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Alrimali AM, Alreshidi NM. Evaluating ICU nurses' education, practice, and competence in palliative and end-of-life care in Saudi Arabia: A cross-sectional study. BELITUNG NURSING JOURNAL 2024; 10:23-30. [PMID: 38425678 PMCID: PMC10900060 DOI: 10.33546/bnj.3040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/22/2023] [Accepted: 01/11/2024] [Indexed: 03/02/2024] Open
Abstract
Background In palliative and end-of-life (PEOL) care, especially within intensive care units (ICUs), nurses' unique skills are critical, yet their expertise remains under-explored, particularly in Saudi Arabia. Objective This study aimed to evaluate the education, practice, and perceived competence of adult ICU nurses in Saudi Arabia regarding PEOL care and to pinpoint key factors that influence this aspect of healthcare delivery. Methods A cross-sectional design was utilized in this study. Participants were recruited from five public hospitals and one specialized center in Hail, Saudi Arabia. Data were gathered in September 2023 using the PEOL Care Index, which measures various care dimensions on a Likert scale in Arabic and English. IBM SPSS Statistics 29.0 was used for statistical analysis, particularly to conduct ANOVA, t-test, and multiple regression. Results 142 out of the targeted 171 ICU nurses completed the survey, yielding a response rate of 83.04%. Although 81% of the nurses had experience caring for dying patients, only 30.3% had received in-service PEOL care training. Those with this training demonstrated significantly higher scores in education, clinical practice, and perceived competence than their counterparts (p <0.05). Mean scores across these areas were 69.67, 71.01, and 71.61, respectively. In-service training positively correlated with these metrics (p <0.05). Multiple regressions also revealed that in-service training, job satisfaction, and communication authority are strong influencers, explaining 21.6% of the variation in clinical practice and 16.9% in perceived competence. Conclusion The study highlighted the proficiency of ICU nurses in PEOL care, emphasizing that in-service training, job satisfaction, and the authority to communicate effectively with patients and their families significantly improved clinical practice and nurses' competence in PEOL care. This underlines the critical need for healthcare institutions to acknowledge and address these key factors to optimize patient care outcomes.
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Riguzzi M, Thaqi Q, Peng-Keller S, Lorch A, Blum D, Naef R. Adoption of evidence-based end-of-life and bereavement support to families in cancer care: A contextual analysis study with health professionals. J Clin Nurs 2024. [PMID: 38291546 DOI: 10.1111/jocn.17033] [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: 05/24/2023] [Revised: 12/19/2023] [Accepted: 01/07/2024] [Indexed: 02/01/2024]
Abstract
AIMS To investigate the level of adoption of evidence-based family engagement and support during end-of-life cancer care and subsequent bereavement and its contextual facilitators and barriers from health professionals' perspectives, and to explore differences between professional groups. DESIGN Contextual analysis using an online cross-sectional survey. METHODS This study was conducted in four Swiss hospitals and three home care oncology and palliative care services. Non-parametric testing was used to investigate the level of adoption and differences between nurses, physicians, occupational- and physiotherapists and psychosocial professionals (chaplains, onco-psychologists and social workers). The STROBE checklist for cross-sectional studies was followed. RESULTS The majority of the 111 participating health professionals were nurses. Adoption was statistically significantly higher during end-of-life care than bereavement, with nurses and physicians reporting higher levels than the other professional groups. Guidance on end-of-life family care was available in about half of the cases, in contrast to a quarter for bereavement care. Self-perceived knowledge, skills and attitudes were moderate to high, with nurses and physicians reporting higher levels than others, except for general skills in working with families. Organisational structures were experienced as rather supportive, with the psychosocial group appraising the organisational context as significantly less conducive to fully implementing end-of-life and bereavement care than others, particularly during the end-of-life phase. CONCLUSION Evidence-based family engagement and support were better adopted during end-of-life care than bereavement. Overall, nurses and physicians felt better enabled to care for families compared to other professional groups. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution. PROTOCOL REGISTRATION https://osf.io/j4kfh. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Implementation and quality improvement efforts should focus particularly on the bereavement phase and be tailored to professional groups. IMPACT The findings show that evidence-based family engagement and support practices during end-of-life were rather well adopted in contrast to subsequent bereavement care, with nurses and physicians better enabled than other professionals to provide care. A better understanding of health professionals' contributions and roles in family care is important to build interprofessional capacity for evidence-based end-of-life and bereavement support. REPORTING METHOD The STROBE checklist for reports of cross-sectional studies was followed (von Elm et al., 2007).
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Affiliation(s)
- Marco Riguzzi
- Institute for Implementation Science in Health Care, Faculty of Medicine, University of Zurich, Zurich, Switzerland
- Centre of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
| | - Qëndresa Thaqi
- Institute for Implementation Science in Health Care, Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Simon Peng-Keller
- Spiritual Care, Faculty of Theology, University of Zurich, Zurich, Switzerland
| | - Anja Lorch
- Medical Oncology and Hematology, University Hospital Zurich, Zurich, Switzerland
| | - David Blum
- Competence Centre for Palliative Care, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Centre for Palliative Care, City Hospital Zurich, Zurich, Switzerland
| | - Rahel Naef
- Institute for Implementation Science in Health Care, Faculty of Medicine, University of Zurich, Zurich, Switzerland
- Centre of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
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Kero J, Koivisto J, Lee SH, Haavisto E. Nurses' perceptions to alleviate dyspnoea in inpatients with advanced cancer while receiving palliative care. Nurs Open 2024; 11:e2038. [PMID: 38268248 PMCID: PMC10697120 DOI: 10.1002/nop2.2038] [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: 03/06/2022] [Revised: 06/05/2023] [Accepted: 10/19/2023] [Indexed: 01/26/2024] Open
Abstract
AIM To explore nurses' perceptions to alleviate dyspnoea in inpatients with advanced cancer while receiving palliative care. DESIGN A descriptive qualitative design. METHODS Seven focus groups were conducted with nurses (n = 27) from five specialized palliative care wards in four hospitals in south and southwest Finland. The focus groups were conducted between June and November 2019, and the transcripts were analysed using inductive analysis. RESULTS The findings revealed three categories: recognizing dyspnoea is a multi-faceted problem, dealing with the complexity of assessment of dyspnoea and strategies for relieving dyspnoea. Nurses perceived the complexity of dyspnoea as a symptom and emphasized the importance of utilizing patients' subjective experiences and consistent assessment scales to determine its severity. Furthermore, nonpharmacological interventions are as pertinent as pharmacological and medical interventions. The findings can assist nurses in selecting appropriate interventions for dyspnoea care, ultimately enhancing the quality of patient care and patient safety.
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Affiliation(s)
- Johanna Kero
- Department of Nursing ScienceTampere UniversityTampereFinland
| | - Jaana‐Maija Koivisto
- Department of Nursing ScienceTampere UniversityTampereFinland
- Smart Services Research UnitHäme University of Applied SciencesHämeenlinnaFinland
| | - Siew Hwa Lee
- School of Nursing, Midwifery and Paramedic PracticeRobert Gordon UniversityAberdeenUK
| | - Elina Haavisto
- Department of Nursing ScienceTampere UniversityTampereFinland
- Tampere University HospitalTampereFinland
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Yoong SQ, Schmidt LT, Devi KM, Zhang H. Using palliative and end-of-life simulation to enhance pre-licensure nursing students' emotional intelligence, palliative care knowledge and reflective abilities: A single group, pretest-posttest study. NURSE EDUCATION TODAY 2023; 130:105923. [PMID: 37549556 DOI: 10.1016/j.nedt.2023.105923] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 07/12/2023] [Accepted: 07/31/2023] [Indexed: 08/09/2023]
Abstract
BACKGROUND Nursing students have reported that they lack skills and knowledge in palliative and end-of-life care, and as a result, they faced numerous challenges caring for patients and families receiving palliative and end-of-life care during clinical attachments. OBJECTIVES To develop a palliative and end-of-life care simulation program and evaluate its effects on nursing students' emotional intelligence, palliative care knowledge and reflective abilities. DESIGN A single group, pretest-posttest quasi-experimental study. SETTINGS A simulation center in a Singapore university. PARTICIPANTS A convenience sample of 135 third-year undergraduate nursing students. METHODS Students attended a two-day simulation program consisting of four scenarios in total. Outcomes were measured before and after the study. Palliative care knowledge was measured using the Palliative Care Knowledge Test, emotional intelligence using the Trait Meta-Mood Scale-24, and reflective abilities using the Groningen Reflective Ability Scale. Outcome and demographic data were analyzed using descriptive and inferential statistics. RESULTS Total Palliative Care Knowledge Test scores (p = 0.003) and total Trait Meta-Mood Scale-24 scores (p < 0.001) improved significantly, but there was no significant change in Groningen Reflective Ability Scale scores (p = 0.650). Demographic characteristics did not significantly influence most outcome variables. Students' highest education level and experience with caring for a person receiving palliative or end-of-life care significantly affected the posttest scores of the Palliative Care Knowledge Test. Students with prior experience in caring for a person receiving palliative or end-of-life care scored significantly better in the Palliative Care Knowledge Test post-simulation compared to those who did not (p = 0.011). CONCLUSIONS The palliative and end-of-life simulation program significantly improved nursing students' emotional intelligence and palliative care knowledge. Further research is needed on developing a reliable tool to measure nursing students' palliative care knowledge. Future simulations should include structured and deliberate reflection features aside from debriefings to enhance reflective abilities, which is an important nursing competency. More research is needed on the effect of palliative and end-of-life care simulations on emotional intelligence and reflective abilities, and the influence of demographic variables on nursing students' outcomes.
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Affiliation(s)
- Si Qi Yoong
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Laura Tham Schmidt
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Kamala M Devi
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Hui Zhang
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; St Andrew's Community Hospital, Singapore.
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Kristanti MS, Hidayati NW, Maryadi. Comparison of palliative care education for family caregivers in high-and-low-income countries: An integrative review. BELITUNG NURSING JOURNAL 2023; 9:411-420. [PMID: 37901381 PMCID: PMC10600708 DOI: 10.33546/bnj.2713] [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: 05/22/2023] [Revised: 06/22/2023] [Accepted: 09/25/2023] [Indexed: 10/31/2023] Open
Abstract
Background In most resource-limited countries, palliative care is still under development. Despite the differences, the involvement of family caregivers is fundamental in both High-Income Countries (HICs) and Low-Income Countries (LICs). The lack of formal support in LICs implies that educational interventions to support family caregivers in this region could be more complex and urgently needed than in HICs. To comprehend the existing situation and identify the gaps in LICs, using HICs as a benchmark standard and conducting a review comparing educational interventions in both regions is essential. Objective To identify and compare the existing implementation of education for family caregivers of patients with advanced cancer in LICs and HICs. Design An integrative review guideline by Whittemore and Knafl was followed. Interventional studies related to education for family caregivers providing care for adult patients with cancer were included, and review articles were excluded. Data Sources Data were obtained from PubMed, EBSCO, ProQuest, and ClinicalKey. The search was conducted on 18 November 2021 and updated on 9 August 2023. Review methods Data reduction, data comparison, conclusion drawing, and data verification were conducted. Results Out of the 11 studies included, nine were randomized controlled trials, and two were quasi-experimental studies. Among them, seven (63%) were conducted in HICs, and four (37%) were carried out in LICs. In both regions, the psychological aspect was the most commonly addressed subject in palliative care education for family caregivers. However, in LICs, no articles specifically addressed the social and spiritual aspects of family caregivers' education. Research conducted in LICs mostly involved nurses, while studies in HICs included a more diverse range of healthcare professionals. Typically, these programs required two to three sessions, with 30-60 minutes duration for 3-12 weeks. Conclusion The social and spiritual aspects can be integrated into family caregivers' training programs in LICs in the near future. Nurses, as an integral part of the multidisciplinary team, are capable of contributing to the development of educational programs for family caregivers, especially in resource-limited countries where patients rely heavily on their caregivers and relatives. Support from nurses is fundamental in such contexts.
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Affiliation(s)
- Martina Sinta Kristanti
- Department of Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Nurdina Wahyu Hidayati
- Department of Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Maryadi
- Department of Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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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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Abdoli M, Fetz K, Molavynejad S, Sharif-Nia H, Asadizaker M. Psychometrics of the Persian version of the program in palliative care education and practice questionnaire (German revised - PPCEP-GR). BMC Palliat Care 2023; 22:77. [PMID: 37353756 DOI: 10.1186/s12904-023-01196-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 06/19/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND In order to improve the provision of palliative care by nurses, it is necessary to have a tool that measures different dimensions of palliative care and the knowledge and performance of nurses in this field. The Program in Palliative Care Education and Practice Questionnaire (German Revised) is psychometrically evaluated for the first time in Iran. METHODS To measure the psychometric properties, 360 nursing students (BSc, MSc, PhD) and clinical nurses completed the questionnaire. Face and content (CVR and CVI) validity were checked by quantitative and qualitative approach. Construct validity was performed with exploratory and confirmatory factor analysis. The total variance explained was equal to 43%; the internal consistency reported a Cronbach's alpha of more than 0.7; and the composite reliability was greater than 0.7. RESULTS After conducting construct validity and factor analysis, four factors (Knowledge and skill of managing patients' pain and symptoms, management of ethical and psychological issues in patients, communicating with patients and their families & management of patients' exposure to grief and attitudes towards death) were extracted. The total variance was equal to (%43) and coefficients of internal consistency were estimated more than 0.7. Also composite reliability was evaluated greater than 0.7. CONCLUSION Persian version of the Program in Palliative Care Education and Practice Questionnaire (German Revised Version; PPCEP-GR) is a valid and reliable questionnaire that can be used to measure the knowledge and performance of nurses and nursing graduates in the field of palliative care.
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Affiliation(s)
- Mohajer Abdoli
- Nursing Care Research Center in Chronic Diseases, School of Nursing & Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Katharina Fetz
- Chair of Research Methodology and Statistics, Department of Psychology and Psychotherapy, Faculty of Health, Witten/Herdecke University, Witten, Germany
- Institute for Research in Operative Medicine, Department Biometrics and Registry Data Research, Witten/Herdecke University, Witten, Germany
- Department of Anaesthesiology and Operative Intensive Care, Cologne-Merheim Medical Centre, Cologne, Germany
- Institute for Emergency Medicine, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Shahram Molavynejad
- Nursing Care Research Center in Chronic Diseases, School of Nursing & Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Hamid Sharif-Nia
- Traditional and Complementary Medicine Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Nursing, Amol Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Marziyeh Asadizaker
- Nursing Care Research Center in Chronic Diseases, School of Nursing & Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Soikkeli‐Jalonen A, Mishina K, Virtanen H, Charalambous A, Haavisto E. Healthcare professionals' perceptions of psychosocial support for family members in palliative care inpatient units—A qualitative descriptive study. Nurs Open 2022; 10:3018-3027. [PMID: 36539588 PMCID: PMC10077415 DOI: 10.1002/nop2.1548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 11/18/2022] [Accepted: 11/25/2022] [Indexed: 12/24/2022] Open
Abstract
AIM This study aimed to describe the psychosocial support healthcare professionals in specialist palliative inpatient units provide to family members of palliative care patients. DESIGN A qualitative descriptive design. METHOD The data were collected with focus group interviews and analysed with inductive content analysis. RESULTS Altogether, 48 healthcare professionals, including physicians, registered nurses and practical nurses, participated in the study. Information sharing was recognised as an essential element of support. Methods to improve support of family members included an opportunity to allocate recourses to the families, systematic support and strengthening healthcare professionals' competence in family care. The healthcare professionals describe their perceptions of psychosocial support for family members primarily through patient care and the patient's situation rather than family needs. Direct support for the family members is realised principally by information sharing and conversations. Healthcare professionals express their opportunities to implement support focusing on family members' needs restricted by reason of organisational resources. The information can be used when developing and improving family care in palliative care context to recognise the most relevant needs from healthcare professionals' perspective and also when implementing healthcare professionals' education and training.
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Affiliation(s)
- Anu Soikkeli‐Jalonen
- Department of Health Sciences, Faculty of Social Sciences Tampere University Tampere Finland
| | - Kaisa Mishina
- Department of Nursing Science University of Turku Turku Finland
- Department of Child Psychiatry University of Turku Turku Finland
- INVEST Research Flagship Centre University of Turku Turku Finland
| | - Heli Virtanen
- Department of Nursing Science University of Turku Turku Finland
| | - Andreas Charalambous
- Department of Nursing Science University of Turku Turku Finland
- Cyprus University of Technology Limassol Cyprus
| | - Elina Haavisto
- Department of Health Sciences, Faculty of Social Sciences Tampere University Tampere Finland
- Satakunta Central Hospital Pori Finland
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Zulueta Egea M, Prieto-Ursúa M, Bermejo Toro L, Palmar-Santos AM. Dimensions of good palliative nursing care: Expert panel consensus and perceptions of palliative professionals. J Clin Nurs 2022. [PMID: 36380458 DOI: 10.1111/jocn.16583] [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: 06/23/2022] [Revised: 10/17/2022] [Accepted: 10/26/2022] [Indexed: 11/17/2022]
Abstract
AIMS AND OBJECTIVES To analyse the dimensions of quality of palliative nursing care and to explore the perceptions of professionals for the development and validation of the Palliative Nursing Care Quality Scale. BACKGROUND The study of palliative nursing care quality has been approached from analysis of the competencies of palliative care nurses, based on various theoretical models. However, there are fewer qualitative empirical studies that have evaluated what good palliative nursing care is and what its dimensions are. DESIGN Mixed-method, Delphi approach and exploratory qualitative study. METHODS Consensus by a panel of experts using the Delphi technique and semi-structured interviews. The study was reported in a comprehensive manner following COREQ criteria. Data collection took place between January and June 2018. RESULTS The eight-person expert panel reached consensus on the following dimensions of the Palliative Nursing Care Quality Scale: control and relief of symptoms, family and/or primary caregiver, therapeutic relationship, spiritual support and continuity of care. Thematic analysis of ten interviews identified four emergent themes related to good nursing care: (1) the patient and family as a whole; (2) finding meaning; (3) responsible communication; and (4) caring for the human element. CONCLUSIONS The quality of palliative nursing care goes beyond providing comprehensive care; it means meticulously looking after every detail of what is important to the patient. The expectations of professionals are not as important. Instead, care should be based primarily on the needs and respect for the wishes of the patient and their family. RELEVANCE TO CLINICAL PRACTICE Specifying the quality of nursing care in routine practice and reaching a consensus on its dimensions means moving towards excellence in care, as well as improving the professional profile of advanced practice palliative care nurses. PATIENT OR PUBLIC CONTRIBUTION Two primary caregivers participated in the panel of experts and the semi-structured interview.
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Affiliation(s)
- Mar Zulueta Egea
- University Centre for Health Sciences, San Juan de Dios Foundation, San Rafael, Nebrija University Madrid, Spain
| | - María Prieto-Ursúa
- Psychology Department and Clinical Unit of Psychology (UNINPSI), Comillas Pontifical University, Madrid, Spain
| | - Laura Bermejo Toro
- Psychology Department and Clinical Unit of Psychology (UNINPSI), Comillas Pontifical University, Madrid, Spain
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López-García M, Rubio L, Martin-de-Las-Heras S, Suárez J, Pérez-Cárceles MD, Martin-Martin J. Instruments to measure skills and knowledge of physicians and medical students in palliative care: A systematic review of psychometric properties. MEDICAL TEACHER 2022; 44:1133-1145. [PMID: 35486883 DOI: 10.1080/0142159x.2022.2067033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE Palliative care is constantly increasing around the world. The knowledge and skills of future physicians in this area are crucial. This study evaluates the psychometric properties of knowledge and skills questionnaires used in palliative care, validated by physicians or medical students based on the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology. METHODS A systematic review was carried out in Cosmin Databases, Cochrane Library, PsycINFO, SciELO, Cinahl, and Medline up to September 2020 (updated June 2021), based on the COSMIN methodology and PRISMA recommendations. The psychometric properties of each included questionnaire were identified. Methodological quality, quality of results, and quality of evidence were evaluated. RESULTS The search strategy yielded 12 questionnaires assessing the knowledge and skills of physicians or medical students. The Palliative Care Knowledge Questionnaire for PEACE (PEACE-Q) and Palliative Care Knowledge Test (PCKT) were the instruments with the highest scores for methodological quality, quality of results, and quality of evidence-based on the COSMIN methodology. CONCLUSIONS PEACE-Q and PCKT should be the preferred choice to assess palliative care knowledge and skills in physicians. In-depth studies following COSMIN validation criteria are recommended to improve the psychometric properties and cross-cultural validation of the questionnaires.
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Affiliation(s)
- Mónica López-García
- Cudeca Hospice (Palliative Care Foundation), Málaga, Spain
- Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain
| | - Leticia Rubio
- Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain
- Department of Legal Medicine, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
| | - Stella Martin-de-Las-Heras
- Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain
- Department of Legal Medicine, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
| | - Juan Suárez
- Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain
- Department of Legal Medicine, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
| | - María D Pérez-Cárceles
- Department of Legal and Forensic Medicine, Faculty of Medicine, Biomedical Research Institute (IMIB-Arrixaca), University of Murcia, Murcia, Spain
| | - Jaime Martin-Martin
- Cudeca Hospice (Palliative Care Foundation), Málaga, Spain
- Department of Legal Medicine, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
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Zulueta Egea M, Prieto-Ursúa M, Bermejo Toro L, Jodar Anchía R. Quality of palliative nursing care: Meaning, death anxiety, and the mediating role of well-being. Palliat Support Care 2022; 21:1-9. [PMID: 35139982 DOI: 10.1017/s1478951521001954] [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: 11/07/2022]
Abstract
BACKGROUND There is increasing concern regarding the quality of palliative nursing care. However, despite the growing number of studies identifying related variables, there is still a paucity of studies analyzing models of how these variables interrelate. OBJECTIVE The study aimed to identify the role played in the quality of palliative care of nursing professionals by the variables meaning and death anxiety and to investigate the mediating role of psychological well-being and engagement. METHOD 176 palliative nursing professionals participated, selected by non-probabilistic convenience sampling using the snowball method. A simple mediation analysis and a multiple mediator model were performed in parallel, and data were collected using a paper and online questionnaire between January and May 2018. RESULTS Well-being mediated the impact of meaning (indirect effect = 0.096, SE = 0.044, 95% confidence interval (CI): 0.028, 0.213) and death anxiety (indirect effect = -0.032, SE = 0.013, 95% CI: -0.064, -0.010) on the quality of care. Engagement, on the other hand, only mediated the impact of meaning (indirect effect = 0.185, SE = 0.085, 95% CI: 0.035, 0.372), while the indirect effect of death anxiety with the quality of care through engagement was not statistically significant (indirect effect = 0.008, SE = 0.009, 95% CI: -0.004, 0.032). SIGNIFICANCE OF RESULTS Death anxiety is not directly related to the quality of care, but rather has an effect through psychological well-being, a variable acting as a mediator between the two. The effect of meaning on the quality of care is explained by the mediation of both engagement and psychological well-being, and its impact on the quality of care is thereby mediated by more variables than death anxiety.
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Affiliation(s)
- Mar Zulueta Egea
- Nursing, Centro Universitario de Ciencias de la Salud San Rafael-Nebrija, Madrid, Spain
| | - María Prieto-Ursúa
- Psychology Department and Clinical Unit of Psychology (UNINPSI), Comillas Pontifical University - Cantoblanco Campus, Comunidad de Madrid, Spain
| | - Laura Bermejo Toro
- Psychology Department and Clinical Unit of Psychology (UNINPSI), Comillas Pontifical University - Cantoblanco Campus, Comunidad de Madrid, Spain
| | - Rafa Jodar Anchía
- Psychology Department and Clinical Unit of Psychology (UNINPSI), Comillas Pontifical University - Cantoblanco Campus, Comunidad de Madrid, Spain
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Dadsetan F, Shahrbabaki PM, Mirzai M, Nouhi E. Palliative care needs of patients with multiple sclerosis in southeast Iran. BMC Palliat Care 2021; 20:169. [PMID: 34706707 PMCID: PMC8554857 DOI: 10.1186/s12904-021-00867-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 10/19/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Due to the chronic nature of multiple sclerosis, palliative care can play a significant role in improving the quality of life and well-being of the affected patients. An essential step for developing appropriate palliative care for these patients is to determine the types of palliative care necessary, from different points of view. Therefore, this study was conducted to compare the palliative care needs from the nurses' and patients' points of view in southeast Iran in 2017. METHOD This descriptive-analytical cross-sectional study was conducted on 154 nurses working in neurology wards of teaching hospitals associated with Kerman University of Medical Sciences and 132 patients with multiple sclerosis who were referred to these hospitals in southeast Iran. The data were collected using a questionnaire for assessing the palliative care needs of patients with multiple sclerosis. Pearson correlation coefficient, independent t-test, ANOVA, chi-square, and the Mann-Whitney and Kruskal-Wallis tests were used to examine the data. RESULTS Both nurses and patients mentioned the palliative needs of patients with multiple sclerosis in terms of physical, social, spiritual, psychological, and economic dimensions, respectively, but the results showed that there was a significant difference between the two groups in all dimensions of palliative needs (P < 0.0001). CONCLUSION Given the differences in how patients and nurses prioritize palliative care needs, it is essential to consider the different dimensions of palliative needs of patients with multiple sclerosis.
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Affiliation(s)
- Fatemeh Dadsetan
- M.s Medical Surgical Nursing, Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Parvin Mangolian Shahrbabaki
- Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran.,Razi Faculty of Nursing and Midwifery, Department of Critical Care Nursing, Kerman University of Medical Sciences, Kerman, Iran
| | - Moghadameh Mirzai
- Health Modeling Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Esmat Nouhi
- Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran. .,Razi Faculty of Nursing and Midwifery, Department of Medical Surgical Nursing, Kerman University of Medical Sciences, Kerman, Iran.
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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: 2] [Impact Index Per Article: 0.7] [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.
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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:
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Nouhi E, Faramarzpour V, Shahrbabaki PM. Iranian nurses' educational needs and competence in palliative cancer care. Int J Palliat Nurs 2021; 27:418-426. [PMID: 34672785 DOI: 10.12968/ijpn.2021.27.8.418] [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: 11/11/2022]
Abstract
AIM This study was conducted to determine the competence and educational needs of Iranian nurses in the field of palliative cancer care. METHOD This cross-sectional study was performed on nurses working in oncology departments of hospitals in Kerman, in southeast Iran. The data were collected using nurses' core competence in palliative care inventory and a questionnaire for assessing the educational needs of nurses in the field of palliative cancer care. Pearson correlation coefficient, Independent t-test, ANOVA and Linear regression were used to examine the data. RESULTS 210 nurses participated in this study and the response rate was 98.13%. The results showed that the mean score of educational needs in palliative cancer care was 3.6±0.7. The highest average score was observed in the mental and psychological (3.83±0.89) dimensions, and the lowest in the social dimension (3.34±0.84). The mean score of nurses' competence in palliative cancer care was 1.78±0.51. The highest mean score was related to interpersonal skills (2.28±0.74), and the lowest mean score belonged to the use of Edmonton symptoms evaluation (1.10±1.27). There was a low significant and inverse correlation between nurses' competence and their educational needs. (P<0.001, r=- 0.242). CONCLUSION This study showed that Iranian nurses have the need for palliative cancer care training. Therefore, it is necessary to assign a higher priority to the evaluation of the clinical competence and educational needs of nurses in different healthcare centres.
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Affiliation(s)
- Esmat Nouhi
- Associate Professor, Nursing Research Center, Department of Medical Surgical Nursing, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Vahid Faramarzpour
- MSN, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Parvin Mangolian Shahrbabaki
- Assistant Professor, Nursing Research Center, Department of Critical Care Nursing, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
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Haavisto E, Soikkeli-Jalonen A, Tonteri M, Hupli M. Nurses' required end-of-life care competence in health centres inpatient ward - a qualitative descriptive study. Scand J Caring Sci 2020; 35:577-585. [PMID: 32400040 DOI: 10.1111/scs.12874] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 04/13/2020] [Accepted: 04/20/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND Studies of nurses' required competence in EOL care in health centres are rare. It is important to produce information about experienced nurses' perceptions of the competence they consider important in their practical work. AIM The aim of this study was to describe nurses' required competence in EOL care in health centre inpatient wards as experienced by nurses. METHOD A descriptive qualitative study using four semi-structured group interviews (20 nurses) and inductive descriptive content analysis. RESULTS Five categories describing nurses' required competence in EOL care in a health centre inpatient ward were identified: (1) ethics and courage in action, (2) support for the patient, (3) support for the family, (4) care planning and (5) physical care. Factors promoting nurses' competence in EOL care comprised two categories: (1) professional development in EOL care and (2) an organisation that supports EOL care. CONCLUSIONS End-of-life care in health centre inpatient wards requires wide and complex competence from nurses. Nurses' experiences of required competence are associated with holistic care of the patient, encountering the family and multiprofessional cooperation. Nurses' competence in EOL care could be enhanced with postgraduate education, and educational planning should be given more attention in the future.
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Affiliation(s)
- Elina Haavisto
- Department of Nursing Science, Satakunta Central Hospital, University of Turku, Pori, Finland
| | | | - Mia Tonteri
- Department of Nursing Science, University of Turku, Pori, Finland
| | - Maija Hupli
- Department of Nursing Science, University of Turku, Pori, Finland
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