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Tunnard I, Sleeman KE, Bradshaw A, Bone AE, Evans CJ. The influence of care home registration type and size on senior care leader's confidence to provide palliative and end-of-life care: an explanatory sequential mixed methods study. BMC Palliat Care 2024; 23:213. [PMID: 39174986 PMCID: PMC11340158 DOI: 10.1186/s12904-024-01525-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 07/18/2024] [Indexed: 08/24/2024] Open
Abstract
BACKGROUND Care home staff are key providers of palliative and end-of-life care. Yet, little is known about how care home characteristics can influence care leader's confidence in their ability to provide optimal palliative and end-of-life care. AIM To understand the influence of care home registration type (nursing, residential or dual registered) and size on senior care leader's confidence to provide palliative and end-of-life care. DESIGN An explanatory sequential mixed methods study comprising an online cross-sectional survey (including the Palliative Care Self-Efficacy Scale) and qualitative individual interviews. Analysis of survey data used a multivariate logistic regression and qualitative interview data used Framework Analysis. A 'Following the Thread' method was undertaken for data integration. SETTING/PARTICIPANTS UK care home senior care leaders, purposively sampled by registration type, size and geographical location. RESULTS The online survey (N = 107) results indicated that nursing home senior care leaders had higher confidence scores on the Palliative Care Self-Efficacy Scale than residential care home leaders (aOR: 3.85, 95% CI 1.20-12.31, p = 0.02). Care home size did not show effect when adjusting for registration type (medium - aOR 1.71, 95% CI 0.59-4.97, p = 0.33; large - aOR 0.65, 95% CI 0.18-2.30, p = 0.5). Interviews (n = 27) identified three themes that promote confidence, (1) 'feelings of preparedness' stemming from staff expertise and experience and care home infrastructure, (2) 'partnership working' with external services as a valued member of the multidisciplinary team, and (3) a shared language developed from end-of-life care guidance. CONCLUSION Care home senior care leader's confidence is influenced by care home characteristics, particularly availability of on-site registered nurses and the infrastructure of large care homes. All care home leaders benefit from training, working with external, multidisciplinary teams and use of guidance. However, mechanisms to achieve this differed by care home type and size. Further exploration is needed on successful integration of palliative care services and interventions to enhance confidence in residential care homes.
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Affiliation(s)
- India Tunnard
- Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, King's College London, Cicely Saunders Institute, London, UK.
| | - Katherine E Sleeman
- Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, King's College London, Cicely Saunders Institute, London, UK
| | - Andy Bradshaw
- Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, King's College London, Cicely Saunders Institute, London, UK
| | - Anna E Bone
- Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, King's College London, Cicely Saunders Institute, London, UK
| | - Catherine J Evans
- Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, King's College London, Cicely Saunders Institute, London, UK
- Sussex Community NHS Foundation Trust, Brighton, UK
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Salmani N, Keshmiri F, Bagheri I. The effect of combined training (theoretical-practical) of palliative care on perceived self-efficacy of nursing students. PLoS One 2024; 19:e0302938. [PMID: 38990859 PMCID: PMC11238957 DOI: 10.1371/journal.pone.0302938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 04/15/2024] [Indexed: 07/13/2024] Open
Abstract
BACKGROUND Nurses and researchers emphasize the importance of adding educational content of palliative care to nursing curricula in Iran as a means to improve the quality of care at the end of life and self-efficacy is considered as an important determinant in palliative care nursing. However, undergraduate nursing students are not sufficiently trained to achieve the qualifications required in palliative care. The aim of this study was to determine the effect of combined training (theoretical-practical) of palliative care on the perceived self-efficacy of nursing students. METHODS This is a semi-experimental study with a pretest-posttest design. Sampling was nonrandomized with convenience method and included 23 seventh-semester students. The intervention consisted of palliative care training for ten theoretical sessions and three practical sessions. Data were collected using demographic and the perceived self-efficacy questionnaires completed before and after the intervention. Data were then analyzed in the statistical SPSS 23 software using descriptive and analytical statistics. RESULTS The mean age of the samples was 22.78 (SD1.17). Most of the participants were male (56.5%) and single(91.3%). The findings showed that, perceived self-efficacy, psycho-social support and symptom management improved significantly after the intervention (p<0.05). CONCLUSION Palliative care training can increase the nursing students perceived self-efficacy. Since nursing students are the future nurses of the care system, therefore, managers and planners can take a step towards improving the quality of nursing care by using palliative care training programs. Since nursing students will be future nurses in health care system, therefore, managers and planners can take steps to improve the quality of nursing care by using palliative care education programs.
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Affiliation(s)
- Naiire Salmani
- Research Center for Nursing and Midwifery Care, Non-Communicable Diseases Institute, Nursing Faculty, Meybod Nursing School, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Fatemeh Keshmiri
- Educational Development Center, Medical Education Department, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Imaneh Bagheri
- Research Center for Nursing and Midwifery Care, Department of Nursing, Non-Communicable Diseases Institute, Nursing Faculty, School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Guo J, Chen Y, Shen B, Peng W, Wang L, Dai Y. Translation and validation of the Chinese version of Palliative Care Self-Efficacy Scale. Palliat Support Care 2024:1-7. [PMID: 38587037 DOI: 10.1017/s1478951524000518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
OBJECTIVES Accurately assessing the self-efficacy levels of palliative care professionals' is crucial, as low levels of self-efficacy may contribute to the suboptimal provision of palliative care. However, there is currently lacking a reliable and valid instrument for evaluating the self-efficacy of palliative care practitioners in China. Therefore, this study aimed to translate, adapt, and validate the Palliative Care Self-Efficacy Scale (PCSS) among Chinese palliative care professionals. METHODS This study involved the translation and cross-cultural adaptation of the PCSS, and the evaluation of its psychometric properties through testing for homogeneity, content validity, construct validity, known-groups validity, and reliability. RESULTS A total of 493 palliative care professionals participated in this study. The results showed the critical ratio value of each item was >3 (p < 0.01), and the corrected item-total correlation coefficients of all items ranged from 0.733 to 0.818, indicating a good homogeneity of the items with the scale. Additionally, the scale was shown to have good validity, with item-level content validity index ranged from 0.857 to 1.000, and scale-level content validity index/Ave was 0.956. The exploratory factor analysis and confirmatory factor analysis (CFA) confirmed the 2-factor structure of the Chinese version of PCSS (C-PCSS), explaining 74.19% of the variance. CFA verified that the 2-factor model had a satisfactory model fit, with χ2/df = 2.724, RMSEA = 0.084, GFI = 0.916, CFI = 0.967, and TLI = 0.952. The known-groups validity of C-PCSS was demonstrated good with its sensitive in differentiating levels of self-efficacy between professionals with less than 1 year of palliative care experience (p < 0.001) or without palliative care training (p = 0.014) and their counterparts. Furthermore, the C-PCSS also exhibited an excellent internal consistency, with the Cronbach's α for the total scale of 0.943. SIGNIFICANCE OF RESULTS The findings from this study affirmed good validity and reliability of the C-PCSS. It can be emerged as a valuable and reliable instrument for assessing the self-efficacy levels of palliative care professionals in China.
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Affiliation(s)
- Junchen Guo
- Department of Palliative Care, Hunan Cancer Hospital, Changsha, China
- School of Nursing, University of South China, Hengyang, China
| | - Yongyi Chen
- Department of Palliative Care, Hunan Cancer Hospital, Changsha, China
| | - Boyong Shen
- Department of Palliative Care, Hunan Cancer Hospital, Changsha, China
| | - Wei Peng
- Department of Palliative Care, Hunan Cancer Hospital, Changsha, China
| | - Lianjun Wang
- School of Nursing, Guilin Medical University, Guilin, China
| | - Yunyun Dai
- School of Nursing, Guilin Medical University, Guilin, China
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
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Guleria A, Rai K, Kumar Y, Sarin J. Educational intervention on perceived stress among adults with type 2 diabetes and metabolic syndrome: a non-randomized clinical trial. INVESTIGACION Y EDUCACION EN ENFERMERIA 2024; 42:e04. [PMID: 39083816 PMCID: PMC11290900 DOI: 10.17533/udea.iee.v42n1e04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 02/02/2024] [Indexed: 08/02/2024]
Abstract
Objective To evaluate the effectiveness of Virtual Teaching (VT) Programme regarding palliative care on knowledge, self-efficacy and attitude among Nursing Personnel working in selected hospitals of North India. Methods A quasi-experimental study with non-equivalent control group pre-test-post-test design was conducted on 121 Nursing Personnel, selected by convenient sampling technique. Knowledge, self-efficacy and attitude were assessed using structured knowledge questionnaire, Palliative Care Self-efficacy Scale, and Frommelt Attitudes toward care of dying scale respectively. Nursing personnel in experimental group received Virtual Teaching Programme regarding palliative care whereas those in comparison group received conventional teaching (CT). The study included a pre-test followed by the teaching (virtual/ conventional) on day one. The post-test was conducted on 15th day after the intervention. Results The results showed that there was a significant difference in mean post-test knowledge (VT group: 17.11 to CT group: 25.05; t=9.25, p<0.001), self-efficacy (VT group: 39.27 to CT group: 43.38; t=6.39, p<0.001) and attitude (VT group: 108.86 to CT group: 133.23; t=9.27, p<0.001) scores between virtual teaching group and conventional teaching group. ANCOVA test revealed statistically significant differences in the mean scores of knowledge [F (1.11) = 86.61, p<0.001], self-efficacy [F (1.11) = 841.75, p<0.001] and attitude [F (1.11) = 82.92, p<0.001] between the groups, with higher means obtained in the CT group. Conclusion Virtual Teaching programme and Conventional teaching both were effective in enhancing the knowledge, self-efficacy and attitude among Nursing Personnel regarding palliative care with conventional teaching being more effective.
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Affiliation(s)
- Alka Guleria
- MSN, RN, Nursing Tutor, Maharishi Markandeshwar Institute of Nursing, Maharishi Markandeshwar (deemed to be university), Mullana, Ambala, Haryana, India.Maharishi Markandeshwar UniversityMaharishi Markandeshwar Institute of NursingMaharishi MarkandeshwarIndia
| | - Kanika Rai
- Ph.D, RN. Chitkara School of Health Sciences, Chitkara University, Punjab, India. , (Corresponding author)Chitkara UniversityChitkara School of Health SciencesChitkara UniversityPunjabIndia
- Centre for Evidence Based Practice in Health Care, Chitkara School of Health Sciences, Chitkara University, Punjab, IndiaChitkara UniversityCentre for Evidence Based Practice in Health CareChitkara School of Health SciencesChitkara UniversityPunjabIndia
| | - Yogesh Kumar
- Ph.D, RN. Professor, College of Nursing, Teerthankar Mahavir University, Moradabad, Uttar Pradesh, IndiaCollege of NursingTeerthankar Mahavir UniversityIndia
| | - Jyoti Sarin
- PhD, RN. Principal, Maharishi Markandeshwar College of Nursing, Maharishi Markandeshwar (deemed to be university), Mullana, Ambala, Haryana, India.Maharishi Markandeshwar UniversityMaharishi Markandeshwar College of NursingMaharishi MarkandeshwarIndia
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Kim J, Gray JA. Measuring palliative care self-efficacy of intellectual and developmental disability staff using Rasch models. Palliat Support Care 2024; 22:146-154. [PMID: 36683394 DOI: 10.1017/s1478951522001833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVES The objectives of this study were to evaluate the psychometric properties of a palliative care self-efficacy instrument developed for intellectual and developmental disability (IDD) staff using Rasch analysis and assess the change in palliative care self-efficacy between 2 time points using Rasch analysis of stacked data. METHODS Staff from 4 nonprofit IDD services organizations in a US Midwestern state (n = 98) answered 11 questions with Likert-style responses at baseline and 1-month follow-up post training. Rasch analysis was performed to examine rating scale structure, unidimensionality, local independence, overall model fit, person and item reliability and separation, targeting, individual item and personal fit, differential item functioning (DIF), and change in palliative care self-efficacy between 2 time points. RESULTS The rating scale structure improved when 5 response categories were collapsed to 3. With the revised 3 response categories, the instrument demonstrated good psychometric properties. Principal components analysis of Rasch residuals supported the assumption of unidimensionality. Model fit statistics indicated an excellent fit of the data to the Rasch model. The instrument demonstrated good person and item reliability and separation. Gender-related DIF was found in 1 item, and work tenure-related DIF in 3 items. Overall palliative care self-efficacy improved between 2 time points. SIGNIFICANCE OF RESULTS Rasch analysis allowed for a more thorough examination of this palliative care self-efficacy instrument than classical test theory and provided information on rating scale structure, targeting, DIF, and individual persons and items. These recommendations can improve this instrument for research and practical contexts.
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Affiliation(s)
- Jinsook Kim
- School of Health Studies, Northern Illinois University, DeKalb, IL, USA
| | - Jennifer A Gray
- School of Health Studies, Northern Illinois University, DeKalb, IL, USA
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Feng M, Wang F, Liu Q, Yang BX, Hao J, Yu S, Hu F, Luo D, Chen J. Validation of the Simplified Chinese Palliative Care Nursing Self-Competence Scale: Two Cross-sectional Studies. West J Nurs Res 2023; 45:1043-1052. [PMID: 37752762 DOI: 10.1177/01939459231201616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
BACKGROUND Due to the increasing burden of life-limiting illnesses, the need for palliative care has increased. Nurses' palliative care competence is a vital factor in improving its accessibility. A reliable instrument is needed to measure nurses' competence in providing palliative care. OBJECTIVE Our aim was to translate and culturally adapt the Palliative Care Nursing Self-Competence Scale (PCNSC) into the Palliative Care Nursing Self-Competence Scale-Simplified Chinese (PCNSC-SC). METHODS Two cross-sectional studies were conducted after content validity had been confirmed during the instrument's translation and adaption. The convergent validity, construct validity, internal consistency, and homogeneity were evaluated in both the first and second studies. Test-retest reliability was assessed only in the first study. Clinical nurses who had a registered nurse qualification certificate and at least 12 months of work experience from a tertiary hospital in Hubei, China participated in the 2 studies. RESULTS The PCNSC-SC contains 8 dimensions and 34 items, based on goodness-of-fit indices and confirmatory factor analysis. The Cronbach's alpha of the PCNSC-SC was .984 and .990 in the 2 studies, respectively. The test-retest reliability of the PCNSC-SC after 2 weeks was .717. CONCLUSION The PCNSC-SC can be used to evaluate perceived self-competence in palliative care of Chinese nurses with good reliability and validity.
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Affiliation(s)
- Mei Feng
- School of Nursing, Wuhan University, Wuhan, China
- Emergency Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fang Wang
- Emergency Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qian Liu
- School of Nursing, Wuhan University, Wuhan, China
- Population and Health Research Center, Wuhan University, Wuhan, China
| | - Bing Xiang Yang
- School of Nursing, Wuhan University, Wuhan, China
- Population and Health Research Center, Wuhan University, Wuhan, China
| | - Jie Hao
- School of Nursing, Wuhan University, Wuhan, China
- Emergency Department of the East Campus, Renmin Hospital of Wuhan University, Wuhan, China
| | - Sihong Yu
- School of Nursing, Wuhan University, Wuhan, China
| | - Fen Hu
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Dan Luo
- School of Nursing, Wuhan University, Wuhan, China
- Population and Health Research Center, Wuhan University, Wuhan, China
| | - Jie Chen
- Florida State University College of Nursing, Tallahassee, FL, USA
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Wazqar DY. Arabic version of the Palliative Care Self-Efficacy Scale: Translation, adaptation, and validation. Palliat Support Care 2023; 21:863-870. [PMID: 36285511 DOI: 10.1017/s1478951522001456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES A lack of confidence among oncology nurses might be problematic when providing palliative care. No valid and reliable tool is currently available in Saudi Arabia to assess oncology nurses' confidence in providing palliative care. This study aims to explain the process of translation, adaptation, and validation of the Palliative Care Self-Efficacy Scale (PCSS) to support its use in the Saudi context. METHODS This was a methodological study of translation, cultural adaptation, and content validation of PCSS. The process of translation and adaptation was conducted according to the World Health Organization guidelines, including forward and backward translations, an expert panel review, and pretesting and cognitive interviewing, resulting in a final version. Two independent bilingual oncology nurses familiar with palliative care terminology translated the PCSS from English to Modern Standard Arabic. Next, the concise PCSS translation developed from the 2 translations was back-translated to English by 2 English-speaking translators and then compared to the original PCSS. The Arabic version PCSS was evaluated by Saudi professionals (N = 5) in oncology and palliative care nursing using a Likert scale for essentiality, relevance, clarity, and appropriateness. The content validity was examined using the calculation of the content validity ratio, item-level content validity index (I-CVI), and modified kappa statistics. The thinking aloud method was also used to interview Saudi oncology nurses (N = 8) who had palliative care experience. RESULTS The relevance, clarity, and appropriateness of the first Arabic version PCSS were validated. It had a level of content validity index of 1.00 for all items after improvements were made based on the recommendations of experts and oncology nurses. SIGNIFICANCE OF RESULTS The PCSS demonstrated face and content validity in the assessment of oncology nurses' confidence in providing palliative care. The PCSS is suitable for use in palliative cancer care units in Saudi Arabia to identify the educational needs of nurses to promote their confidence and improve the quality of care. Additional reliable and valid language versions of the PCSS allow for international and national comparisons, which may be useful for oncology nursing administrators or managers who are accountable for the quality of palliative care during the strategic health-care planning process in cancer services.
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Affiliation(s)
- Dhuha Youssef Wazqar
- Department of Medical Surgical Nursing, Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia
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Tapp D, Plaisance A, Boudreault N, St-Pierre I, Desbiens JF, Poitras SC, Lemay E, Urrea LA, Lapointe A, Henry M, Bravo G. Development of a bilingual interdisciplinary scale assessing self-efficacy for participating in Medical Assistance in Dying. CANADIAN MEDICAL EDUCATION JOURNAL 2023; 14:157-159. [PMID: 37719388 PMCID: PMC10500409 DOI: 10.36834/cmej.76161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
Medical Assistance in Dying (MAiD) is a complex process involving the person seeking care and their relatives. MAiD involves physical, psychosocial and spiritual needs, and consequently the involvement of an interdisciplinary team is beneficial. Therefore, updating the knowledge and skills of healthcare and social services professionals is critical. An interdisciplinary team from Laval University (Quebec, Canada) has developed a continuous training program for all health care and social services professionals who could be involved in the care of persons who request MAiD and their loved ones. It is crucial to assess whether the objectives of the continuous training program are being met, especially since this new training addresses several complex issues (legal, ethical, and clinical). Bandura's self-efficacy theory has been widely used to develop scales for assessing the impact of training programs and identifying knowledge gaps. Bandura's theory states that feeling secure in one's self-efficacy leads to self-determined motivation. Although there are various scales intended to measure self-efficacy in palliative care, none include self-efficacy for participating in the process surrounding MAiD. As a result, we aim to create a bilingual (English-French) interdisciplinary scale to assess self-efficacy for participating in the process surrounding MAiD. The scale will allow decision-makers and researchers to identify current knowledge gaps. It will also be useful for assessing the impact of current and future training programs addressing this end-of-life practice. In this work in progress, we briefly introduce the training program and the future steps in the development and validation of the scale.
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Affiliation(s)
- Diane Tapp
- Faculty of Nursing, Laval University, Quebec, Canada
- Institute of Palliative and End of Life Care, Laval University, Quebec, Canada
- CHU de Quebec, Laval University Research Center, Quebec, Canada
| | - Ariane Plaisance
- Faculty of Nursing, Laval University, Quebec, Canada
- Institute of Palliative and End of Life Care, Laval University, Quebec, Canada
- Department of Health Sciences, University of Quebec in Rimouski, Quebec, Canada
| | - Nathalie Boudreault
- Institute of Palliative and End of Life Care, Laval University, Quebec, Canada
- Faculty of Medicine, Laval University, Quebec Canada
- CHU de Quebec, Laval University, Quebec, Canada
| | | | - Jean-François Desbiens
- CHU de Quebec, Laval University Research Center, Quebec, Canada
- Faculty of Medicine, Laval University, Quebec Canada
| | | | | | | | | | - Melissa Henry
- Department of Oncology, McGill University, Quebec, Canada
| | - Gina Bravo
- Department of Community Health Sciences, Faculty of Medicine and Health Sciences, Sherbrooke University, Québec, Canada
- Research Centre on Aging, University Institute of Geriatrics of Sherbrooke, Canada
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Salameh B, Ayed A, Fashafsheh I, Alrazeeni DM, Batran A, Ahmed F. Nursing Students' Understanding of Palliative Care in Palestine. Crit Care Nurs Q 2023; 46:203-216. [PMID: 36823747 DOI: 10.1097/cnq.0000000000000453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Palliative care is a method of preventing and alleviating suffering for patients who have been diagnosed with terminal diseases by early detection, accurate assessments, and pain and symptom management. Patients and their families can then mitigate related physical, psychological, and spiritual challenges and thus will have a better quality of life. This article reports a study that evaluated undergraduate nursing students' knowledge of and attitude and self-efficacy toward palliative and end-of-life care in Palestine. A descriptive, cross-sectional design was used among a convenience sample of 449 undergraduate nursing students at the end of their second, third, and fourth years. The results of this research revealed that nursing students had low levels of knowledge about palliative care and low self-efficacy toward end-of-life care. The majority of students reported a positive disposition toward the provision of end-of-life care. The most important predictors of knowledge, attitudes, and self-efficacy were age, having attended a seminar/lecture on the issue, experiencing death while providing care, and having experienced a death in the family or close friends. Furthermore, elevated levels of knowledge were significantly associated with higher level of attitude (P < .001) about palliative care.
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Affiliation(s)
- Basma Salameh
- Faculty of Nursing, Arab American University, Jenin, Palestine (Drs Salameh, Ayed, and Fashafsheh); King Saud University, Riyadh, Saudi Arabia (Dr Alrazeeni); Palestine Ahliya University, Bethlehem, Palestine (Dr Batran); and Nursing Department, College of Applied Medical Sciences, Jouf University, Sakakah, Saudi Arabia, and Critical Care and Emergency Nursing, Mansoura University, Mansoura, Egypt (Dr Ahmed)
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Sabolish RM, Pennartz LE, Caldwell HK. They're Dying. Now What? The Impact of a 2-Hour End-of-Life Educational Intervention on Bedside Nurse Self-efficacy, Knowledge, and Clinical Practice. J Hosp Palliat Nurs 2023; 25:E32-E40. [PMID: 36622898 DOI: 10.1097/njh.0000000000000931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The palliative care team identified a lack of knowledge and confidence for nurses providing end-of-life care in a hospital. The team completed a quality improvement project establishing significant improvement in knowledge and self-efficacy after a 2-hour educational intervention. The next step was to study the impact on practice. Clinical management of pain, dyspnea, secretions, and agitation was compared for a 3-month period before and after intervention. Thirty-six patients were identified in the preintervention group, and 46 patients were in the postintervention group. A 2-sample proportion Z test ( α = .05, 2-tailed) showed no statistical significance in the number of doses of opioids administered between preintervention and postintervention groups; however, the number of patients in the postintervention group that received an opioid orally was significantly greater ( z = -2.098, P = .0357). A significantly lower proportion of the postintervention group received benzodiazepines ( z = -4.334, P < .00001). The postintervention group had a statistically significant lower proportion of anticholinergics administered ( z = -4.189, P < .00001). Significantly more patients in the postintervention group had oxygen titrated ( z = -3.196, P = .0014) and were on room air at the time of death ( z = -3.891, P = .0001). A 2-hour training led to statistically significant changes in the use of evidence-based interventions.
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DeFusco C, Lewis A, Cohn T. Improving Critical Care Nurses Perceived Self-Efficacy in Providing Palliative Care: A Quasi-Experimental Study. Am J Hosp Palliat Care 2023; 40:117-121. [PMID: 35513023 DOI: 10.1177/10499091221094313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Palliative care is a service that focuses on quality of life and symptom management. It is particularly important for patients with chronic disease. Palliative care in general is an underutilized service for various reasons. Many nurses have only learned about palliative care from experience and express a need for more education. PURPOSE This study focused on educating critical care nurses on palliative care through online training videos. This quasi-experimental study aims to determine if an online palliative care educational program improves critical care nurses' self-efficacy in providing palliative care. PROCEDURES The study was conducted using a pre-survey and post-survey that was created with a validated tool called the Palliative Care Self-Efficacy Scale. In between the surveys, the respondents were directed to online education. MAIN FINDINGS The overall Palliative Care Self-Efficacy Scale showed a median score of the Palliative Care Self-Efficacy Scale increased from pre education (Md=38) to post-education (Md = 43.5), z = -4.868, p <.001, with a large effect size (r = -.76). PRINCIPAL CONCLUSIONS The majority of critical care nurses have received some form of palliative care education. Online resources similar to the VitalTalk videos and handouts provide added education and improve perceived self-efficacy in providing palliative care in both psychosocial and symptom management aspects of care. The data suggests that improvements to access to education can be done by employers. Further studies can be done to assess current access to palliative care education in undergraduate nursing programs.
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Affiliation(s)
| | - Auriel Lewis
- Department of Nursing, 1849Simmons University, Boston, MA, USA
| | - Tanya Cohn
- Department of Nursing, 1849Simmons University, Boston, MA, USA
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Ko E, Lowie S, Ni P. Confidence in carrying out palliative care among intensive care nurses. Nurs Crit Care 2023; 28:13-20. [PMID: 34889484 DOI: 10.1111/nicc.12735] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 11/11/2021] [Accepted: 11/12/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Nurses in intensive care units (ICUs) play a crucial role in providing palliative care. Effective provision of palliative care in the ICU requires nurses' active engagement, yet little is known about the confidence for palliative care that ICU nurses hold in China. AIM To explore confidence in performing palliative care among ICU nurses in China and factors related to nurses' level of confidence. STUDY DESIGN A cross-sectional design was implemented. METHODS This study utilized convenience sampling to recruit ICU nurses from nine hospitals in Wuhan, China. Data were collected via an online survey. Multiple regression was conducted to identify the predictors of the ICU nurses' confidence in performing palliative care. RESULTS A total of 231 ICU nurses participated in the study, resulting in a response rate of 78% (231/296). Participants reported a relatively low level of confidence for carrying out palliative care (mean score = 2.60 ± 0.53; range = 1-4). Nurses who had more positive attitudes toward palliative care communication (P < .001), higher levels of formal training on palliative care (P < .001), more years of working as an ICU nurse (P < .05) and those working in integrated ICU (P < .001) showed a higher level of confidence in carrying out palliative care. CONCLUSION Participants' lack of confidence in performing palliative care makes for increased challenges, particularly in uncertainty about family assessments, palliative care discussions and lack of palliative care training. Strengthening palliative care curricula in nursing education and professional training is imperative to enhance ICU nurses' confidence. RELEVANCE TO CLINICAL PRACTICE Strengthening palliative care education and training, particularly in relation to palliative care communication, is critical. Implementing and tailoring culturally relevant palliative care call for attention to practice and for policy changes in palliative care delivery in China.
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Affiliation(s)
- Eunjeong Ko
- School of Social Work, San Diego State University, San Diego, California, USA
| | - Samantha Lowie
- Outpatient Behavioral Health, Vista Hill Foundation, San Diego, California, USA
| | - Ping Ni
- Nursing School, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Heo S, Kim M, You H, Hong SW, An M, Yang J, Kim HJ, Shim J, Chon S, Kim J. Reliability and validity of the Self-Efficacy in Palliative Care Scale among nurses. Palliat Support Care 2022:1-7. [PMID: 36472251 DOI: 10.1017/s147895152200164x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To provide appropriate palliative care, nurses should have appropriate level of self-efficacy in palliative care, but the levels among nurses were low. To improve the levels effectively, self-efficacy in palliative care should be assessed using reliable and valid instruments. The purpose of this study was to examine the reliability and validity of the Self-Efficacy in Palliative Care Scale in Korean nurses. METHODS In this cross-sectional, observational study, 272 nurses (mean age: 30 years) were enrolled from 6 university-affiliated medical centers or community hospitals in South Korea. Data on self-efficacy and demographic characteristics were collected. Validity was assessed by exploratory and confirmatory factor analyses (SPSS and Mplus). Reliability and homogeneity were assessed by Cronbach's alpha and item analyses (SPSS), respectively. RESULTS The exploratory and confirmatory factor analyses supported the 4-factor structure (communication, assessment and symptom management, psychosocial and spiritual management of patient and family, and multiprofessional teamworking) with factor loadings >.60 and with good model fit: root mean square error of approximation =.07, Tucker-Lewis index =.94, comparative fit index =.95, and standardized root mean square residual =.04. Cronbach's alphas for the total scale and each of the subscales ranged from .883 to .965. The corrected item-total correlation coefficients of all items ranged from .61 to .90. SIGNIFICANCE OF RESULTS The findings of this study supported the reliability and validity of this instrument among Korean nurses. This instrument can be used to assess nurses' self-efficacy in palliative care and to test intervention effects on it.
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Affiliation(s)
- Seongkum Heo
- Georgia Baptist College of Nursing, Mercer University, Atlanta, GA, USA
| | - Miyeong Kim
- Department of Nursing, Gachon University Gil Medical Center, Incheon, South Korea
| | - HyunMi You
- Department of Nursing, National Health Insurance Service Ilsan Hospital, Goyang-si, Gyeonggi-do, South Korea
| | - Sun Woo Hong
- Department of Emergency Medical Services, Daejeon University, Daejeon, South Korea
| | - Minjeong An
- College of Nursing, Chonnam National University, Gwangju, South Korea
| | - Jisun Yang
- Department of Nursing, Gachon University Gil Medical Center, Incheon, South Korea
| | - Hee Jung Kim
- College of Nursing, Gachon University, Incheon, South Korea
| | - JaeLan Shim
- College of Nursing, Dongguk University, Gyeongju, South Korea
| | - SaeHyun Chon
- College of Nursing, Gachon University, Incheon, South Korea
| | - JinShil Kim
- College of Nursing, Gachon University, Incheon, South Korea
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14
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Taels B, Hermans K, Van Audenhove C, Cohen J, Hermans K, Declercq A. Development of an intervention (PICASO) to optimise the palliative care capacity of social workers in Flanders: a study protocol based on phase I of the Medical Research Council framework. BMJ Open 2022; 12:e060167. [PMID: 36220327 PMCID: PMC9558801 DOI: 10.1136/bmjopen-2021-060167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION An important challenge for future palliative care delivery is the growing number of people with palliative care needs compared with the limited qualified professional workforce. Existing but underused professional potential can further be optimised. This is certainly the case for social work, a profession that fits well in multidisciplinary palliative care practice but whose capacities remain underused. This study aims to optimise the palliative care capacity of social workers in Flanders (Belgium) by the development of a Palliative Care Program for Social Work (PICASO). METHODS AND ANALYSIS This protocol paper covers the steps of the development of PICASO, which are based on phase I of the Medical Research Council framework. However, additional steps were added to the original framework to include more opportunities for stakeholder involvement. The development of PICASO follows an iterative approach. First, we will identify existing evidence by reviewing the international literature and describe the problem by conducting quantitative and qualitative research among Flemish social workers. Second, we will further examine practice and identify an appropriate intervention theory by means of expert panels. Third, the process and outcomes will be depicted in a logic model. ETHICS AND DISSEMINATION Ethical approval for this study was given by the KU Leuven Social and Societal Ethics Committee (SMEC) on 14 April 2021 (reference number: G-2020-2247-R2(MIN)). Findings will be disseminated through professional networks, conference presentations and publications in scientific journals.
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Affiliation(s)
- Brent Taels
- LUCAS Centre for Care Research and Consultancy, KU Leuven, Leuven, Belgium
| | - Kirsten Hermans
- LUCAS Centre for Care Research and Consultancy, KU Leuven, Leuven, Belgium
| | - Chantal Van Audenhove
- LUCAS Centre for Care Research and Consultancy, KU Leuven, Leuven, Belgium
- Academic Center for General Practice, KU Leuven, Leuven, Belgium
| | - Joachim Cohen
- End-of-Life Care Research Group, Vrije Universiteit Brussel, Brussel, Belgium
| | - Koen Hermans
- LUCAS Centre for Care Research and Consultancy, KU Leuven, Leuven, Belgium
- CESO Centre for Sociological Research, KU Leuven, Leuven, Belgium
| | - Anja Declercq
- LUCAS Centre for Care Research and Consultancy, KU Leuven, Leuven, Belgium
- CESO Centre for Sociological Research, KU Leuven, Leuven, Belgium
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15
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Delivering person-centred palliative care in long-term care settings: is humanism a quality of health-care employees or their organisations? AGEING & SOCIETY 2022. [DOI: 10.1017/s0144686x22000459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Abstract
Reflecting on sustained calls for patient-centredness and culture change in long-term care, we evaluated the relative importance of personal and organisational predictors of palliative care, hypothesising the former as weaker predictors than the latter. Health-care employees (N = 184) from four Canadian long-term care homes completed a survey of person-centred care, self-efficacy, employee wellbeing and occupational characteristics. Using backward stepwise regression models, we examined the relative contributions of these variables to person-centred palliative care. Specifically, blocks of variables representing personal, organisational and occupational characteristics; palliative care self-efficacy; and employee wellbeing were simultaneously regressed on variables representing aspects of person-centred care. The change in R2 associated with the removal of each block was examined to determine each block's overall contribution to the model. We found that occupational characteristics (involvement in care planning), employee wellbeing (compassion satisfaction) and self-efficacy were reliably associated with person-centred palliative care (p < 0.05). Facility size was not associated, and facility profit status was less consistently associated. Demographic characteristics (gender, work experience, education level) and some aspects of employee wellbeing (burnout, secondary trauma) were also not reliably associated. Overall, these results raise the possibility that humanistic care is less related to intrinsic characteristics of employees, and more related to workplace factors, or to personal qualities that can be cultivated in the workplace, including meaningful role engagement, compassion and self-efficacy.
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16
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Feng M, Liu Q, Hao J, Luo D, Yang B, Yu S, Chen J. Emergent care nurses' perceived self-competence in palliative care and its predictors: A cross-sectional study. J Nurs Manag 2022; 30:1225-1234. [PMID: 35261105 DOI: 10.1111/jonm.13582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/03/2022] [Accepted: 03/01/2022] [Indexed: 11/30/2022]
Abstract
AIM To describe the prevalence of perceived self-competence in palliative care among emergent care nurses, and explore its predictors. BACKGROUND Emergent care nurses have a responsibility to develop palliative care competence to enhance the quality of life of dying patients and their families in the emergency department. METHODS With a convenience sample, a cross-sectional study was conducted among 415 emergent care nurses from 22 hospitals in China. Descriptive analysis, Spearman correlation analysis, and multivariate linear stepwise regression were performed. RESULTS Variables including marital status (single), emergency department not implementing palliative care, no palliative care training, and true cooperation dimension were selected as independent predictors and explained 19.9% of variation in the regression model. CONCLUSIONS Interventions to improve healthy work environments, offering palliative care training, advocating for policies in palliative care, and offering support to unmarried nurses can advance nurses' palliative care competence. IMPLICATIONS FOR NURSING MANAGEMENT This is the first study of emergent care nurses in China aimed at identifying predictors associated with palliative care self-competence. It is significant in that palliative care training and a cooperative work environment are required to encourage the development of palliative care.
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Affiliation(s)
- Mei Feng
- Emergency Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,School of nursing, Wuhan University, Wuhan, China
| | - Qian Liu
- School of nursing, Wuhan University, Wuhan, China.,Population and Health Research Center, Wuhan University, Wuhan, China
| | - Jie Hao
- School of nursing, Wuhan University, Wuhan, China.,Emergency Department of the East Campus, Renmin Hospital of Wuhan University, Wuhan, China
| | - Dan Luo
- School of nursing, Wuhan University, Wuhan, China.,Population and Health Research Center, Wuhan University, Wuhan, China
| | - Bingxiang Yang
- School of nursing, Wuhan University, Wuhan, China.,Population and Health Research Center, Wuhan University, Wuhan, China
| | - Sihong Yu
- School of nursing, Wuhan University, Wuhan, China
| | - Jie Chen
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, U.S.A
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17
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Parajuli J, Hupcey J, Walsh A. Validation of the Palliative Care Nursing Self-Competence Scale for Oncology Nurses in the United States. Am J Hosp Palliat Care 2022; 39:1288-1297. [PMID: 35068193 DOI: 10.1177/10499091211069077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Oncology nurses care for persons with cancer and thus play an important role in providing palliative care to this population. However, a valid instrument to measure United States oncology nurses' confidence in providing palliative care service to persons with cancer is not available. This study examined the psychometric properties of the Palliative Care Nursing Self-Competence (PCNSC) scale in measuring oncology nurses' confidence in providing all aspects of palliative care to persons with cancer. An online survey with demographic questions and the PCNSC scale was sent to registered nurse (RN) members of the Oncology Nursing Society (ONS). The PCNSC scale consists of 50 items and 10 domains. A confirmatory factor analysis (CFA) was conducted to test the psychometric properties of the PCNSC scale in examining oncology nurses' confidence in providing palliative care. The CFA showed that the model fit reached adequate levels with the 10-factor structure of the PCNSC scale (χ2 = 2104.1, df = 1130, CFI = 0.88, RMSEA = 0.06) thus validating the scale in measuring oncology nurses' confidence in providing palliative care to persons with cancer in the United States. PCNSC retained the same 10-factor structure with 5 items in each factor, thus validating the scale. This scale can be used to assess oncology nurses' overall confidence and confidence in each domain of palliative care provision. These results can inform the development of targeted educational programs geared to enhancing oncology nurses' confidence in the United States.
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Affiliation(s)
- Jyotsana Parajuli
- Assistant Professor, School of Nursing, 14727University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Judith Hupcey
- Professor of Nursing and Medicine, Associate Dean for Research and Innovation, College of Nursing, The Pennsylvania State University, University Park, PA, USA
| | - Amanda Walsh
- MPH Student, Department of Public Health Sciences, 14727University of North Carolina at Charlotte, Charlotte, NC, USA
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18
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Translation, Cultural Adaptation, and Content Validation of the Palliative Care Self-Efficacy Scale for Use in the Swedish Context. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031143. [PMID: 35162163 PMCID: PMC8834529 DOI: 10.3390/ijerph19031143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/03/2022] [Accepted: 01/17/2022] [Indexed: 11/16/2022]
Abstract
The Palliative Care Self-Efficacy Scale (PCSE) is a valid instrument in English for assessing healthcare professionals’ self-efficacy in providing palliative care; it has not been translated into Swedish. The aim of this study was to describe the translation, cultural adaptation, and content-validation process of the PCSE scale. In this study, forward and backward translations, pretesting including an expert panel (n = 7), and cognitive interviewing with possible healthcare professionals (physicians, nurses, and assistant nurses) (n = 10) were performed. Experts in palliative care rated items on a Likert scale based on their understandability, clarity, sensitivity, and relevance. The item-level content validity index (I-CVI) and modified kappa statistics were calculated. Healthcare professionals were interviewed using the think-aloud method. The translation and validation process resulted in the final version of the PCSE scale. The average I-CVI for sensitivity was evaluated and approved. Most of the items were approved for clarity, some items lacked understandability, but a majority of the items were considered relevant. The healthcare professionals agreed that the items in the questionnaire evoked emotions, but were relevant for healthcare professionals. Thus, the Palliative Care Self-Efficacy scale is relevant for assessing healthcare professionals’ self-efficacy in palliative care in a Swedish care context. Further research using psychometric tests is required.
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19
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Kim J, Gray JA. Effect of Online Palliative Care Training on Knowledge and Self-Efficacy of Direct Care Workers. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2021; 59:392-404. [PMID: 34551101 DOI: 10.1352/1934-9556-59.5.392] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 11/24/2020] [Indexed: 06/13/2023]
Abstract
We evaluated the effectiveness of an online training on palliative care knowledge and self-efficacy among staff working with people with intellectual and developmental disabilities (IDD) using a one-group pretest-posttest design. Staff from four nonprofit residential and day services organizations in a U.S. Midwestern state participated. Among 132 staff who completed a baseline assessment, a 2-hour online training, and a posttest, 98 staff completed a 1-month follow-up survey. Palliative care knowledge was assessed before and after the training, and palliative care self-efficacy, at baseline and 1-month follow-up. We used linear regression to identify the factors that influence the effect of the training on main outcomes. Overall palliative care knowledge and self-efficacy significantly improved while higher education and longer work tenure enhanced training effectiveness.
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Affiliation(s)
- Jinsook Kim
- Jinsook Kim and Jennifer A. Gray, Northern Illinois University
| | - Jennifer A Gray
- Jinsook Kim and Jennifer A. Gray, Northern Illinois University
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20
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James HSE, Smith AC, Thomas EE, Snoswell CL, Caffery LJ, Haydon HM. Exploring paramedics’ intention to use a specialist palliative care telehealth service. PROGRESS IN PALLIATIVE CARE 2021. [DOI: 10.1080/09699260.2020.1852657] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
| | - A. C. Smith
- Centre for Online Health, The University of Queensland, Princess Alexandra Hospital, Ground Floor, Building 33, Woolloongabba, QLD 4102, Australia
- Centre for Health Services Research, The University of Queensland, Princess Alexandra Hospital, Ground Floor, Building 33, Woolloongabba, QLD 4102, Australia
| | - E. E. Thomas
- Centre for Online Health, The University of Queensland, Princess Alexandra Hospital, Ground Floor, Building 33, Woolloongabba, QLD 4102, Australia
- Centre for Health Services Research, The University of Queensland, Princess Alexandra Hospital, Ground Floor, Building 33, Woolloongabba, QLD 4102, Australia
| | - C. L. Snoswell
- Centre for Online Health, The University of Queensland, Princess Alexandra Hospital, Ground Floor, Building 33, Woolloongabba, QLD 4102, Australia
- Centre for Health Services Research, The University of Queensland, Princess Alexandra Hospital, Ground Floor, Building 33, Woolloongabba, QLD 4102, Australia
| | - L. J. Caffery
- Centre for Online Health, The University of Queensland, Princess Alexandra Hospital, Ground Floor, Building 33, Woolloongabba, QLD 4102, Australia
- Centre for Health Services Research, The University of Queensland, Princess Alexandra Hospital, Ground Floor, Building 33, Woolloongabba, QLD 4102, Australia
| | - H. M. Haydon
- Centre for Online Health, The University of Queensland, Princess Alexandra Hospital, Ground Floor, Building 33, Woolloongabba, QLD 4102, Australia
- Centre for Health Services Research, The University of Queensland, Princess Alexandra Hospital, Ground Floor, Building 33, Woolloongabba, QLD 4102, Australia
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21
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Zhou Y, Li Q, Zhang W. Undergraduate nursing students' knowledge, attitudes and self-efficacy regarding palliative care in China: A descriptive correlational study. Nurs Open 2021; 8:343-353. [PMID: 33318842 PMCID: PMC7729553 DOI: 10.1002/nop2.635] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 08/14/2020] [Accepted: 09/03/2020] [Indexed: 11/07/2022] Open
Abstract
Aim To describe nursing students' knowledge, attitudes and self-efficacy about palliative care and to examine the associations between these variables in China. Design A descriptive correlational study. Methods Undergraduate nursing students (N = 187) at the end of third year of education from a university were surveyed. Measurements included the Chinese versions of the Palliative Care Quiz for Nursing, the Death Attitude Profile-Revised, the Frommelt Attitude Toward Care of the Dying Scale and the Palliative Care Self-Efficacy Scale. Descriptive and correlational analyses were performed. Results Although most nursing students had favourable attitudes towards death and caring for the dying, students had low level of knowledge and self-efficacy regarding palliative care, suggesting the need for integrating palliative care education into nursing curriculum in China. Moreover, special attention should be paid to psychosocial and spiritual care teaching and preparing students to psychologically deal with the challenges in the process of patient's dying.
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Affiliation(s)
- Yinghua Zhou
- Faculty of NursingSchool of MedicineJiangsu UniversityZhenjiangChina
| | - Qiao Li
- Department of SociologyJiangnan UniversityWuxiChina
| | - Wei Zhang
- Faculty of NursingSchool of MedicineJiangsu UniversityZhenjiangChina
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22
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Eltaybani S, Igarashi A, Yamamoto-Mitani N. Palliative care in adult intensive care units: A nationwide survey. Nurs Crit Care 2020; 26:315-325. [PMID: 33107206 DOI: 10.1111/nicc.12565] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/30/2020] [Accepted: 10/05/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND There are no data on the provision of palliative nursing care in Egyptian adult intensive care units (ICUs). The Palliative and End-Of-Life (PEOL) Care Index is reliable and content valid; however, its construct and criterion validities have not been examined. AIMS AND OBJECTIVES First, to assess palliative care education, practice, and perceived competence among adult ICU nurses in Egypt. Second, to explore factors related to palliative care nursing practice and perceived competence. Third, to assess the construct and criterion validities of the PEOL Care Index. DESIGN A cross-sectional survey. METHODS Nurse managers and staff nurses in 33 adult ICUs completed self-administered questionnaires. The questionnaires assessed nurses' palliative care practice and perceived competence. A multilevel regression analysis was used to determine the best predictors of palliative care practice and perceived competence. Theory evidence construct validity and predictive criterion validity of the PEOL Care Index were examined. RESULTS Thirty-three nurse managers and 403 staff nurses participated in the study-response rate = 100% and 72.5%, respectively. On a 0-100 scale, the mean scores of undergraduate education, practice, and perceived competence were 54.0 ± 18.7, 49.7 ± 18.1, and 54.5 ± 17.0, respectively. Palliative care practice was significantly related to receiving in-service training on palliative care or end-of-life care (regression coefficients: 3.39), higher job satisfaction (0.97), and higher organizational support (1.85). Palliative care perceived competence was significantly related to older nurses' age (0.20), higher job satisfaction (0.97), and higher palliative care undergraduate education (0.63). CONCLUSIONS Palliative care education, practice, and perceived competence among adult ICU nurses in Egypt are inadequate, especially in terms of spiritual and cultural care. The PEOL Care Index is construct and criterion valid. RELEVANCE TO CLINICAL PRACTICE Palliative care education should begin in nursing schools and extend through clinical in-services. Guidelines should be developed to maximize staff collaboration and the utilization of chaplains in ICUs.
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Affiliation(s)
- Sameh Eltaybani
- Department of Gerontological Home Care and Long-term Care Nursing/Palliative Care Nursing, The University of Tokyo, Tokyo, Japan.,Department of Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University, Alexandria, Egypt
| | - Ayumi Igarashi
- Department of Gerontological Home Care and Long-term Care Nursing/Palliative Care Nursing, The University of Tokyo, Tokyo, Japan
| | - Noriko Yamamoto-Mitani
- Department of Gerontological Home Care and Long-term Care Nursing/Palliative Care Nursing, The University of Tokyo, Tokyo, Japan
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Edwards C, Hardin-Pierce M, Anderson D, Rexford T. Evaluation of Self-efficacy and Confidence Levels Among Newly Graduated Nurses Exposed to an End-of-Life Simulation: A Comparison Study. J Hosp Palliat Nurs 2020; 22:504-511. [PMID: 33044419 DOI: 10.1097/njh.0000000000000698] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Self-efficacy and confidence levels among newly graduated nurses who participated in an end-of-life simulation were compared with nurses who had been practicing for no more than a year but had not participated in an end-of-life simulation. The study included a pretest-and-posttest evaluation of an end-of-life simulation intervention during a new graduate residency program among newly graduated nurses to improve self-efficacy and confidence with end-of-life care. Nurses who had been in practice for no more than a year but had not been exposed to an end-of-life simulation intervention were also surveyed. The Palliative Care Evaluation Tool Kit was adapted and used for this project. The 2 groups of nurses were compared in terms of self-efficacy and confidence levels regarding end-of-life care. An end-of-life simulation intervention was successful in improving self-efficacy and confidence levels among newly graduated nurses, in regard to views about end of life and death and dying compared with the nurses who did not receive the end-of-life simulation intervention. The results of this study have implications for both schools of nursing and hospital training programs.
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Development and psychometric validation of a comprehensive end-of-life care competence scale: A study based on three-year surveys of health and social care professionals in Hong Kong. Palliat Support Care 2020; 19:198-207. [PMID: 32830639 DOI: 10.1017/s1478951520000723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study aimed to develop an assessment tool measuring comprehensive interdisciplinary competence in end-of-life care (EoLC) and investigate its content, construct validity, reliability, and their correlates. METHOD Items of the Comprehensive End-of-Life Care Competence Scale (CECCS) were developed according to a comprehensive core competence framework in EoLC and refined by a multi-disciplinary panel of experts. The psychometric properties were further tested through region-wide surveys of self-administered questionnaires completed by health and social care professionals in Hong Kong. RESULTS Participants comprised social workers, nurses, physicians, and allied health care professionals (445 participants in 2016, 410 in 2017, and 523 in 2018). Factor analysis validated the construct of the questionnaire which encompassed 26 items describing EoLC core competences in seven domains with satisfactory internal reliability (confirmatory factor analysis: χ2/df = 3.12, GFI = 0.85, TLI = 0.93, CFI = 0.94, RMSEA = 0.07; Cronbach's alphas ranged from 0.89 to 0.97): overarching value & knowledge, communication skills, symptom management, psychosocial and community care, end-of-life decision-making, bereavement care, and self-care. Higher perceived levels in these competences were correlated with a higher level of job meaningfulness and satisfaction (r ranged from 0.17 to 0.39, p < 0.01) and correlated with lower perceived stress (r ranged from -0.11 to -0.28, p < 0.05). Regression analysis found that age and work involvement in EoLC were positively associated with the perceived competences in all domains; professionals working in hospices reported higher levels of competence than workers in other settings; social workers showed lower perceived competences in symptom management, but higher levels in bereavement care than other health care professionals. SIGNIFICANCE OF RESULTS The validity and internal reliability of CECCS were demonstrated. The levels of perceived competences working in EoLC were significantly associated with professionals' job-related well-being. Practically, there is still room for improvement in comprehensive competences among health and social care workers in Hong Kong.
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25
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Knowledge, attitude and self-efficacy towards palliative care among nurses in Mongolia: A cross-sectional descriptive study. PLoS One 2020; 15:e0236390. [PMID: 32702007 PMCID: PMC7377484 DOI: 10.1371/journal.pone.0236390] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 07/06/2020] [Indexed: 12/20/2022] Open
Abstract
Background Nurses have a primary role in providing palliative and end-of-life (EOL) care. Their knowledge of EOL care, attitudes toward care of the dying, and palliative care self-efficacy are important in care delivery. Little is known regarding palliative care preparedness among Mongolian nurses. This study examines palliative care knowledge, attitude towards death and dying, and self-efficacy among Mongolian nurses, and examines predictors of self-efficacy. Methods A cross-sectional descriptive study was conducted. Participants were 141 nurses employed at the National Cancer Center in Mongolia. Data was collected using a self-administered questionnaire. Results The median score for the knowledge of palliative care was 8.0/20. “Psychosocial and spiritual care” was the lowest score on the palliative care knowledge subscale. The mean score for attitude toward care of the dying was 69.1%, indicating positive attitudes. The mean score for the palliative care self-efficacy was 33.8/48. Nurses reported low self-efficacy toward communicating with dying patients and their families, and managing delirium. Palliative care knowledge and duration of experience as an oncology nurse significantly predicted self-efficacy toward palliative care, accounting for 14.0% of the variance. Conclusions Palliative education for nurses should address the knowledge gaps in EOL care and focus in increasing palliative care self-efficacy. Considering palliative care knowledge and nursing experience as an oncology nurse were significant predictors of self-efficacy toward palliative care, more effort is needed to fill the knowledge gaps in EOL care among nurses, especially for less experienced nurses.
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Dehghani F, Barkhordari-Sharifabad M, Sedaghati-Kasbakhi M, Fallahzadeh H. Effect of palliative care training on perceived self-efficacy of the nurses. BMC Palliat Care 2020; 19:63. [PMID: 32366232 PMCID: PMC7199299 DOI: 10.1186/s12904-020-00567-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 04/22/2020] [Indexed: 11/12/2022] Open
Abstract
Background Nurses are involved in providing end-of-life care for end stage individuals and their self-efficacy is one of the key factors bearing on such care. The purpose of this study was to determine the effect of palliative care on perceived self-efficacy of the nurses. Methods This is a quasi-experimental study with pretest-posttest design. Sampling was randomized and included 40 individuals. The intervention consisted of palliative care training for four sessions, each lasting 45 min. Data were collected using demographic and perceived self-efficacy questionnaires completed before and after the intervention. Data were then analyzed by SPSS 16 software using descriptive and inferential statistics. Results The mean age of the participants was 38.6 and their work experience was 14.25 years. The majority of the participants were female (85%) and had a bachelor level of education (92.5%). The findings showed that “perceived self-efficacy”, “psychosocial support” and “symptom management” improved significantly after intervention (p < 0.05). Conclusion Based on the results, palliative care education has the potential to increase nurses’ perceived self-efficacy. Since all members of the health care team Including nurses play an important role in providing palliative care, nursing managers can take an effective step to maximize the capacity of nurses by planning and supporting training in this regard.
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Affiliation(s)
- Fatemeh Dehghani
- Department of Nursing, School of Medical Sciences, Yazd Branch, Islamic Azad University, Shohadaye Gomnam Blvd., Safaiyeh, Yazd, 8916871967, Iran
| | - Maasoumeh Barkhordari-Sharifabad
- Department of Nursing, School of Medical Sciences, Yazd Branch, Islamic Azad University, Shohadaye Gomnam Blvd., Safaiyeh, Yazd, 8916871967, Iran.
| | - Maryam Sedaghati-Kasbakhi
- Department of Nursing, School of Medical Sciences, Tonekabon Branch, Islamic Azad University, Tonekabon, Iran
| | - Hossein Fallahzadeh
- Department of Biostatistics and Epidemiology, Faculty of Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
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Death Attitudes, Palliative Care Self-efficacy, and Attitudes Toward Care of the Dying Among Hospice Nurses. J Clin Psychol Med Settings 2020; 28:295-300. [DOI: 10.1007/s10880-020-09714-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Perry LM, Hoerger M, Malhotra S, Gerhart JI, Mohile S, Duberstein PR. Development and Validation of the Palliative Care Attitudes Scale (PCAS-9): A Measure of Patient Attitudes Toward Palliative Care. J Pain Symptom Manage 2020; 59:293-301.e8. [PMID: 31539604 DOI: 10.1016/j.jpainsymman.2019.09.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 09/05/2019] [Accepted: 09/06/2019] [Indexed: 11/28/2022]
Abstract
CONTEXT Palliative Care is underutilized, and research has neglected patient-level factors including attitudes that could contribute to avoidance or acceptance of Palliative Care referrals. This may be due in part to a lack of existing measures for this purpose. OBJECTIVES The objective of this study was to develop and validate a nine-item scale measuring patient attitudes toward Palliative Care, comprised of three subscales spanning emotional, cognitive, and behavioral factors. METHODS Data were collected online in three separate waves, targeting individuals with cancer (Sample 1: N = 633; Sample 2: N = 462) or noncancer serious illnesses (Sample 3: N = 225). Participants were recruited using ResearchMatch.org and postings on the web sites, social media pages, and listservs of international health organizations. RESULTS Internal consistency was acceptable for the total scale (α = 0.84) and subscales: emotional (α = 0.84), cognitive (αs = 0.70), and behavioral (α = 0.90). The PCAS-9 was significantly associated with a separate measure of Palliative Care attitudes (ps < 0.001) and a measure of Palliative Care knowledge (ps < 0.004), supporting its construct validity in samples of cancer and noncancer serious illnesses. The scale's psychometric properties, including internal consistency and factor structure, generalized across patient subgroups based on diagnosis, other health characteristics, and demographics. CONCLUSION Findings support the overall reliability, validity, and generalizability of the PCAS-9 in serious illness samples and have implications for increasing Palliative Care utilization via clinical care and future research efforts.
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Affiliation(s)
- Laura M Perry
- Department of Psychology, Tulane University, New Orleans, Louisiana, USA.
| | - Michael Hoerger
- Department of Psychology, Tulane University, New Orleans, Louisiana, USA; Department of Medicine, Section of Hematology and Medical Oncology, Tulane University, New Orleans, Louisiana, USA
| | - Sonia Malhotra
- Department of General Internal Medicine & Geriatrics, Section of Palliative Medicine, Tulane University, New Orleans, Louisiana, USA
| | - James I Gerhart
- Department of Psychology, Central Michigan University, Mount Pleasant, Michigan, USA
| | - Supriya Mohile
- James P. Wilmot Cancer Center, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Paul R Duberstein
- Department of Health Behavior, Society and Policy, Rutgers University School of Public Health, Piscataway, New Jersey, USA
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Cultural Adaptation, Validation, and Analysis of the Self-Efficacy in Palliative Care Scale for Use with Spanish Nurses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234840. [PMID: 31810175 PMCID: PMC6926837 DOI: 10.3390/ijerph16234840] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 11/20/2019] [Accepted: 11/28/2019] [Indexed: 12/12/2022]
Abstract
The aim of the present study is to validate the Self-Efficacy in Palliative Care Scale (SEPC) in Spanish nursing professionals and students, to describe their levels of self-efficacy, and to determine the influencing factors. A validation study and a cross-sectional descriptive study were carried out, with the data analysed using contrast tests and multiple linear regression; 552 nurses and 440 nursing students participated. The Spanish version consists of 23 items and has a high degree of reliability (α = 0.944). Confirmatory factor analysis revealed one additional factor (i.e., management of psychosocial and spiritual aspects) in comparison to the original scale. Contrast tests revealed that the mean SEPC score was higher in professionals than in students (p < 0.001) and that the professionals who had higher levels of self-efficacy were older (p < 0.001), had more previous training (p < 0.001), and had more experience in end-of-life care (p = 0.001). The linear analysis results confirm a significant association between age and previous training in end-of-life care. The Spanish version of the SEPC is a reliable tool for both nursing professionals and students. The level of self-efficacy of both groups is moderate and is influenced by age, experience, and training in end-of-life care.
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Karacsony S, Good A, Chang E, Johnson A, Edenborough M. An instrument to assess the education needs of nursing assistants within a palliative approach in residential aged care facilities. BMC Palliat Care 2019; 18:61. [PMID: 31337388 PMCID: PMC6647142 DOI: 10.1186/s12904-019-0447-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 07/15/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Providing quality palliative care in residential aged care facilities (RACFs) (aged care homes) is a high priority for ageing populations worldwide. Older people admitted to these facilities have palliative care needs. Nursing assistants (however termed) are the least qualified staff and provide most of the direct care. They have an important role at the frontline of care spending more time with residents than any other care provider but have been found to lack the necessary knowledge and skills to provide palliative care. The level of competence of this workforce to provide palliative care requires evaluation using a valid and reliable instrument designed for nursing assistants' level of education and the responsibilities and practices of their role. METHOD The overall study purpose was to develop and test an instrument capable of evaluating the knowledge, skills and attitudes of nursing assistants within a palliative approach in RACFs. Development consisted of a four-phase mixed-methods sequential design. In this paper, the results and key findings following psychometric testing of the instrument in Phase 4 is reported using data collected from a random sample of 17 RACFs and 348 nursing assistants in the Greater Sydney region. Study hypotheses were tested to confirm discriminative validity and establish the utility of the instrument in both research and training assessment. RESULTS Individual item properties were analysed for difficulty, discrimination and item-total correlations. Discriminative and structural validity, and internal consistency and test-retest reliability were demonstrated. Three separate questionnaires comprising 40 items were finalised: The Palliative Approach for Nursing Assistants (PANA)_Knowledge Questionnaire (17 items), the PANA_Skills Questionnaire (13 items) and the PANA_Attitudes Questionnaire (10 items). CONCLUSIONS This study provides preliminary evidence for the validity and reliability of three new questionnaires that demonstrate sensitivity for nursing assistants' level of education and required knowledge, skills and attitudes for providing a palliative approach. Implications for practice include the development of palliative care competencies through structured education and training across this workforce, and ongoing professional development opportunities for nursing assistants, especially for those with the longest tenure.
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Affiliation(s)
- Sara Karacsony
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia. .,School of Nursing, College of Health and Medicine, University of Tasmania, UTAS Education Centre, 1 Leichhardt Street, Darlinghurst, NSW, 2010, Australia.
| | - Anthony Good
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Esther Chang
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Amanda Johnson
- School of Nursing, Midwifery and Paramedicine NSW/ACT, Australian Catholic University, PO Box 968, North Sydney, NSW, 2059, Australia
| | - Michel Edenborough
- School of Social Sciences and Psychology, University of Western Sydney, Locked Bag 1797, Penrith, NSW, 2751, Australia
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Abstract
AbstractThe average expected lifespan in Canadian long-term care (LTC) homes is now less than two years post-admission, making LTC a palliative care setting. As little is known about the readiness of LTC staff in Canada to embrace a palliative care mandate, the main objective of this study was to assess qualities relevant to palliative care, including personal emotional wellbeing, palliative care self-efficacy and person-centred practices (e.g. knowing the person, comfort care). A convenience sample of 228 professional and non-professional staff (e.g. nurses and nursing assistants) across four Canadian LTC homes participated in a survey. Burnout, secondary traumatic stress and poor job satisfaction were well below accepted thresholds, e.g. burnout: mean = 20.49 (standard deviation (SD) = 5.39) for professionals; mean = 22.09 (SD = 4.98) for non-professionals; cut score = 42. Furthermore, only 0–1 per cent of each group showed a score above cut-off for any of these variables. Reported self-efficacy was moderate, e.g. efficacy in delivery: mean = 18.63 (SD = 6.29) for professionals; mean = 15.33 (SD = 7.52) for non-professionals; maximum = 32. The same was true of self-reported person-centred care, e.g. knowing the person; mean = 22.05 (SD = 6.55) for professionals; mean = 22.91 (SD = 6.16) for non-professionals; maximum = 35. t-Tests showed that non-professional staff reported relatively higher levels of burnout, while professional staff reported greater job satisfaction and self-efficacy (p < 0.05). There was no difference in secondary traumatic stress or person-centred care (p > 0.05). Overall, these results suggest that the emotional wellbeing of the Canadian LTC workforce is unlikely to impede effective palliative care. However, palliative care self-efficacy and person-centred care can be further cultivated in this context.
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Phillips JL, Heneka N, Hickman L, Lam L. Self-Perceived Pain Assessment Knowledge and Confidence (Self-PAC) Scale for Cancer and Palliative Care Nurses: A Preliminary Validation Study. Pain Manag Nurs 2018; 19:619-626. [PMID: 30316611 DOI: 10.1016/j.pmn.2018.07.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 04/24/2018] [Accepted: 07/21/2018] [Indexed: 01/12/2023]
Abstract
BACKGROUND Pain is highly prevalent in all health care settings, and frequently poorly managed. Effective pain management is predicated on a continuous cycle of screening, assessing, intervening and evaluating. Identifying gaps in nurses' self-perceived pain assessment competencies is an essential first step in the design of tailored interventions to embed effective pain assessment into routine clinical practice, and improve patient reported pain outcomes. Yet, few validated instruments focus on the competencies required for undertaking a comprehensive pain assessment, with most focusing on clinician's pain management competencies. AIM To examine the validity of the 'Self-Perceived Pain Assessment Knowledge and Confidence' (Self-PAC) Scale. DESIGN Preliminary instrument validation. SETTING Two Australian cancer and palliative care services. PARTICIPANTS/SUBJECTS 186 cancer and palliative care nurses. METHODS The Self-PAC Scale was administered to participants online. Factor Analyses, including Exploratory and Confirmatory, were applied to examine the structural validity, Cronbach's alpha was calculated for internal consistency. Criterion validity was investigated by comparing responses from experienced and non-experienced nurses. RESULTS Two components resulted with a single factor structure for pain assessment confidence and a two-factor structure for the knowledge of pain assessment. The factor loading for the subscales ranged from 0.653 to 0.969, with large proportions of the variances explained by the factors. Cronbach's alpha of the subscales ranged from 0.87-0.92 and significant difference in responses were found between experienced and non-experienced nurses. CONCLUSION Preliminary validation of the Self-PAC Scale suggests that it is a helpful instrument for assessing cancer and palliative care nurse' pain assessment competencies.
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Affiliation(s)
- Jane L Phillips
- IMPACCT-Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, University of Technology Sydney, Sydney, New South Wales, Australia.
| | - Nicole Heneka
- IMPACCT-Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Louise Hickman
- Nursing Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Lawrence Lam
- IMPACCT-Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, University of Technology Sydney, Sydney, New South Wales, Australia; Vice President (Academic), Tung Wah College, Hong Kong
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Karacsony S, Chang E, Johnson A, Good A, Edenborough M. Assessing nursing assistants' competency in palliative care: An evaluation tool. Nurse Educ Pract 2018; 33:70-76. [PMID: 30248577 DOI: 10.1016/j.nepr.2018.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Revised: 09/04/2018] [Accepted: 09/07/2018] [Indexed: 11/30/2022]
Abstract
Nursing assistants are the largest aged care workforce providing direct care to older people in residential aged care facilities (RACF) in Australia and internationally. A palliative approach is a large component of this direct care that necessitates nursing assistants possess requisite knowledge, skills and attitudes. While training needs have been identified to enhance their practices, preservice education is variable, educational interventions have been adhoc and professional development found to be inadequate to the demands of the workplace. In addition, evaluation of nursing assistants' knowledge, skills and attitudes has lacked an instrument specifically tailored to nursing assistants' level of education and role responsibilities when providing a palliative approach. This paper reports on Phase 3 of a research study to develop such an instrument capable of assessing nursing assistants' knowledge of, skills in, and attitudes within a palliative approach. This phase assesses the usability and performance capabilities of the new instrument on a purposive sample of nursing assistants in two RACFs using the survey method. Results showed that the instrument was able to discriminate between groups of nursing assistants based on experience in role. Usability results indicated that the instrument is user friendly and time efficient.
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Affiliation(s)
- Sara Karacsony
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.
| | - Esther Chang
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.
| | - Amanda Johnson
- School of Nursing, Midwifery and Paramedicine NSW/ACT, Australian Catholic University, PO Box 968, North Sydney, NSW 2059, Australia.
| | - Anthony Good
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.
| | - Michel Edenborough
- School of Social Sciences and Psychology, University of Western Sydney, Locked Bag 1797, Penrith, NSW 2751, Australia.
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Chan HY, Chun GK, Man CW, Leung EM. Staff preparedness for providing palliative and end-of-life care in long-term care homes: Instrument development and validation. Geriatr Gerontol Int 2018; 18:745-749. [PMID: 29336103 DOI: 10.1111/ggi.13244] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 11/07/2017] [Accepted: 11/21/2017] [Indexed: 11/27/2022]
Abstract
AIM Although much attention has been on integrating the palliative care approach into services of long-term care homes for older people living with frailty and progressive diseases, little is known about the staff preparedness for these new initiatives. The present study aimed to develop and test the psychometric properties of an instrument for measuring care home staff preparedness in providing palliative and end-of-life care. METHODS A 16-item instrument, covering perceived knowledge, skill and psychological readiness, was developed. A total of 247 staff members of different ranks from four care homes participated in the study. Exploratory factor analysis using the principal component analysis extraction method with varimax rotation was carried out for initial validation. Known group comparison was carried out to examine its discriminant validity. Reliability of the instrument was assessed based on test-retest reliability of a subsample of 20 participants and the Cronbach's alpha of the items. RESULTS Exploratory factor analysis showed that the instrument yielded a three-factor solution, which cumulatively accounted for 68.5% of the total variance. Three subscales, namely, willingness, capability and resilience, showed high internal consistency and test-retest reliability. It also showed good discriminant validity between staff members of professional and non-professional groups. CONCLUSIONS This is a brief, valid and reliable scale for measuring care home staff preparedness for providing palliative and end-of-life care. It can be used to identify their concerns and training needs in providing palliative and end-of-life care, and as an outcome measure to evaluate the effects of interventional studies for capacity building in this regard. Geriatr Gerontol Int 2018; 18: 745-749.
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Affiliation(s)
- Helen Yl Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | | | - C W Man
- Hong Kong Association of Gerontology, Hong Kong, China
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Sánchez-García MR, Gutiérrez-Romero JA, Fernández-Alcántara M, Hueso-Montoro C, Goodman C, Montoya-Juárez R. End of life care in nursing homes in Spain: Exploratory analysis and evidences of validity of a new scale. Appl Nurs Res 2017; 37:6-12. [PMID: 28985922 DOI: 10.1016/j.apnr.2017.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 05/10/2017] [Accepted: 07/03/2017] [Indexed: 10/19/2022]
Abstract
Quality end-of-life care is a central issue in nursing homes, requiring the assessment of individual and family needs by health professionals. Although previous instruments have been developed, they usually rely on family reports and have been adapted from other clinical contexts (hospital or primary care). It is important to consider how health care professionals working in nursing homes perceive what is necessary to achieve quality end-of-life care. In this study, the objective was to develop an instrument to assess quality of end-of-life care in the context of Spanish care homes. A 24 item scale Nursing Home End of Life Care Scale (NHEOLC) was developed through a systematic evaluation of existing tools combined with an iterative process of consultation with group experts in end of life care in long term care settings. A total of 307 health care professionals agreed to participate in the study and completed the scale. The scale was grouped in six dimensions: physical, psychological aspects and spiritual aspects of care, family care, bereavement, and patient/family preferences management. The results suggest an adequate factorial structure of the scale and good internal consistency for the total score and the subscales. In addition, the results showed significant differences depending on the size of the nursing home, the category of health professionals, and their own perceptions of his work regarding end-of-life care.
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Affiliation(s)
| | | | | | | | - Claire Goodman
- Centre for Research in Primary and Community Care, University of Hertfordshire, United Kingdom.
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Karacsony S, Chang E, Johnson A, Good A, Edenborough M. Measuring nursing assistants' knowledge, skills and attitudes in a palliative approach: A literature review. NURSE EDUCATION TODAY 2015; 35:1232-1239. [PMID: 26043658 DOI: 10.1016/j.nedt.2015.05.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 05/03/2015] [Accepted: 05/14/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND Nursing assistants are the largest aged care workforce providing care to older people in residential aged care facilities. Although studies have focused on their training and development needs when providing a palliative approach, a valid and reliable instrument to evaluate their knowledge, skills and attitudes is required. AIMS To examine what instruments have been used to evaluate nursing assistants' knowledge of, skills in and attitudes towards a palliative approach in residential aged care facilities, critically evaluate development processes, and discuss the strengths and limitations of existing instruments for this population. METHODS CINAHL, the Cochrane Library, ERIC, MEDLINE, PubMed, Scopus and Web of Science were searched using key words. Selected articles were published in English in the period 2004-2014 and included instruments which evaluated nursing assistants and a palliative approach. RESULTS Ten studies using seven instruments met the inclusion criteria. One of these instruments measured nursing assistants' level of comfort in providing end-of-life care. The six remaining instruments measured palliative care knowledge, palliative care practice, self-efficacy, knowledge and attitudes towards people with advanced dementia, beliefs and attitudes to death, dying, palliative and interdisciplinary care across the aged care workforce. CONCLUSION Seven instruments have been used to evaluate nursing assistants' knowledge, skills and attitudes in a palliative approach. Instrument design and recommended psychometric processes for development limit specificity and usefulness of these instruments for nursing assistants' scope of practice. Adhering to recommended psychometric processes will increase the validity and reliability of an instrument tailored to this population and a palliative approach.
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Affiliation(s)
- Sara Karacsony
- School of Nursing and Midwifery, University of Western Sydney, Locked Bag, 1797, Penrith, NSW 2751, Australia.
| | - Esther Chang
- School of Nursing and Midwifery, University of Western Sydney, Locked Bag, 1797, Penrith, NSW 2751, Australia.
| | - Amanda Johnson
- School of Nursing and Midwifery, University of Western Sydney, Locked Bag, 1797, Penrith, NSW 2751, Australia.
| | - Anthony Good
- Centre for Complementary Medicine Research (CompleMED), University of Western Sydney, Locked Bag, 1797, Penrith, NSW 2751, Australia.
| | - Michel Edenborough
- School of Social Sciences and Psychology, University of Western Sydney, Locked Bag, 1797, Penrith NSW 2751, Australia.
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Pesut B, Potter G, Stajduhar K, Sawatzky R, McLeod B, Drabot K. Palliative approach education for rural nurses and health-care workers: a mixed-method study. Int J Palliat Nurs 2015; 21:142-51. [DOI: 10.12968/ijpn.2015.21.3.142] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Barbara Pesut
- Associate Professor of Nursing, Canada Research Chair in Health, Ethics and Diversity, University of British Columbia
| | - Gail Potter
- Nursing Faculty, Selkirk College, British Columbia
| | - Kelli Stajduhar
- Professor School of Nursing and Centre on Aging, University of Victoria and Research Scientist, Fraser Health Authority End of Life Program, Fraser Health, British Columbia
| | - Richard Sawatzky
- Associate Professor and Canada Research Chair, Trinity Western University, British Columbia and Research Scientist, Centre for Health Evaluation and Outcome Sciences, Providence Health Care Research Institute
| | - Barbara McLeod
- Hospice Palliative Care Clinical Nurse Specialist, Fraser Health and Adjunct Professor, School of Nursing, University of British Columbia
| | - Karly Drabot
- Research Coordinator, University of British Columbia, Okanagan, Canada
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Knowledge, Skills, and Attitudes in Caring for Older Adults With Advanced Illness Among Staff Members of Long-Term Care and Assisted Living Facilities. Am J Hosp Palliat Care 2014; 33:327-34. [DOI: 10.1177/1049909114561996] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
In long-term care and assisted living facilities, many groups of health care professionals contribute to the work of the health care team. These staff members perform essential, direct patient care activities. An educational needs assessment was conducted to determine the learning needs and preferences of staff members related to providing care for patients with life-limiting illnesses. Staff members placed importance on understanding topics such as principles of palliative care, pain assessment, pain management, and nonpain symptom management. The majority of survey respondents were also interested in learning more about these topics. The results of this educational needs analysis suggest staff members would benefit from a course tailored to these identified educational needs and designed to overcome previously identified educational barriers.
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