior study, the needs of 10 terminally ill and their caregivers were identified. In the present study, based on a focus group, 8 expert nurses analysed the needs and validated both the functions and the focus of supervision. Results: Data on terminally ill patients confirm the normative function of supervision through the diagnostic criteria for self-care deficit and risks. The formative function of supervision is evident when family caregivers have no knowledge/skills to provide care or are not aware of a problem. Finally, the restorative function concerns the assessment of the caregivers' physical, emotional and relational capacity, as well as their time and resources available to provide care. Conclusion: The contributions of our study emphasises a 3 function model that covers the needs of terminally ill patients and their family caregivers.

Background In the UK 17.8 million people have musculoskeletal pathophysiology, which becomes universal with age. Levels of discomfort and incapability correlate with symptoms of anxiety and depression. People with sufficient symptoms who seek care can benefit from collaborative diagnosis and treatment of mental and physical health organised by a case manager. This paper presents the protocol for a feasibility trial of collaborative care in an orthopaedic setting. Aims To determine the feasibility and acceptability of providing collaborative care for patients with musculoskeletal conditions and co-existing symptoms of anxiety and depression identified on a screening tool in a physical and occupational therapy out-patient setting. Method A two-arm parallel-group randomised controlled trial will recruit 40 adult out-patients with at least moderate anxiety and depression, who have been referred for physiotherapy and occupational therapy. Participants will be allocated on a 1:1 ratio to collaborative care or to usual care. Co-primary outcomes will be key feasibility indicators collected at baseline and at 6 months. A qualitative study will be conducted post-intervention to explore the acceptability and potential improvements to the collaborative care model. Results This study will investigate the use of the collaborative care model for patients with musculoskeletal and co-existing moderate or severe levels of anxiety or depression. Conclusions The results will provide important evidence to determine a future trial.

Background: Family caregivers play an important role supporting their relatives with advanced progressive disease to live at home. There is limited research to understand family caregiver needs over time, particularly outside of high-income settings. The aim of this study was to explore family caregivers’ experiences of caring for a relative living with advanced progressive disease at home, and their perceptions of met and unmet care needs over time. Methods: An ethnographic study comprising observations and interviews. A purposive sample of 10 family caregivers and 10 relatives was recruited within a rural area in the north of Portugal. Data were collected between 2014-16 using serial participant observations (n=33) and in-depth interviews (n=11). Thematic content analysis was used to analyse the data. Results: Five overarching themes were yielded: (1) provision of care towards independence and prevention of complications; (2) perceived and (3) unknown caregiver needs; (4) caregivers’ physical and emotional impairments; and (5) balancing limited time. An imbalance towards any one of these aspects may lead to reduced capability and performance of the family caregiver, with increased risk of complications for their relative. However, with balance, family caregivers embraced their role over time. Conclusions: These findings enhance understanding around the needs of family caregivers, which are optimally met when professionals and family caregivers work together with a collaborative approach over time. Patients and their families should be seen as equal partners. Family-focused care would enhance nursing practice in this context and this research can inform nursing training and educational programs.

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