1
|
De Oliveira LC, Rosa KSDC, Salman AA, Salman MSM, Simões AG, Siqueira ASDA, Richard AAO, Yamaguchi A, Ribeiro JB, Vinicius da Silva M, Bolzan M, Freitas R, Bryan L. Quality of death educational programme in a national reference palliative care unit. BMJ Support Palliat Care 2024; 13:e924-e927. [PMID: 37468223 DOI: 10.1136/spcare-2023-004478] [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] [Received: 07/06/2023] [Accepted: 07/09/2023] [Indexed: 07/21/2023]
Abstract
OBJECTIVE To report the experience of offering the Quality End of Life Care for All (QELCA) Programme, highlighting the distinct methodology for the training of health professionals. DEVELOPMENT The QELCA Programme, intellectual property of St Christopher's Hospice, was offered to seven health professionals working in the hospital palliative care unit at the National Cancer Institute, between June and December 2022, with the support of Premier Institute. The programme, which originates in the UK, has been evaluated there and is currently being evaluated in Hong Kong, and is delivered in two phases: (1) a 5-day immersion programme; (2) monthly sessions of Action Learning for 6 months. Participants realised that communication between members of the multidisciplinary team, as well as between health professionals and patients/loved ones, was one of the key challenges for achieving quality of death in the hospital palliative care unit. This insight empowered them to drive forward significant changes in practice that promise to improve quality of care. CONCLUSION The QELCA Programme enabled participants to engage in active problem-solving to promote the relief of suffering of patients and their families in end-of-life care.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - João Barroso Ribeiro
- Palliative Care Unit, National Cancer Institute, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Mônica Bolzan
- Palliative Care Unit, National Cancer Institute, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Renata Freitas
- Palliative Care Unit, National Cancer Institute, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Liz Bryan
- Education and Training, St Christopher's Hospice, London, UK
| |
Collapse
|
2
|
Ling M, Chen P, He Q, Long Y, Cheng L, You C. Cognition and attitudes of hospice care among healthcare providers: a case study of Sichuan Province. BMC MEDICAL EDUCATION 2023; 23:953. [PMID: 38093198 PMCID: PMC10720220 DOI: 10.1186/s12909-023-04898-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 11/23/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Under the background of the increasing aging population and cancer burden in China, the role of hospice care has become increasingly prominent. The government has paid more attention to the development of hospice care and set up pilot hospitals to promote hospice care. Moreover, healthcare providers play a leading role in hospice care services. To improve the quality of hospice care, the National Health Commission of the People's Republic of China proposed to set up hospice care training bases in municipal or above-level hospitals with hospice care or relevant work foundations, and train healthcare providers on hospice care. This study aimed to investigate the current situation of cognition and attitudes about hospice care among healthcare providers and provide a theoretical basis for hospital training. METHODS We used a quantitative design. A questionnaire survey was conducted among 1591 healthcare providers from August 2022 to November 2022. SPSS 22.0 software was used to analyze the data. RESULTS As a significant way of continuing education for healthcare providers, hospital training hasn't been effectively exploited in hospice care education. The average score of hospice care knowledge among participants was (7.74 ± 2.242) and the average score of hospice care attitudes among participants was (4.55 ± 1.503). According to multivariate linear regression analysis, sex (p < 0.001), education levels (p < 0.001), and professional titles (p = 0.018) of participants had significant difference on the score of hospice care knowledge; education levels (p = 0.009) and professional titles (p = 0.016) of participants had significant difference on the score of hospice care attitudes. CONCLUSIONS There were some misunderstandings about hospice care among healthcare providers and their attitudes towards hospice care were inactive. It's suggested that hospitals should carry out professional and systematic education courses to help healthcare providers understand hospice care correctly, and participate in hospice care services actively.
Collapse
Affiliation(s)
- Meng Ling
- Department of Hepatobiliary Surgery, Affiliated Hospital of North Sichuan Medical College, No.1 Maoyuan North Road, Shunqing District, Nanchong, Sichuan, China
| | - Pengru Chen
- Health Management Center, Second Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Qiaoying He
- Nursing Teaching and Research Office, Nanchong Health School of Sichuan Province, Nanchong, Sichuan, China
| | - Yi Long
- College of Basic Medicine, Zunyi Medical University, Zunyi, Guizhou, China
| | - Lei Cheng
- Department of Hepatobiliary Surgery, Affiliated Hospital of North Sichuan Medical College, No.1 Maoyuan North Road, Shunqing District, Nanchong, Sichuan, China.
| | - Chuan You
- Department of Hepatobiliary Surgery, Affiliated Hospital of North Sichuan Medical College, No.1 Maoyuan North Road, Shunqing District, Nanchong, Sichuan, China.
| |
Collapse
|
3
|
Hamre TJ, O'Shea ER, Hinderer KA, Mosha MH, Wentland BA. Impact of an Evidence-Based Pediatric Palliative Care Program on Nurses' Self-Efficacy. J Contin Educ Nurs 2022; 53:264-272. [PMID: 35647631 DOI: 10.3928/00220124-20220505-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background The purpose of this study was to determine the effect of a 1-day evidence-based pediatric palliative care continuing professional development program on nurses' and advanced practice registered nurses' perceived self-efficacy regarding palliative care. Method The revised Pediatric Palliative Care Questionnaire was administered to participants before and after a 7½-hour program. A multimodal approach was used to teach topics specific to pediatric palliative care. Results Thirty-one participants completed questionnaires. Notably, most of the participants had provided palliative or end-of-life care, but few had previous education specific to pediatrics. The self-efficacy scores of the participants significantly increased after program attendance (Z = 3.53, p < .001). Conclusion Continuing professional development in pediatric palliative care improves nurses' and advanced practice registered nurses' confidence in their skills to provide this care. Findings of this study support the need for pediatric-specific education in nursing training programs and continuing professional development offerings. Continuing education may be the key to improving access to high-quality care for children living with serious illness and their families. [J Contin Educ Nurs. 2022;53(6):264-272.].
Collapse
|
4
|
Pereira J, Meadows L, Kljujic D, Strudsholm T, Parsons H, Riordan B, Faulkner J, Fisher K. Learner Experiences Matter in Interprofessional Palliative Care Education: A Mixed Methods Study. J Pain Symptom Manage 2022; 63:698-710. [PMID: 34998952 DOI: 10.1016/j.jpainsymman.2021.12.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 12/09/2021] [Accepted: 12/31/2021] [Indexed: 12/17/2022]
Abstract
CONTEXT Interprofessional collaboration is needed in palliative care and many other areas in health care. Pallium Canada's two-day interprofessional Learning Essential Approaches to Palliative care Core courses aim to equip primary care providers from different professions with core palliative care skills. OBJECTIVES Explore the learning experience of learners from different professions who participated in Learning Essential Approaches to Palliative care Core courses from April 2015 to March 2017. METHODS This mixed methods study was designed as a secondary analysis of existing data. Learners had completed a standardized course evaluation survey online immediately post-course. The survey explored the learning experience across several domains and consisted of seven closed ended (Likert Scales; 1 = "Total Disagree", 5 = "Totally Agree") and three open-ended questions. Quantitative data were analyzed using descriptive statistics and Kruskal-Wallis non-parametric test tests, and qualitative data underwent thematic analysis. RESULTS During the study period, 244 courses were delivered; 3045 of 4636 participants responded (response rate 66%); physicians (662), nurses (1973), pharmacists (74), social workers (80), and other professions (256). Overall, a large majority of learners (96%) selected "Totally Agree" or "Agree" for the statement "the course was relevant to my practice". A significant difference was noted across profession groups; X2 (4) = 138; p < 0.001. Post-hoc analysis found the differences to exist between physicians and pharmacists (X2 = -4.75; p < 0.001), and physicians and social workers (X2 = -6.63; p < 0.001). No significant differences were found between physicians and nurses (X2 = 1.31; p = 1.00), and pharmacists and social workers (X2 = -1.25; p = 1.00). Similar results were noted for five of the other statements. CONCLUSION Learners from across profession groups reported this interprofessional course highly across several learning experience parameters, including relevancy for their respective professions. Ongoing curriculum design is needed to fully accommodate the specific learning needs of some of the professions.
Collapse
Affiliation(s)
- José Pereira
- Pallium (J.P., B.R., J.F.), Ontario, Canada; Division of Palliative Care, Department of Family Medicine (J.P.), McMaster University, Hamilton, Canada; Institute for Culture and Society (ICS) (J.P.), University of Navara, Pamplona, Spain.
| | - Lynn Meadows
- Department of Community Health Sciences (L.M.), Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Dragan Kljujic
- Database Manager and Analyst (D.K.), Independent Consultant, Brampton, Canada
| | - Tina Strudsholm
- School of Health Sciences (T.S.), University of Northern British Columbia, Prince George, Canada
| | - Henrique Parsons
- Division of Palliative Care (H.P.), Department of Medicine, University of Ottawa; The Ottawa Hospital Research Institute Clinical Epidemiology Program; Bruyere Research Institute, Ontario, Canada
| | | | | | - Kathryn Fisher
- School of Nursing, Faculty of Health Sciences (K.F.), McMaster University, Hamilton, Canada
| |
Collapse
|
5
|
Pereira J, Chary S, Faulkner J, Tompkins B, Moat JB. Primary-level palliative care national capacity: Pallium Canada. BMJ Support Palliat Care 2021:bmjspcare-2021-003036. [PMID: 34315718 DOI: 10.1136/bmjspcare-2021-003036] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 07/11/2021] [Indexed: 01/29/2023]
Abstract
The need to improve access to palliative care across many settings of care for patients with cancer and non-cancer illnesses is recognised. This requires primary-level palliative care capacity, but many healthcare professionals lack core competencies in this area. Pallium Canada, a non-profit organisation, has been building primary-level palliative care at a national level since 2000, largely through its Learning Essential Approaches to Palliative Care (LEAP) education programme and its compassionate communities efforts. From 2015 to 2019, 1603 LEAP course sessions were delivered across Canada, reaching 28 123 learners from different professions, including nurses, physicians, social workers and pharmacists. This paper describes the factors that have accelerated and impeded spread and scale-up of these programmes. The need for partnerships with local, provincial and federal governments and organisations is highlighted. A social enterprise model, that involves diversifying sources of revenue to augment government funding, enhances long-term sustainability. Barriers have included Canada's geopolitical realities, including large geographical area and thirteen different healthcare systems. Some of the lessons learned and strategies that have evolved are potentially transferrable to other jurisdictions.
Collapse
Affiliation(s)
- Jose Pereira
- Family Medicine, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
- Pallium Canada, Ottawa, Ontario, Canada
| | - Srini Chary
- Pallium Canada, Ottawa, Ontario, Canada
- Division of Palliative Medicine, Foothills Hospital, Calgary, Alberta Health Services, Edmonton, Alberta, Canada
| | | | | | | |
Collapse
|
6
|
Abstract
PURPOSE OF REVIEW This review was undertaken to analyze the main reasons behind the limited development of hospice care in China, and to put forward some suggestions. RECENT FINDINGS Although the Chinese government has increased its support for hospice care in recent years, however, owing to the lack of education around hospice care and the heavy influence of the traditional Chinese Confucian concept of "filial piety," many individuals resist hospice care. Moreover, due to impaired patient rights, inadequate composition of hospice care teams, unbalanced geographical distribution, and limited service range, the development of hospice care in China is hindered. Hospice care education and continued training should be popularized and the government should strengthen the legal structure of the medical system to protect the rights of patients, families, and medical staff to promoting social support for hospice care. Through graded diagnosis and referral systems in medical institutions to integrate medical resources and expand the range of hospice care services.
Collapse
Affiliation(s)
- Meng Ling
- Research Center for Humanistic Medicine, Zunyi Medical University, Zunyi, China.,Department of Hepatobiliary, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Xuchun Wang
- Research Center for Humanistic Medicine, Zunyi Medical University, Zunyi, China.,Department of Nursing, Zunyi Medical and Pharmaceutical College, Zunyi, China
| | - Yonghui Ma
- Centre for Bioethics, Medical College, Xiamen University, Xiamen, China
| | - Yi Long
- Research Center for Humanistic Medicine, Zunyi Medical University, Zunyi, China.
| |
Collapse
|
7
|
Downar J. Resources for Educating, Training, and Mentoring All Physicians Providing Palliative Care. J Palliat Med 2020; 21:S57-S62. [PMID: 29283871 DOI: 10.1089/jpm.2017.0396] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
This article presents a rapid review of the published literature and available resources for educating Canadian physicians to provide palliative and end-of-life care. Several key messages emerge from the review. First, there are many palliative care educational resources already available for Canadian physicians. Second, the many palliative care education resources are often not used in physician training. Third, we know that some palliative care educational interventions are inexpensive and scalable, while others are costly and time-consuming; we know very little about which palliative care educational interventions impact physician behavior and patient care. Fourth, two palliative care competency areas in particular can be readily taught: symptom management and communication skill (e.g., breaking bad news and advance care planning). Fifth, palliative care educational interventions are undermined by the "hidden curriculum" in medical education; interventions must be accompanied by continuing education and faculty development to create lasting change in physician behavior. Sixth, undergraduate and postgraduate medical training is shifting from a time-based training paradigm to competency-based training and evaluation. Seventh, virtually every physician in Canada should be able to provide basic palliative care; physicians in specialized areas of practice should receive palliative care education that is tailored to their area, rather than generic educational interventions. For each key message, one or more implications are provided, which can serve as recommendations for a framework to improve palliative care as a whole in Canada.
Collapse
Affiliation(s)
- James Downar
- Division of Palliative Care, Department of Family and Community Medicine and Interdepartmental Division of Critical Care Medicine, Department of Medicine, University of Toronto , Toronto, Ontario, Canada
| |
Collapse
|
8
|
Gillett K, Reed L, Bryan L. Using action learning sets to support change in end-of-life care. Leadersh Health Serv (Bradf Engl) 2017; 30:184-193. [DOI: 10.1108/lhs-10-2016-0055] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to describe the delivery of facilitated action learning sets as an integral component of a multidisciplinary end-of-life care course.
Design/methodology/approach
The educational intervention described in this paper is delivered by specialist palliative care practitioners to those working with dying patients and their families in non-specialist settings. The programme consists of two components: the first taught/experience-based component takes place in a hospice. The second integral component involves action learning sets which are facilitated by specialist palliative care staff over a six-month period. This paper reports the challenges, learning and benefits of using action learning sets to improve end-of-life care.
Findings
Action learning sets provide support which enables staff to implement changes to end-of-life care. Participants in the successful action learning sets were motivated to change practice and identified themselves as change agents. Management support was vital to allow participants the authority to implement changes to practice.
Practical implications
Facilitators need to gain participant and management commitment to the action learning process before the programme begins if they are to be successful in achieving changes to end-of-life care.
Originality/value
Hospices and other health care organisations work in partnership to deliver this programme, and this paper demonstrates how action learning sets can increase mutual understanding and communication between specialist and non-specialist end-of-life care settings.
Collapse
|
9
|
Affiliation(s)
| | - Sharon Chadwick
- West Hertfordshire Hospitals NHS Trust, Watford, UK The Hospice of St Francis, Berkhamsted, UK
| |
Collapse
|