"Beyond Feasibility": A Qualitative Study of Patients, Their Whānau (Family) and Staff Perspectives and Experiences of a Non- Pharmacological Delirium-Prevention Intervention in Two Aotearoa/New Zealand Hospices.

CONTEXT:Delirium is prevalent in the hospice population. Despite causing significant distress to patients and families, delirium is under-recognised. There is a need to better understand delirium prevention and outcomes in this population including people's experiences of delirium-prevention strategies in different cultural contexts. OBJECTIVES:To determine whether the "PRESERVE Aotearoa" delirium prevention intervention was feasible and acceptable for Māori (indigenous peoples of Aotearoa/ New Zealand) and non-Māori patients with advanced cancer, their families (called whānau in this paper), and clinical staff. METHODS:A qualitative semistructured interview substudy of a cohort PRESERVE Aotearoa feasibility study codesigned with a Māori partner to ensure inclusion of Māori-centred values. The study was underpinned conceptually by He Awa Whiria (braided rivers)-combining Western and Māori knowledges. Data were analysed using Hopwood and Srivasta's framework. RESULTS:Twenty-six patients and their whānau, 21 clinical staff and five researchers from two stand-alone hospices in the North Island, Aotearoa/New Zealand. Finding showed that, for the most part, participants considered the study interventions feasible and acceptable. Inductive analysis resulted in four themes highlighting the importance to whānau of their participation in the study: benefits of learning about delirium; the affirmation of the caregiver role and whānau-centred care; valuing fundamentals of care; and research as legacy. CONCLUSION:This qualitative study found that it is feasible and acceptable to study multicomponent nonpharmacological delirium-prevention interventions in Aotearoa/New Zealand hospice inpatient units. The study also highlights the value of Māori-centred approaches and whānau involvement in these settings.