Study design

This prospective interventional mixed methods study was conducted between November 2019 and November 2021. It combines a quantitative study part, including a longitudinal questionnaire survey at baseline (pre-intervention), after each module and at follow-up three months after baseline as well as a qualitative study part with semi-structured interviews post- intervention. As shown in Fig. 1, the six modules were offered as an ongoing program, one module per week. After six weeks, the program started from the beginning, as illustrated by the two arrows forming a cycle. ICs could join the intervention at any time and in any order.

Study design

The mixed methods design approach was applied to triangulate the study, as mixed methods designs have been increasingly used in palliative care research to enrich findings [50]. Quantifying the ICs experience solely by questionnaires might be weak in understanding reasons behind their experiences with the intervention. Therefore, qualitative research was used for a deeper insight into the ICs subjective experience. To combine the approaches, we used a convergent triangulation method. The convergent triangulation design is a mixed methods design in which quantitative and qualitative data are collected and analysed separately and then results from both databases are compared and merged for interpretation [51].

The ethics committee of the Medical Association in Hamburg, Germany approved the study (June 04, 2019; Reference: PV7009).