1
|
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.
Collapse
Affiliation(s)
- Dhuha Youssef Wazqar
- Department of Medical Surgical Nursing, Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia
| |
Collapse
|
2
|
Wu X, Li X, Su T, Liang J, Wang L, Huang Q, Zhang J, Wang S, Wang N, Xiang R. Development and validation of a questionnaire to evaluate the knowledge, attitude, behaviour and care preference of family members of Chinese older adults related to palliative care. Nurs Open 2022; 10:673-686. [PMID: 36114724 PMCID: PMC9834548 DOI: 10.1002/nop2.1334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 07/11/2022] [Accepted: 08/07/2022] [Indexed: 01/19/2023] Open
Abstract
AIM To develop and validate a questionnaire on knowledge, attitude, behaviour and care preference of family members of Chinese older adults related to palliative care. DESIGN A descriptive study design and STROBE checklist were applied in this research. METHODS The theoretical framework of the questionnaire was knowledge-attitude-behaviour model. An additional dimension of palliative care preference of family members was set up in the questionnaire. Items were generated from a rapid review of international literature and interviews with 61 family members of the older adults living either in an aged care service organization or the community. The content validity was examined by five experts. A preliminary questionnaire with 69 items was then set up, and its psychometric property was assessed. RESULTS A final version of questionnaire with 42 items under four dimensions was constructed. The content validity index of the overall questionnaire was 0.93 and of each item ranged 0.80-1.00. The factor loading of all items was higher than 0.50 as per exploratory and confirmatory factor analysis; the average variance extracted for each dimension was higher than 0.50; the composite reliability was higher than 0.90; and the absolute value of the correlation coefficient of each dimension was <0.50 and less than the square root of the average variance extracted. The Cronbach's alpha value and the split-half reliability value of the overall questionnaire were 0.93 and 0.97, respectively. CONCLUSIONS This questionnaire has good validity and reliability, but needs further testing in multi-centered settings.
Collapse
Affiliation(s)
- Xiaofen Wu
- Centre for General PracticeThe Seventh Affiliated Hospital, Southern Medical UniversityFoshanChina,School of NursingSouthern Medical UniversityGuangzhouChina
| | - Xiran Li
- Centre for General PracticeThe Seventh Affiliated Hospital, Southern Medical UniversityFoshanChina,School of NursingSouthern Medical UniversityGuangzhouChina
| | - Ting Su
- Centre for General PracticeThe Seventh Affiliated Hospital, Southern Medical UniversityFoshanChina,School of NursingSouthern Medical UniversityGuangzhouChina
| | - Jin Liang
- Centre for General PracticeThe Seventh Affiliated Hospital, Southern Medical UniversityFoshanChina,School of NursingSouthern Medical UniversityGuangzhouChina
| | - Lijie Wang
- Centre for General PracticeThe Seventh Affiliated Hospital, Southern Medical UniversityFoshanChina,School of NursingSouthern Medical UniversityGuangzhouChina
| | - Qiuna Huang
- Shunde HospitalSouthern Medical UniversityFoshanChina
| | - Jiayi Zhang
- Centre for General PracticeThe Seventh Affiliated Hospital, Southern Medical UniversityFoshanChina,School of NursingSouthern Medical UniversityGuangzhouChina
| | - Shuang Wang
- Centre for General PracticeThe Seventh Affiliated Hospital, Southern Medical UniversityFoshanChina,School of NursingSouthern Medical UniversityGuangzhouChina
| | - Ning Wang
- Centre for General PracticeThe Seventh Affiliated Hospital, Southern Medical UniversityFoshanChina
| | - Rihui Xiang
- Centre for General PracticeThe Seventh Affiliated Hospital, Southern Medical UniversityFoshanChina
| |
Collapse
|
3
|
Chen X, Zhang Y, Arber A, Huo X, Liu J, Sun C, Yuan L, Wang X, Wang D, Wu J, Du J. The training effects of a continuing education program on nurses’ knowledge and attitudes to palliative care: a cross sectional study. Palliat Care 2022; 21:56. [PMID: 35473551 PMCID: PMC9040326 DOI: 10.1186/s12904-022-00953-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 04/20/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Most nurses in China have not been trained to take care of end-of-life patients appropriately due to lack of educational resources and insufficient training. A palliative care program was launched by the Jiangsu Nursing Association (JNA training program) and to identify gaps in palliative care training. The main aim of this study was to evaluate the training effects of the JNA training program on nurses’ knowledge and attitudes to palliative care.
Methods
A cross-sectional study was conducted with 10 048 registered nurses in all regions of Jiangsu. All participants completed an online questionnaire using the Chinese version of The Palliative Care Quiz for Nursing (PCQN-C) and the Frommelt Attitude Toward Care of the Dying scale (FATCOD-B-C). A propensity score matched analysis was performed between the nurses who had attended the JNA training program and whose who hadn’t.
Results
The average score of PCQN-C among all nurses was 8.79, while the mean score of the FATCOD-B-C was 103.62. Those participants who attended the JNA training program had significantly better scores than those who did not. Propensity score matching analysis showed that the palliative care training program failed to improve nurses’ knowledge in psychosocial and spiritual care or their attitudes towards the necessity of family support although there was positive impact on other aspects of palliative care.
Conclusions
Knowledge of palliative care among Chinese nurses remains low. Training programs may improve general knowledge and attitudes to palliative care. However, important aspects of knowledge such as communication skills, family support, and psychosocial aspects of care, are missing. These gaps should be filled in future palliative care training programs targeting nurses with oriental culture background.
Collapse
|
4
|
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.
Collapse
|
5
|
Martínez-Sabater A, Chover-Sierra P, Chover-Sierra E. Spanish Nurses' Knowledge about Palliative Care. A National Online Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111227. [PMID: 34769747 PMCID: PMC8583050 DOI: 10.3390/ijerph182111227] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/17/2021] [Accepted: 10/22/2021] [Indexed: 11/16/2022]
Abstract
(1) Background: Nurses can find people with advanced diseases or in their last days of life during their professional careers and in many different care settings. For this reason, they need to have at least a basic level of palliative care education since they are the professional cohort treating these patients in a very close way. This research aims to determine the level of knowledge in palliative care of Spanish nurses and establish any possible difference based on their experience and training in palliative care. (2) Methods: A cross-sectional design using survey methods (distributed an online questionnaire) aimed at Spanish registered nurses. A validated questionnaire (PCQN-SV) was used to determine the level of knowledge in palliative care; information on some variables to characterize the population was also collected (experience and education in palliative care, years of professional experience, academic level, and others). Uni and bivariate descriptive analyses were performed. A binary logistic regression model was also developed to identify those variables that influenced obtaining results higher than the population’s average. (3) Results: Spanish nurses have a medium–low level of knowledge in palliative care, higher in those who have previous experience or education in this area. Statistically significant differences were also found according to the area in which their caring activity was developed. (4) Conclusions: It is necessary to implement strategies for the basic training of nursing professionals in palliative care to offer quality care to people in advanced stages of illnesses or at the end of their lives.
Collapse
Affiliation(s)
- Antonio Martínez-Sabater
- Nursing Department, University of Valencia, 46010 Valencia, Spain; (A.M.-S.); (P.C.-S.)
- Nursing Care and Education Research Group (GRIECE), GIUV2019-456, Faculty of Nursing and Podiatrics, University of Valencia, 46010 Valencia, Spain
- Grupo Investigación en Cuidados (INCLIVA), Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain
- Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain
| | - Pilar Chover-Sierra
- Nursing Department, University of Valencia, 46010 Valencia, Spain; (A.M.-S.); (P.C.-S.)
| | - Elena Chover-Sierra
- Nursing Department, University of Valencia, 46010 Valencia, Spain; (A.M.-S.); (P.C.-S.)
- Nursing Care and Education Research Group (GRIECE), GIUV2019-456, Faculty of Nursing and Podiatrics, University of Valencia, 46010 Valencia, Spain
- Internal Medicine Department, Consorcio Hospital General Universitario de Valencia, 46014 Valencia, Spain
- Correspondence:
| |
Collapse
|
6
|
Yang H, Shang M, Sun C, Li L, Wang C. Comprehensive Hospitals Nurses' Cognition on Palliative Care in Shandong Province, China: A Cross-Sectional Study. IRANIAN JOURNAL OF PUBLIC HEALTH 2021; 50:1343-1351. [PMID: 34568172 PMCID: PMC8426764 DOI: 10.18502/ijph.v50i7.6623] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 09/06/2020] [Indexed: 11/24/2022]
Abstract
Background: Palliative care is an essential part of medical practice, however, it has developed slowly in China. We aimed to analyze the current situations of the cognition on palliative care among the nurses in Shandong Province, China. Methods: This was a cross sectional study. Investigation of 1050 nurses came from 5 third-class hospitals and 5 second-class hospitals in Shandong Province, China from Jul to Oct in 2018. The questionnaire included 4 parts: general information of the subject, the questionnaire of palliative nursing knowledge, attitude, and the behavior. Data were collected by the APP. Overall, after eliminating the invalid questionnaires, 1026 questionnaires were included in the final analyses. The software Stata 14.2 was used for all statistical analyses. Results: The score of knowledge and attitude was low, the practice was higher. Multivariate analysis results: the significant independent variables of univariate analysis were included in the multivariate non-conditional logistic regression model for analysis. Some departments had statistical significance in knowledge multivariate Logistic regression analysis. The multivariate logistic regression analysis of practice was significant for physical health and religious beliefs. The statistical variables of the total score of cognition were gender, age of care, health status and religious beliefs. Conclusion: Nursing knowledge is lacking and attitude remains to be improved as soon as possible. It is vital to improve the cognition of palliative care of nurses in Shandong general hospitals by developing relevant rules and regulations, strengthening the supervision of relevant ant departments, and enhancing training for nurses.
Collapse
Affiliation(s)
- Hailing Yang
- Nursing Department, Qilu Hospital of Shandong University, Jinan 250012, P.R. China
| | - Meimei Shang
- Nursing Department, Shandong Cancer Hospital and Institute, Jinan 250117, P.R. China
| | - Chunhua Sun
- Health Manage Department, Qilu Hospital of Shandong University, Jinan 250012, P.R. China
| | - Lihua Li
- Urology Surgery Department, The Third Affiliated Hospital of Shandong Province, Jinan 250031, P.R. China
| | - Chao Wang
- Outpatient Department, Qilu Hospital of Shandong University, Jinan 250012, P.R. China
| |
Collapse
|
7
|
Khalil H, Byrne A, Ristevski E. The development and implementation of a clinical skills matrix to plan and monitor palliative care nurses' skills. Collegian 2019. [DOI: 10.1016/j.colegn.2019.05.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
8
|
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.
Collapse
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
| | | |
Collapse
|
9
|
Chover-Sierra E, Martínez-Sabater A, Lapeña-Moñux YR. An instrument to measure nurses' knowledge in palliative care: Validation of the Spanish version of Palliative Care Quiz for Nurses. PLoS One 2017; 12:e0177000. [PMID: 28545037 PMCID: PMC5436641 DOI: 10.1371/journal.pone.0177000] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 04/20/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Palliative care is nowadays essential in nursing care, due to the increasing number of patients who require attention in final stages of their life. Nurses need to acquire specific knowledge and abilities to provide quality palliative care. Palliative Care Quiz for Nurses is a questionnaire that evaluates their basic knowledge about palliative care. The Palliative Care Quiz for Nurses (PCQN) is useful to evaluate basic knowledge about palliative care, but its adaptation into the Spanish language and the analysis of its effectiveness and utility for Spanish culture is lacking. PURPOSE To report the adaptation into the Spanish language and the psychometric analysis of the Palliative Care Quiz for Nurses. METHOD The Palliative Care Quiz for Nurses-Spanish Version (PCQN-SV) was obtained from a process including translation, back-translation, comparison with versions in other languages, revision by experts, and pilot study. Content validity and reliability of questionnaire were analyzed. Difficulty and discrimination indexes of each item were also calculated according to Item Response Theory (IRT). FINDINGS Adequate internal consistency was found (S-CVI = 0.83); Cronbach's alpha coefficient of 0.67 and KR-20 test result of 0,72 reflected the reliability of PCQN-SV. The questionnaire had a global difficulty index of 0,55, with six items which could be considered as difficult or very difficult, and five items with could be considered easy or very easy. The discrimination indexes of the 20 items, show us that eight items are good or very good while six items are bad to discriminate between good and bad respondents. DISCUSSION Although in shows internal consistency, reliability and difficulty indexes similar to those obtained by versions of PCQN in other languages, a reformulation of the items with lowest content validity or discrimination indexes and those showing difficulties with their comprehension is an aspect to take into account in order to improve the PCQN-SV. CONCLUSION The PCQN-SV is a useful Spanish language instrument for measuring Spanish nurses' knowledge in palliative care and it is adequate to establish international comparisons.
Collapse
Affiliation(s)
- Elena Chover-Sierra
- Nursing Department, University of Valencia, Valencia, Spain
- Hospital General Universitario de Valencia, Valencia, Spain
| | | | | |
Collapse
|
10
|
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.
Collapse
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.
| |
Collapse
|
11
|
Nguyen LT, Yates P, Osborne Y. Palliative care knowledge, attitudes and perceived self-competence of nurses working in Vietnam. Int J Palliat Nurs 2014; 20:448-56. [DOI: 10.12968/ijpn.2014.20.9.448] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Patsy Yates
- Head, School of Nursing, Queensland University of Technology, Queensland, Australia
| | - Yvonne Osborne
- Senior Lecturer, School of Nursing, Queensland University of Technology, Queensland, Australia
| |
Collapse
|
12
|
Validation of a new instrument for self-assessment of nurses' core competencies in palliative care. Nurs Res Pract 2014; 2014:615498. [PMID: 25132989 PMCID: PMC4124716 DOI: 10.1155/2014/615498] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 04/04/2014] [Accepted: 05/25/2014] [Indexed: 12/03/2022] Open
Abstract
Competence can be seen as a prerequisite for high quality nursing in clinical settings. Few research studies have focused on nurses' core competencies in clinical palliative care and few measurement tools have been developed to explore these core competencies. The purpose of this study was to test and validate the nurses' core competence in palliative care (NCPC) instrument. A total of 122 clinical nurse specialists who had completed a postbachelor program in palliative care at two university colleges in Norway answered the questionnaire. The initial analysis, with structural equation modelling, was run in Mplus 7. A modified confirmatory factor analysis revealed the following five domains: knowledge in symptom management, systematic use of the Edmonton symptom assessment system, teamwork skills, interpersonal skills, and life closure skills. The actual instrument needs to be tested in a practice setting with a larger sample to confirm its usefulness. The instrument has the potential to be used to refine clinical competence in palliative care and be used for the training and evaluation of palliative care nurses.
Collapse
|
13
|
Witkamp FE, van Zuylen L, van der Rijt CCD, van der Heide A. Validation of the Rotterdam MOVE2PC Questionnaire for assessment of nurses' knowledge and opinions on palliative care. Res Nurs Health 2013; 36:512-23. [PMID: 23813723 DOI: 10.1002/nur.21551] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2013] [Indexed: 11/11/2022]
Abstract
The purpose of this study was the psychometric testing of a questionnaire to assess nurses' opinions, subjective norms, perceived difficulties, and knowledge related to palliative care. The 63-item MOVE2PC Questionnaire was tested among 219 nurses in groups differing in education and experience. The intra-rater agreement was moderate to good (к > .5κmax ), and internal consistency was good (alpha = .77). Construct validity was demonstrated by between-groups differences in knowledge, opinions, and perceived difficulties. Responsiveness was shown by improved scores after an education program. Time of completion was 20 minutes, and 99% skipped at most five items, demonstrating feasibility. Findings support the usefulness of the instrument for assessing nurses' knowledge and views on palliative care.
Collapse
Affiliation(s)
- Frederika E Witkamp
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, PO Box 2040, 3000, CA, Rotterdam, The Netherlands; Department of Medical Oncology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | | | | | | |
Collapse
|
14
|
Pfister D, Markett S, Müller M, Müller S, Grützner F, Rolke R, Kern M, Schmidt-Wolf G, Radbruch L. German nursing home professionals' knowledge and specific self-efficacy related to palliative care. J Palliat Med 2013; 16:794-8. [PMID: 23701034 DOI: 10.1089/jpm.2012.0586] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND In Germany, more and more terminally ill patients spend their last days of life in nursing homes, and this presents a challenge for these institutions. Even though palliative care is a growing domain in health care, no quantitative in-depth evaluations of the status quo in nursing homes has been conducted so far in Germany, partly because of lacking measuring tools. OBJECTIVE This study used a new questionnaire to assess German health care professionals' theoretical knowledge of palliative care and their perceived self-efficacy. Both variables have been proven to be indicators for the quality of the implementation of palliative care in nursing homes. METHODS We used the Bonn Palliative Care Knowledge Test (Bonner Palliativwissenstest, BPW) questionnaire to measure knowledge of palliative care in the domains of medicine, care, and psychosocial care and to measure self-efficacy relating to palliative care. RESULTS Care workers (N=130) in five nursing homes in the region of Aachen in western Germany answered the questionnaires. The results show low knowledge (on average 52.8% correct answers) and self-efficacy relating to palliative care, although work with dying people is their daily challenge. While general knowledge correlated with work experience, a negative correlation of specific self-efficacy with age and working experience was observed. CONCLUSIONS Lower self-efficacy of care workers experienced in palliative care probably implies that the difficulty of palliative care skills is underestimated by inexperienced care workers. Palliative care training is urgently needed to improve knowledge and self-efficacy. Guidance to assist care professionals involved in palliative care in nursing homes needs to be developed and provided.
Collapse
|
15
|
Schulz C, Möller MF, Seidler D, Schnell MW. Evaluating an evidence-based curriculum in undergraduate palliative care education: piloting a phase II exploratory trial for a complex intervention. BMC MEDICAL EDUCATION 2013; 13:1. [PMID: 24370117 PMCID: PMC3546306 DOI: 10.1186/1472-6920-13-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Accepted: 12/11/2012] [Indexed: 05/11/2023]
Abstract
BACKGROUND By 2013 Palliative Care will become a mandatory examination subject in the medical curriculum in Germany. There is a pressing need for effective and well-designed curricula and assessment methods. Debates are on going as how Undergraduate Palliative Care Education (UPCE) should be taught and how knowledge and skills should be assessed. It is evident by this time that the development process of early curricula in the US and UK has led to a plethora of diverse curricula which seem to be partly ineffective in improving the care for the seriously ill and dying offered by newly qualified doctors, as is demonstrated in controlled evaluations. The goals of this study were to demonstrate an evidence-based approach towards developing UPCE curricula and investigate the change in medical students' self-perceived readiness to deal with palliative care patients and their families. METHODS To evaluate the effects of the UPCE curriculum we chose a prospective, controlled, quasi-experimental, pre, retrospective-pre, post study design. A total of n = 37 3rd and 4th -year medical students were assigned to the intervention group (n = 15; 4th -year) and to the control group (n = 22; 3rd-year). Resting on the self-efficacy concept of Bandura the measurement was conducted by a refined test-battery based on two independent measurements (the revised Collet-Lester-Fear-of-Death-Scale and the instrument of the "Program in Palliative Care Education and Practice" at Harvard Medical School) including 68 items altogether in a five-point Likert-scale. These items were designed to test elementary skills in caring for the dying and their relatives as perceived by medical undergraduates. Datasets from both groups were analysed by paired and independent two-sample t-test. The TREND statement for reporting non-randomized evaluations was applied for reporting on this quasi-experimental study. RESULTS Three constructs showed statistically significant differences comparing the intervention group before and after. Willingness to accompany a dying patient increased from 21.40 to 37.30 (p < .001). Self-estimation of competence in communication with dying patients and their relatives increased from 12.00 to 23.60 (p = .001). Finally, self-estimation of knowledge and skills in Palliative Care increased from 8.30 to 13.20 (p = .001). CONCLUSIONS This study is a small but systematic step towards rigorous curricular development in palliative care. Our manualised curriculum is available for scrutiny and scientific feedback to support an open and constructive process of best-practice comparison in palliative care.
Collapse
Affiliation(s)
- Christian Schulz
- University Dusseldorf, Medical Faculty, Interdisciplinary Centre for Palliative Medicine, Moorenstraße 5, D-40225, Dusseldorf, Germany
- University Dusseldorf, Medical Faculty, Clinical Institute for Psychosomatic Medicine and Psychotherapy, Moorenstraße 5, D-40225, Dusseldorf, Germany
| | - Mischa F Möller
- Institute for Ethics and Communication in Healthcare Systems, School of Medicine, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, D-58448, Witten, Germany
| | - Daniel Seidler
- University Dusseldorf, Medical Faculty, Clinical Institute for Psychosomatic Medicine and Psychotherapy, Moorenstraße 5, D-40225, Dusseldorf, Germany
| | - Martin W Schnell
- Institute for Ethics and Communication in Healthcare Systems, School of Medicine, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, D-58448, Witten, Germany
| |
Collapse
|
16
|
Pfister D, Müller M, Müller S, Kern M, Rolke R, Radbruch L. [Validation of the Bonn test for knowledge in palliative care (BPW)]. Schmerz 2012; 25:643-53. [PMID: 22120918 DOI: 10.1007/s00482-011-1111-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
BACKGROUND Palliative care in nursing homes has become an increasing focal point of healthcare in Germany and the evaluation of the specific quality of palliative care in this setting is under discussion. The assessment of quantitative data has the advantage of allowing pre-post comparisons of different interventions and implementation procedures and can therefore be used for evaluation of effectiveness. However, no assessment tool in German is available yet. Recent research on the assessment of healthcare professionals' knowledge indicated that knowing about technical and psychosocial aspects of palliative care is an easily measurable index for the quality of care. In consequence this index will be used as the core of the test instrument. The specific self-efficacy related to palliative care should be additionally included. METHOD An analysis of the two most common tests of palliative care knowledge by three experts revealed that these instruments were only partly useful in Germany because of differences in the healthcare systems. The experts also criticised that the tests included only a few items concerning psychosocial care and that these items often showed ceiling effects. In addition, the instruments were not suitable for use in nursing homes. For specific self-efficacy only one test is available in Dutch. The items of these three instruments were face validated by 5 experts and new items were generated where needed. The content validity was verified again by five experts with the think-aloud method. Items were validated in 23 calliative care trainers whose expert knowledge served as an external criterion. Items that scored low in this group were eliminated. A second sample of 36 assistant nurses working in nursing homes who took part in a workshop for palliative care was used to assess change sensitivity before and after training. RESULTS A total of 23 items for the knowledge test and 15 items for specific self-efficacy were selected. The level of difficulty was suitable because an expert group could answer the questions while for assistant nurses the items were sufficiently difficult to show a difference between groups. Items were very sensitive to change after a training course. CONCLUSION The BPW is the first standardized test instrument for palliative care in the German language. In comparison to the other tests it includes items from the psychosocial domain without demonstrating a ceiling effect for these items. Content and criterion validity were good. Additional tests with larger samples and with other groups of nurses working in other settings would be needed to improve the data on reliability and to extend the validation to other settings.
Collapse
Affiliation(s)
- D Pfister
- ALPHA Rheinland, Von-Hompesch-Str. 1, 53123, Bonn, Deutschland.
| | | | | | | | | | | |
Collapse
|
17
|
Phillips J, Salamonson Y, Davidson PM. An instrument to assess nurses’ and care assistants’ self-efficacy to provide a palliative approach to older people in residential aged care: A validation study. Int J Nurs Stud 2011; 48:1096-100. [DOI: 10.1016/j.ijnurstu.2011.02.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2010] [Revised: 01/03/2011] [Accepted: 02/08/2011] [Indexed: 10/18/2022]
|
18
|
|
19
|
|
20
|
Abstract
Changes in our society increasingly place the old and impaired in institutions, where they spend their last remaining days. The authors explore the burden of being confronted with death and dying on nursing home staff using mixed methodology. Findings from open-ended interviews with 17 representatives of different occupational groups inform the design of a questionnaire used to conduct a survey in 52 nursing homes of the Federal Province of Carinthia (Austria). In total, 894 questionnaires were returned, yielding a response rate of 49%. Results indicate that it is more difficult to talk about death with family members of terminally ill residents than with the dying themselves. The need for end-of-life training is not only essential for nursing staff but is also needed for nonnursing staff, who are found to be substantially strained by aspects of death and dying in their workplace.
Collapse
|
21
|
Adriaansen M, van Achterberg T. The content and effects of palliative care courses for nurses: A literature review. Int J Nurs Stud 2008; 45:471-85. [PMID: 17509596 DOI: 10.1016/j.ijnurstu.2007.01.016] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2006] [Revised: 01/08/2007] [Accepted: 01/12/2007] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The present literature review describes the literature (1990-2005) that concerns the effects of courses in palliative care at the pre- and postgraduate levels. DATA SOURCES A search was made for literature from the period between 1990 and 2005 using CINAHL, Pubmed and Psychlit, supplemented with a search for relevant systematic reviews from the Cochrane Library. DESIGN The research questions were directed on the areas of expertise and skills, the didactical methods, the effects of the courses and the standards to measure these effects. RESULTS The studies were all focused on general palliative care. Out of 27 studies 21 reported positive effects for communication, attitude, empathy and pain. Six of these 21 positive trails were studies with good quality designs, whereas 15 had moderate designs. The six studies with a lack of effects was one study with good quality and five studies with moderate quality designs. The effects on patients were described in only a few cases. There was still frequent use of self-constructed rating scales, where data about validity and reliability were lacking or where these aspects were not studied. CONCLUSIONS The most successful were integrated courses focused on several themes with a variety of didactical methods.
Collapse
Affiliation(s)
- Marian Adriaansen
- Department of Nursing, University of Professional Education at Nijmegen, The Netherlands.
| | | |
Collapse
|
22
|
Colthart I, Bagnall G, Evans A, Allbutt H, Haig A, Illing J, McKinstry B. The effectiveness of self-assessment on the identification of learner needs, learner activity, and impact on clinical practice: BEME Guide no. 10. MEDICAL TEACHER 2008; 30:124-45. [PMID: 18464136 DOI: 10.1080/01421590701881699] [Citation(s) in RCA: 213] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
BACKGROUND Health professionals are increasingly expected to identify their own learning needs through a process of ongoing self-assessment. Self-assessment is integral to many appraisal systems and has been espoused as an important aspect of personal professional behaviour by several regulatory bodies and those developing learning outcomes for clinical students. In this review we considered the evidence base on self-assessment since Gordon's comprehensive review in 1991. The overall aim of the present review was to determine whether specific methods of self-assessment lead to change in learning behaviour or clinical practice. Specific objectives sought evidence for effectiveness of self-assessment interventions to: a. improve perception of learning needs; b. promote change in learning activity; c. improve clinical practice; d. improve patient outcomes. METHODS The methods for this review were developed and refined in a series of workshops with input from an expert BEME systematic reviewer, and followed BEME guidance. Databases searched included Medline, CINAHL, BNI, Embase, EBM Collection, Psychlit, HMIC, ERIC, BEI, TIMElit and RDRB. Papers addressing self-assessment in all professions in clinical practice were included, covering under- and post-graduate education, with outcomes classified using an extended version of Kirkpatrick's hierarchy. In addition we included outcome measures of accuracy of self-assessment and factors influencing it. 5,798 papers were retrieved, 194 abstracts were identified as potentially relevant and 103 papers coded independently by pairs using an electronic coding sheet adapted from the standard BEME form. This total included 12 papers identified by hand-searches, grey literature, cited references and updating. The identification of a further 12 papers during the writing-up process resulted in a total of 77 papers for final analysis. RESULTS Although a large number of papers resulted from our original search only a small proportion of these were of sufficient academic rigour to be included in our review. The majority of these focused on judging the accuracy of self-assessment against some external standard, which raises questions about assumed reliability and validity of this 'gold standard'. No papers were found which satisfied Kirkpatrick's hierarchy above level 2, or which looked at the association between self-assessment and resulting changes in either clinical practice or patient outcomes. Thus our review was largely unable to answer the specific research questions and provide a solid evidence base for effective self-assessment. Despite this, there was some evidence that the accuracy of self-assessment can be enhanced by feedback, particularly video and verbal, and by providing explicit assessment criteria and benchmarking guidance. There was also some evidence that the least competent are also the least able to self-assess accurately. Our review recommends that these areas merit future systematic research to further our understanding of self-assessment. CONCLUSION As in other BEME reviews, the methodological issues emerging from this review indicate a need for more rigorous study designs. In addition, it highlights the need to consider the potential for combining qualitative and quantitative data to further our understanding of how self-assessment can improve learning and professional clinical practice.
Collapse
|
23
|
Zanolin ME, Visentin M, Trentin L, Saiani L, Brugnolli A, Grassi M. A questionnaire to evaluate the knowledge and attitudes of health care providers on pain. J Pain Symptom Manage 2007; 33:727-36. [PMID: 17531913 DOI: 10.1016/j.jpainsymman.2006.09.032] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2006] [Revised: 09/26/2006] [Accepted: 09/29/2006] [Indexed: 11/25/2022]
Abstract
The aims of this study were to survey the knowledge and attitudes of Italian health care professionals toward pain and develop a valid instrument to assess pain knowledge of physicians and nurses. A 21-item questionnaire on a Likert scale was given to 4,961 health professionals in 20 hospitals in Italy who volunteered to participate in the study. The results were analyzed psychometrically in three phases: the Principal Component Analysis phase identified two components, of which only the one that had 10 items about pain knowledge and attitudes (PAK) was studied; the Homogeneity Analysis revealed its acceptable internal reliability (Cronbach's alpha=0.72) and confirmed the Likert equidistance of the item options response; and the Confirmatory Factor Analysis proved that it had a very good construct validity. A standardized score was calculated on the PAK questionnaire using the final 10 selected items, considering 100% as the best level of knowledge of pain management and 0% as the worst. The standardized mean score on the whole sample was equal to 52.6% (95% Confidence Interval: 52.3%-53.0%). There was a statistically significant difference (P<0.001) in percentage score between physicians (56.5%) and nurses (51.3%). Knowledge was best among physicians in Anesthesiology and Emergency; this was followed by doctors in Medicine and then surgeons. The knowledge of nurses was almost constant. This scale fills a void by providing a validated instrument for testing the general knowledge about pain treatment of hospital staff. It is brief and can easily be administered to a considerable number of people.
Collapse
Affiliation(s)
- M Elisabetta Zanolin
- Unit of Epidemiology & Medical Statistics, Department of Public Health and Medicine, University of Verona, Verona, Italy.
| | | | | | | | | | | |
Collapse
|
24
|
Jenull-Schiefer B, Mayr M, Mayring P. [Behind each door you will find death: institutionalized dying]. Z Gerontol Geriatr 2006; 39:308-14. [PMID: 16900452 DOI: 10.1007/s00391-006-0333-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2005] [Accepted: 07/22/2005] [Indexed: 11/26/2022]
Abstract
Basic changes in our society and social system lead to a repression of old, frail and impaired people. They are increasingly institutionalized, and the issue of death and dying is delegated to experts. The present investigation describes the burden of routine care of dying people. "Mixed methodology" was used to obtain comprehensive and relevant data. General questions were deduced for the research subject based on qualitative interviews with 17 members of the nursing staff. These questions complete the questionnaire used to conduct the survey in 49 nursing homes. All kinds of occupational groups took part in the study. The quantitative data (n=894) were analyzed descriptively and proved for group differences with nonparametric methods. The results show that talking about the end of life with residents is difficult for almost a quarter of the participating persons. Nearly one third of the staff members tend to avoid the topic of death and dying when talking with relatives. High importance was attached to further interdisciplinary training in terminal care. Working together with different occupational groups like hospice volunteers, chaplains, psychologists and caregivers is seen as a fruitful way and a possibility of increasing the quality of dying in nursing homes.
Collapse
Affiliation(s)
- Brigitte Jenull-Schiefer
- Institut für Psychologie, Abteilung für Angewandte Psychologie und Methodenforschung, 9020 Klagenfurt, Austria.
| | | | | |
Collapse
|
25
|
Adriaansen MJ, van Achterberg T, Borm G. Effects of a postqualification course in palliative care. J Adv Nurs 2005; 49:96-103. [DOI: 10.1111/j.1365-2648.2004.03268.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|