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Fortin Magaña M, Diaz S, Salazar-Colocho P, Feng A, López-Saca M. Long-term effects of an undergraduate palliative care course: a prospective cohort study in El Salvador. BMJ Support Palliat Care 2024; 14:200-207. [PMID: 33219104 DOI: 10.1136/bmjspcare-2020-002311] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 09/14/2020] [Accepted: 10/07/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND International organisations recommend the inclusion of palliative care undergraduate education as a way to meet increasing demand; the long-term effects, however, are unknown. Since 2013 the Dr José Matías Delgado University has offered an undergraduate course for palliative care. AIMS To assess whether a palliative care course results in improvement in self-perceived comfort among students and if it lasts up to 4 years later; and to examine students' knowledge of palliative care and assess the relationship between comfort and knowledge. DESIGN This is a prospective cohort study where students attending the course were requested to complete the Scale of Self-Perceived Comfort in palliative care pre and post course. Participants were contacted in 2018 and a group without palliative care education was established as a control group, matched one-to-one according to current academic level. They were asked to complete the Scale of Self-Perceived Comfort questionnaire together with the Palliative Care Knowledge Test. SETTINGS/PARTICIPANTS 83 students who attended the course between the years 2014 and 2017 and 101 controls. RESULTS In the postcourse test, participants had a 1.13-point increase (p≤0.001) in comfort, which persisted 4 years later and was superior to the control group by 0.6 points (p≤0.001). The control group showed no difference in the precourse test despite having more clinical experience (p=0.68). The students outscored the control group in the knowledge test by 4.2 points (p≤0.001). There appears to be no correlation between comfort and knowledge. CONCLUSION A palliative care undergraduate course results in improvement in student comfort and knowledge which persists up to 4 years later.
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Affiliation(s)
- Miguel Fortin Magaña
- Palliative Medicine, Dr Jose Matias Delgado University, San Salvador, El Salvador
| | - Susana Diaz
- Palliative Medicine, Dr Jose Matias Delgado University, San Salvador, El Salvador
| | | | - Ancu Feng
- Palliative Medicine, Dr Jose Matias Delgado University, San Salvador, El Salvador
| | - Mario López-Saca
- Palliative Medicine, Dr Jose Matias Delgado University, San Salvador, El Salvador
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Mollman S, Gierach M, Sedlacek A. Palliative Care Knowledge Following an Interdisciplinary Palliative Care Seminar. Am J Hosp Palliat Care 2024; 41:501-507. [PMID: 37321259 DOI: 10.1177/10499091231184623] [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: 06/17/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic created a unique opportunity to evolve an interdisciplinary palliative care seminar (IPC) into a virtual platform. This seminar provides foundational palliative and hospice concepts, introductions into palliative care disciplines, integration of teamwork, and incorporates interdisciplinary student led patient encounters. Traditionally, this experience had been in person, however during the COVID-19 pandemic, healthcare restrictions transitioned the educational delivery to a virtual platform. METHODS To assess the knowledge gained from this novel experience, the Palliative Care Knowledge Test (PCKT) was administered before and after the IPC Seminar. A 1-year follow up survey was also administered to evaluate how the IPC Seminar was applicable to the students' clinical experiences and practice. RESULTS The virtual didactics and virtual student led patient encounters significantly improved learners understanding of palliative and hospice care. This gain of knowledge was noted across undergraduate and graduate programs, which highlights the need for and benefit from foundational concepts. Furthermore, a 1-year follow up survey noted the IPC seminar was applicable to their practices and suggests that this experience will impact future patients. DISCUSSION Many of the students practice in rural areas where access to palliative care services is limited or non-existent. This experience exponentially impacts the growth of palliative and hospice care understanding and access to care across the region. CONCLUSION Evolving our IPC Seminar has shown to significantly improve knowledge, foster collaboration of student led interdisciplinary teams, and increases capacity to meet the needs of more learners.
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Affiliation(s)
- Sarah Mollman
- College of Nursing, South Dakota State University, Brookings, SD, USA
| | | | - Amanda Sedlacek
- Internal, Palliative and Hospice Medicine, Yankton Medical Clinic, Yankton, SD, USA
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Kim J, Gray JA. Measuring palliative care self-efficacy of intellectual and developmental disability staff using Rasch models. Palliat Support Care 2024; 22:146-154. [PMID: 36683394 DOI: 10.1017/s1478951522001833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVES The objectives of this study were to evaluate the psychometric properties of a palliative care self-efficacy instrument developed for intellectual and developmental disability (IDD) staff using Rasch analysis and assess the change in palliative care self-efficacy between 2 time points using Rasch analysis of stacked data. METHODS Staff from 4 nonprofit IDD services organizations in a US Midwestern state (n = 98) answered 11 questions with Likert-style responses at baseline and 1-month follow-up post training. Rasch analysis was performed to examine rating scale structure, unidimensionality, local independence, overall model fit, person and item reliability and separation, targeting, individual item and personal fit, differential item functioning (DIF), and change in palliative care self-efficacy between 2 time points. RESULTS The rating scale structure improved when 5 response categories were collapsed to 3. With the revised 3 response categories, the instrument demonstrated good psychometric properties. Principal components analysis of Rasch residuals supported the assumption of unidimensionality. Model fit statistics indicated an excellent fit of the data to the Rasch model. The instrument demonstrated good person and item reliability and separation. Gender-related DIF was found in 1 item, and work tenure-related DIF in 3 items. Overall palliative care self-efficacy improved between 2 time points. SIGNIFICANCE OF RESULTS Rasch analysis allowed for a more thorough examination of this palliative care self-efficacy instrument than classical test theory and provided information on rating scale structure, targeting, DIF, and individual persons and items. These recommendations can improve this instrument for research and practical contexts.
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Affiliation(s)
- Jinsook Kim
- School of Health Studies, Northern Illinois University, DeKalb, IL, USA
| | - Jennifer A Gray
- School of Health Studies, Northern Illinois University, DeKalb, IL, USA
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Swed S, Bohsas H, Alibrahim H, Albakri K, Rais MA, Almoshantaf MB, Hafez W, Abouainain Y, Sawaf B, Alshareef L, Othman ZAA, Elbialy I, Manad H, Faheem Y, John S, Alshareef J, Sheet L, Rakab A. Knowledge and Attitude of Healthcare Providers Regarding Palliative Care and Related Factors: An Online Cross-Sectional Study. Cureus 2024; 16:e54477. [PMID: 38510910 PMCID: PMC10951766 DOI: 10.7759/cureus.54477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Palliative care alleviates pain and enhances the quality of life of patients with life-threatening illnesses. Training programs are required to provide patients with proper care and advance their health because the expertise of healthcare personnel in palliative care is inadequate. AIM We aimed to assess healthcare professionals' knowledge of palliative care because palliative care programs are infrequently used in Syria. METHODS An online cross-sectional study was conducted between July 24, 2022, and August 28, 2022, to assess palliative care knowledge and applications among Syrian healthcare workers. The study questionnaire was designed in accordance with a previous study, and the inclusion criteria included Syrian healthcare workers, physicians, and nurses, as well as medical and nursing students. The first section of the questionnaire included sociodemographic information, while the second, third, and fourth sections assessed healthcare workers' experiences, knowledge, and attitudes toward palliative care, respectively. RESULTS Of the 602 participants, 66.2% of the sample study were females. The majority of the respondents (72.9%) were medical students, with 18.8% residents and 8.3% nurses or nursing students. The majority of the participants (84%) correctly answered the question about pain treatment goals, while only a small percentage (5.3%) correctly answered the question about whether long-term opioid use was addictive. There were no statistically significant differences in the overall knowledge levels across demographic areas, genders, or specialties. Only 14 participants were considered knowledgeable about palliative care. Regarding attitudes toward palliative care, the three responses that received the greatest degree of agreement were "Pain relievers should be given as needed to terminally ill patients" (89.7%) and "Patients have the right to determine their own degree of psychosocial intervention" (81%). Residents in urban and rural areas scored markedly different in their attitudes. Students in their fifth year were 8.06 times more likely to have a positive attitude when compared to those in their first year. CONCLUSIONS Our findings show that Syrian healthcare providers lack knowledge of palliative care. It is important to integrate palliative care into Syria's healthcare system to enhance the quality of life of patients who are approaching the end of their lives and to provide care for those who require it.
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Affiliation(s)
- Sarya Swed
- Medicine, University of Aleppo, Aleppo, SYR
| | | | | | | | | | | | - Wael Hafez
- Internal Medicine, NMC Royal Hospital, Abu Dhabi, ARE
- Internal Medicine, National Research Centre, Cairo, EGY
| | | | - Bisher Sawaf
- Internal Medicine, Syrian Private University, Faculty of Medicine, Damascus, SYR
| | | | | | | | - Hekmieh Manad
- Internal Medicine, Mediclinic Hospital, Abu Dhabi, ARE
| | - Youmna Faheem
- College of Medicine, Ras Al Khaimah Medical & Health Sciences University, Ras Al-Khaimah, ARE
- College of Medicine, NMC Royal Hospital, Abu Dhabi, ARE
- Pediatrics, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Steffi John
- College of Medicine, NMC Royal Hospital, Abu Dhabi, ARE
| | - Jalal Alshareef
- Obstetrics and Gynaecology, NMC Royal Hospital, Abu Dhabi, ARE
| | - Lana Sheet
- Faculty of Medicine, University of Aleppo, Aleppo, SYR
| | - Amine Rakab
- Medical Education, Weill Cornell Medicine - Qatar, Education City, QAT
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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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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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Abu-Aziz B, Alkasseh ASM, Bayuo J, Abu-Odah H. Towards the Provision of Palliative Care Services in the Intensive Coronary Care Units: Nurses' Knowledge, Training Needs, and Related-Barriers. Healthcare (Basel) 2023; 11:1781. [PMID: 37372899 DOI: 10.3390/healthcare11121781] [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: 04/14/2023] [Revised: 06/10/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
Despite the notable benefits of palliative care (PC) for patients with chronic diseases, its delivery to people with cardiac problems, particularly in the Middle East region (EMR), remains a critical issue. There is a scarcity of research assessing nursing staff's needs and knowledge in providing PC to cardiac patients in the EMR. This study aimed to assess the level of knowledge and needs of PC among nurses towards the provision of PC in intensive coronary care units (ICCUs) in the Gaza Strip, Palestine. It also identified the barriers to the provision of PC services in ICCUs in the Gaza Strip. A hospital-based descriptive quantitative cross-sectional design was adopted to collect data from 85 nurses working in ICCUs at four main hospitals in the Gaza Strip. Knowledge about PC was collected using a developed questionnaire based on the Palliative Care Quiz Nursing Scale (PCQN) and Palliative Care Knowledge Test (PCKT). PC training needs and barriers were assessed using the PC Needs Assessment instrument. Approximately two-thirds of nurses did not receive any PC educational or training programs, which contributed to their lack of PC knowledge. Most nurses would like to enroll in PC training programs, such as family support and communications skills courses. Nurses reported that there was a high demand for PC guidelines and discharge planning for patients with chronic illnesses. Insufficient healthcare professionals' knowledge about PC and a staff shortage were the main barriers to integrating PC into the Gaza healthcare system. This study suggests incorporating PC into nursing curricula and in-service training, and it covers both basic and advanced PC principles. Intensive coronary care unit nurses need knowledge and training about PC, guidance, and support to provide appropriate care to patients with cardiovascular issues.
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Affiliation(s)
- Baraa Abu-Aziz
- Nasser Medical Complex Hospital, Ministry of Health, Gaza P.O. Box P860, Palestine
| | - Areefa S M Alkasseh
- Department of Midwifery, Nursing College, Islamic University of Gaza, Gaza P.O. Box P108, Palestine
| | - Jonathan Bayuo
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Hammoda Abu-Odah
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China
- WHO Collaborating Centre for Community Health Services (WHOCC), School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China
- Nursing and Health Sciences Department, University College of Applied Sciences (UCAS), Gaza P.O. Box P860, Palestine
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Hamdan N, Yaacob LH, Idris NS, Abdul Majid MS. Primary Care Physicians' Knowledge and Attitudes Regarding Palliative Care in Northeast Malaysia. Healthcare (Basel) 2023; 11:healthcare11040550. [PMID: 36833084 PMCID: PMC9956221 DOI: 10.3390/healthcare11040550] [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: 01/09/2023] [Revised: 02/10/2023] [Accepted: 02/10/2023] [Indexed: 02/16/2023] Open
Abstract
Palliative care in Malaysia has progressed steadily since its inception in 1991, and it has been integrated gradually into primary health care in the past decade. This study aims to assess the level of knowledge and the attitudes towards palliative care and its associated factors among primary care physicians. A cross-sectional study was conducted among primary care physicians using two validated questionnaires: the Palliative Care Knowledge Test (PCKT) and Frommelt's Attitude Toward Care of the Dying (FATCOD). The data were analysed using descriptive and linear regression statistics. A total of 241 primary care physicians from 27 different health clinics participated in the study. The mean PCKT score was 8.68 (2.94), whereas the mean FATCOD score was 106.8 (9.14). The maximum score for each questionnaire was 20 and 150, respectively. There was a significant positive relationship between knowledge and attitudes toward palliative care, with a p-value of 0.003 (CI 0.22-1.04) and an r-value of 0.42. Palliative care knowledge among primary care physicians is still low despite their overall positive attitude towards the service. This finding suggests the urgent need for more education and training on palliative care for primary care physicians in Malaysia.
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Affiliation(s)
- Norhazura Hamdan
- Department of Family Medicine, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
| | - Lili Husniati Yaacob
- Department of Family Medicine, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
- Correspondence: (L.H.Y.); (N.S.I.)
| | - Nur Suhaila Idris
- Department of Family Medicine, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
- Correspondence: (L.H.Y.); (N.S.I.)
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Teng X, Tang M, Jing L, Xu Y, Shu Z. Healthcare Provider Knowledge, Attitudes, and Practices in Hospice Care and Their Influencing Factors: A Cross-sectional Study in Shanghai. Int J Health Policy Manag 2022; 11:3090-3100. [PMID: 35988031 PMCID: PMC10105208 DOI: 10.34172/ijhpm.2022.6525] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 07/31/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND In 2017, the Chinese government launched a pilot project in hospice care (HC), in which Shanghai was a pioneer. Healthcare provider knowledge, attitudes, and practices in hospice care (KAPHC) may facilitate or hinder HC development. To determine how to design targeted training for healthcare providers and policies to improve their KAPHC, we conducted an original study based on an indigenized KAPHC scale to (a) comprehensively measure the KAPHC baseline of healthcare providers in Shanghai and (b) explore its influencing factors. METHODS A cross-sectional study was designed to evaluate healthcare providers' KAPHC with the indigenized KAPHC scale. Descriptive analysis, linear regression, and Pearson's (r) correlation analysis were performed to uncover providers' KAPHC, its influencing factors, and their correlations. RESULTS The KAPHC scale proved applicable to the knowledge, attitudes, and practices of the large sample of providers we surveyed. The 7027 KAPHC scaling results revealed that 42.44% of participants had HC experience and 57.49% were willing to provide HC. The mean accuracy of the responses related to knowledge was 59.30%. Scoring rates for attitudes, confidence, and self-reported practices were 74.20%, 73.96%, and 75.55%, respectively. The linear regression revealed that higher KAPHC scores were associated with experience and willingness and varied with professional specializations. The Pearson's (r) correlation evidenced that HC practices were strongly correlated with confidence (r = 0.648, P<.001) and moderately correlated with attitudes (r = 0.463, P<.001). CONCLUSION We uncovered that targeted training for enhancing healthcare provider KAPHC in Shanghai should focus on psychological and spiritual care, the management of pain and other symptoms, and traditional Chinese medicine (TCM). Additionally, training should be scaled up for providers with different characteristics. Meanwhile, policy should encourage providers to work enthusiastically in HC-universal high-quality HC requires well-trained, supported, and motivated providers.
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Affiliation(s)
- Xiaohan Teng
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Maocheng Tang
- Department of Traditional Chinese Medicine, Shandong College of Traditional Chinese Medicine, Yantai, China
| | - Limei Jing
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yifan Xu
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zhiqun Shu
- Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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Khatib SE, Khoder A, Moghrabi D, Rabah M, Tabbah SA. Nurses' knowledge about palliative care services in North Lebanon. Int J Palliat Nurs 2022; 28:474-481. [DOI: 10.12968/ijpn.2022.28.10.474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Background: The surge in number of people needing palliative care services along with the deficit in nursing knowledge in in this field are challenges to be addressed in order to ensure higher quality end of life life care. Aim: The aim of this cross-sectional, exploratory pilot study was to assess nurses' knowledge in palliative care using the palliative care knowledge test (PCKT). Method: Descriptive analysis and correlations were carried out. Findings: Nurses showed insufficient knowledge in palliative care; 52% had a poor level (≤18 points) and 48% a fair level (19–28) of knowledge. No participants scored more than 73% in the total PCKT score. Nurses scored poorest in the management of dyspnoea and psychiatric problems. Conclusion: This pilot study demonstrated that promoting continuous education in palliative care is needed to provide quality care to terminally ill patients.
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Affiliation(s)
- Sarah El Khatib
- Assistant Professor, Faculty of Public Health, Lebanese University, Lebanon; Center for Epidemiology and Research in Population Health (CERPOP), Université de Toulouse, Inserm, Université Paul Sabatier, France
| | - Ansar Khoder
- Registered Nurse, Faculty of Public Health, Lebanese University; Al Youssef Hospital Center, Lebanon
| | - Dalal Moghrabi
- Registered Nurse, Faculty of Public Health, Lebanese University; Al Youssef Hospital Center, Lebanon
| | - Mohamad Rabah
- Registered Nurse, Faculty of Public Health, Lebanese University; Nini Hospital, Lebanon
| | - Samaa Al Tabbah
- Clinical Pharmacist, Faculty of Health Sciences, American University of Beirut; School of Pharmacy, Lebanese American University, Lebanon
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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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Temiz G, Bayram Z, Akin S, Donmez E, Salamanca Mapi N. Early integration of palliative care among cancer patients: The perspective of oncology nurses in Turkey. Eur J Cancer Care (Engl) 2022; 31:e13665. [DOI: 10.1111/ecc.13665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 06/25/2022] [Accepted: 07/05/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Gamze Temiz
- Faculty of Hamidiye Nursing School Health Science University Istanbul Turkey
| | - Zeyno Bayram
- Medical Faculty Hospital Internal Medicine‐Medical Oncology Istanbul University‐Cerrahpaşa Istanbul Turkey
| | - Semiha Akin
- Faculty of Hamidiye Nursing School Health Science University Istanbul Turkey
| | - Elif Donmez
- Faculty of Hamidiye Nursing School Health Science University Istanbul Turkey
| | - Neila Salamanca Mapi
- Medical Clinic, Medical Specialists and Diagnostic Center (MSDC) The Philippine Women's University Manila Philippines
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Abu-Odah H, Molassiotis A, Liu JYW. Assessment of the Educational and Health Care System-Related Issues From Physicians' and Nurses' Perspectives Before Developing a Palliative Care Program Within the Palestinian Health Care System: A Cross-sectional Study. J Hosp Palliat Nurs 2022; 24:E59-E75. [PMID: 35085161 DOI: 10.1097/njh.0000000000000840] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A scarcity in research assessing the palliative care (PC) educational and health care system-related issues has been reported in the Middle East region; the region comprises a wide range of economically diverse countries. Discrepancies across countries have created difficulties in adopting other countries' experiences. This study aimed to assess PC knowledge, attitude, educational needs, and health care system-related issues from physicians' and nurses' perspectives before developing PC services within the Palestinian health care system. One hundred sixty-nine professionals participated in this cross-sectional survey. Data were collected by validated instruments. Professionals had insufficient knowledge about PC, but they had positive attitudes toward end-of-life care and care of the dying. Patients'/families' avoidance of talking about issues around dying and lack of training for staff related to PC were the most 2 significant barriers to providing PC. Educational level and previous training were found to be associated significantly with knowledge and attitudes toward PC. Study conclusions support the recommendation for integration of education about PC within the health curricula and in-service training and should cover the basic and advanced principles of PC and symptom management.
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Chover-Sierra E, Pérez-Ros P, Julián-Rochina I, Long CO, Cauli O. Knowledge and Attitudes towards Palliative Care: Validation of the Spanish Version of Questionnaire on Palliative Care for Advanced Dementia. Healthcare (Basel) 2022; 10:healthcare10040656. [PMID: 35455834 PMCID: PMC9029205 DOI: 10.3390/healthcare10040656] [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: 01/18/2022] [Revised: 03/24/2022] [Accepted: 03/29/2022] [Indexed: 11/23/2022] Open
Abstract
Background: Palliative care is essential in the care of people with advanced dementia, due to the increasing number of patients requiring care in the final stages of life. Nurses need to acquire specific knowledge and skills to provide quality palliative care. The Questionnaire on Palliative Care for Advanced Dementia (qPAD) is useful for assessing knowledge and attitudes toward palliative care, but its adaptation to the Spanish language and analysis of its effectiveness and usefulness for the Spanish culture is lacking. Objective: To report on the Spanish language adaptation and psychometric analysis of the qPAD. Methods: The Questionnaire on Palliative Care for Advanced Dementia Spanish version (qPAD-SV) was obtained from a process that included translation, back-translation, comparison with other language versions, expert review, and pilot study. Content validity, criterion validity, and reliability of the questionnaire were analyzed. The difficulty and discrimination indices of items composing the knowledge subscale were also calculated. Results: Adequate content validity index obtained after the analysis of qPAD-SV by a heterogeneous group of experts was found (overall CVI = 0.96; 0.95 for the Knowledge subscale and 0.99 for the Attitudes subscale). Significant correlations with the Palliative Care Knowledge test (rho = 0.368, p < 0.001) and Self-Efficacy in Palliative Care Scale (rho = 0.621, p < 0.001) show an adequate criterion validity. Cronbach’s alpha coefficients for the Knowledge subscale (0.60) and the Attitudes subscale (0.91) supported the reliability of the qPAD-SV. The questionnaire had an overall difficulty index of 0.71, with three items that could be considered difficult or very difficult, and eleven items that could be considered very easy. Discussion: Although it shows internal consistency, validity, and difficulty indices similar to those obtained by qPAD versions in other languages, a reformulation of the items with lower content validity or discrimination indices and those that show difficulties in their comprehension is an aspect to be taken into account to improve this tool. Conclusions: The qPAD-SV is a useful instrument in Spanish to measure the knowledge of Spanish nurses in palliative care and is suitable for international comparisons.
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Affiliation(s)
- Elena Chover-Sierra
- Nursing Department, University of Valencia, 46010 Valencia, Spain; (E.C.-S.); (P.P.-R.); (I.J.-R.)
- Nursing Care and Education Research Group (GRIECE), University of Valencia, 46010 Valencia, Spain
- Internal Medicine, Consorcio Hospital General Universitario de Valencia, 46014 Valencia, Spain
| | - Pilar Pérez-Ros
- Nursing Department, University of Valencia, 46010 Valencia, Spain; (E.C.-S.); (P.P.-R.); (I.J.-R.)
- Frailty Research Organized Group (FROG), University of Valencia, 46010 Valencia, Spain
| | - Iván Julián-Rochina
- Nursing Department, University of Valencia, 46010 Valencia, Spain; (E.C.-S.); (P.P.-R.); (I.J.-R.)
- Frailty Research Organized Group (FROG), University of Valencia, 46010 Valencia, Spain
| | - Carol O. Long
- “Palliative Care Essentials” Research Institute, Fredericksburg, VA 22407, USA;
| | - Omar Cauli
- Nursing Department, University of Valencia, 46010 Valencia, Spain; (E.C.-S.); (P.P.-R.); (I.J.-R.)
- Frailty Research Organized Group (FROG), University of Valencia, 46010 Valencia, Spain
- Correspondence:
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Pruthi M, Bhatnagar S, Indrayan A, Chanana G. The Palliative Care Knowledge Questionnaire-Basic (PCKQ-B): Development and Validation of a Tool to Measure Knowledge of Health Professionals about Palliative Care in India. Indian J Palliat Care 2022; 28:180-191. [PMID: 35673683 PMCID: PMC9168284 DOI: 10.25259/ijpc_80_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 01/16/2022] [Indexed: 11/17/2022] Open
Abstract
Objectives: A well-educated and aware staff are the needed to overcome barriers to palliative care provision in the face of ever-increasing needs of palliative care in developing countries like India. Lack of a standardised and locally validated need assessment tool is felt as one of the important requirements for any successful educational program. This project is to develop and validate a basic palliative care knowledge needs assessment questionnaire. Materials and Methods: Development of Palliative Care Knowledge Questionnaire-Basic (PCKQ-B) for Indian nurses working in a tertiary care hospital in Delhi-NCR, India was undertaken with four basic processes, that is, item generation, content validity, pilot testing and field testing. Literature search helped us to find appropriate domains and items; content validity obtained with a panel of seven experts, pilot testing and finally field testing was done on 102 nurses working in 6 branches of Max Super Specialty Hospital, Delhi-NCR, India. The field study data were used to do item analyses including item difficulty, item discrimination and calculate reliability indicators including test-retest correlation and KR-20. Results: Content Validity index (CVI) of all the items was >0.78 (except 1 item) and Scale-CVI was 0.98 (excellent content validity). Items were selected on the basis of item difficulty index of 0.1 to 0.9 and an item discrimination index greater than 0.2. A total of 25 questions were selected that elicited KR-20 value of 0.65 and intra class correlation (test-retest reliability) of 0.52. Conclusion: Overall, PCKQ-B is a 25 item questionnaire with a moderate reliability. Although validated for nurses in tertiary care hospitals, this tool might find utility in education of primary health workers, community health workers, social workers, or physiotherapists in palliative care teams.
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Affiliation(s)
- Megha Pruthi
- Department of Oncology, Division of Pain and Palliative Medicine, Max Super Specialty Hospital, Vaishali, Uttar Pradesh, India,
| | - Sushma Bhatnagar
- Department of Oncoanaesthesia and Palliative Medicine, Dr. B.R.A Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India,
| | - Abhaya Indrayan
- Department of Biostatistics, Max Healthcare Institute Limited, New Delhi, India,
| | - Gaurav Chanana
- Department of Oncology, Division of Pain and Palliative Medicine, Max Super Specialty Hospital, Saket, Delhi, India,
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Perception of pediatric oncology family care providers toward palliative care and its perceived barriers in Egypt. Palliat Support Care 2021; 20:55-61. [PMID: 34763743 DOI: 10.1017/s1478951521001668] [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 Palliative care is comprehensive supportive care addressing the suffering, pain, discomfort, symptoms, and stress of cancer and any serious life-threatening disease. It is a key part of care for our children living with cancer and is an important source of support for their families. The study aimed to assess the perception of pediatric oncology family care providers toward palliative care and its perceived barriers in Egypt. METHOD Total number of 500 oncology children's family care providers was recruited. A descriptive research design was utilized. Researchers used three tools as Structured Interview Questionnaire to assess the participants' knowledge and perceived barriers, Attitude toward palliative care Likert Scale, and Reported Practices Observational Checklist. The study was conducted in outpatient cancer clinics affiliated with El-Nasr governmental hospital located at Port Said governorate. RESULTS 51.8% of the total oncology children's family care providers had sufficient knowledge, 78.6% had a positive attitude, while,76.8% of them had inappropriate Practice towards palliative care. SIGNIFICANCE OF RESULTS The pediatric oncology family care providers had sufficient knowledge and a positive attitude toward palliative care, but their practices were inappropriate. Also, the majority of participants identified Lack of family care providers training in pediatric palliative care and improper communication between the health team and family care providers as the main barriers to providing palliative care to children. Providing a palliative care training program for family caregivers through continuing professional development is highly recommended besides further research studies using large probability samples at different settings.
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García-Salvador I, Chisbert-Alapont E, Antonaya Campos A, Casaña Mohedo J, Hurtado Navarro C, Fernández Peris S, Bonías López J, De la Rica Escuín ML. Design and Validation of the INCUE Questionnaire: Assessment of Primary Healthcare Nurses' Basic Training Needs in Palliative Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010995. [PMID: 34682741 PMCID: PMC8535240 DOI: 10.3390/ijerph182010995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 10/12/2021] [Accepted: 10/14/2021] [Indexed: 11/16/2022]
Abstract
Many instruments have been created to measure knowledge and attitudes in palliative care. However, not only is it important to acquire knowledge, but also that this knowledge should reach patients and their relatives through application in clinical practice. This study aimed to develop and psychometrically test the INCUE questionnaire (Investigación Cuidados Enfermeros/Investigation into Nurses’ Care Understanding of End-of-Life) to assess the basic training needs of primary or home healthcare nurses in palliative care. A questionnaire was developed based on the classical theory of tests and factor analysis models. Initially, 18 experts developed 67 items in two blocks and determined content validity by two rounds of expert panels. Exploratory factor analysis and reliability testing were conducted with a non-probabilistic sample of 370 nurses. Some items were observed to have very low homogeneity indices or presented convergence problems and were eliminated. Questionnaire reliability was 0.700 in the theoretical block (KR20 Index) and 0.941 in the practical block (Cronbach’s alpha). The model converges and shows an adequate fit, specifically CFI = 0.977, TLI = 0.977 and RMSEA = 0.05. The correlation between the two factors in the model is ρ = 0.63. The questionnaire objectively evaluates primary or home healthcare nurses’ knowledge of palliative care and its practical application, thereby facilitating more efficient training plans.
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Affiliation(s)
- Isidro García-Salvador
- Nurse Oncology Service, Valencia Health Department, Doctor Peset, 46017 Valencia, Spain;
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46020 Valencia, Spain; (A.A.C.); (J.C.M.); (C.H.N.); (S.F.P.); (J.B.L.); (M.L.D.l.R.E.)
- Research Group INCUE, Valencia Health Department, Doctor Peset, 46017 Valencia, Spain
| | - Encarna Chisbert-Alapont
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46020 Valencia, Spain; (A.A.C.); (J.C.M.); (C.H.N.); (S.F.P.); (J.B.L.); (M.L.D.l.R.E.)
- Research Group INCUE, Valencia Health Department, Doctor Peset, 46017 Valencia, Spain
- Nurse Oncology Service, Valencia Health Department La Fe, 46026 Valencia, Spain
- Correspondence: ; Tel.: +34-645555901
| | - Amparo Antonaya Campos
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46020 Valencia, Spain; (A.A.C.); (J.C.M.); (C.H.N.); (S.F.P.); (J.B.L.); (M.L.D.l.R.E.)
- Research Group INCUE, Valencia Health Department, Doctor Peset, 46017 Valencia, Spain
- Primary Care Nursing Director, Valencia Health Department, Doctor Peset, 46017 Valencia, Spain
| | - Jorge Casaña Mohedo
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46020 Valencia, Spain; (A.A.C.); (J.C.M.); (C.H.N.); (S.F.P.); (J.B.L.); (M.L.D.l.R.E.)
- Research Group INCUE, Valencia Health Department, Doctor Peset, 46017 Valencia, Spain
- Nursing Department, Faculty of Medicine and Health Sciences, Universidad Católica San Vicente Mártir, 46001 Valencia, Spain
| | - Clara Hurtado Navarro
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46020 Valencia, Spain; (A.A.C.); (J.C.M.); (C.H.N.); (S.F.P.); (J.B.L.); (M.L.D.l.R.E.)
- Research Group INCUE, Valencia Health Department, Doctor Peset, 46017 Valencia, Spain
- Nurse Training Service, Valencia Health Department, Doctor Peset, 46017 Valencia, Spain
| | - Silvia Fernández Peris
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46020 Valencia, Spain; (A.A.C.); (J.C.M.); (C.H.N.); (S.F.P.); (J.B.L.); (M.L.D.l.R.E.)
- Carena Association of Psycho-Oncology, Valencia Health Department, Doctor Peset, 46017 Valencia, Spain
| | - José Bonías López
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46020 Valencia, Spain; (A.A.C.); (J.C.M.); (C.H.N.); (S.F.P.); (J.B.L.); (M.L.D.l.R.E.)
- Research Group INCUE, Valencia Health Department, Doctor Peset, 46017 Valencia, Spain
- Nurse Primary Care Center of San Marcelino, Valencia Health Department, Doctor Peset, 46017 Valencia, Spain
| | - Maria Luisa De la Rica Escuín
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46020 Valencia, Spain; (A.A.C.); (J.C.M.); (C.H.N.); (S.F.P.); (J.B.L.); (M.L.D.l.R.E.)
- Nurse Research Group on Care in End-of-Life Processes, Institute for Health Research Aragón, 50009 Zaragoza, Spain
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Runacres F, Poon P, King S, Lustig J, Ugalde A. Examining the role of specialist palliative care in geriatric care to inform collaborations: a survey on the knowledge, practice and attitudes of geriatricians in providing palliative care. Age Ageing 2021; 50:1792-1801. [PMID: 33837769 DOI: 10.1093/ageing/afab058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The global population is ageing, and rates of multimorbidity and chronic illness are rapidly rising. Given specialist palliative care has been shown to improve overall care and reduce health care costs, how best to provide this care to older people is internationally significant. AIM To examine the knowledge, attitudes and practices of geriatricians in providing palliative care and working with specialist palliative care services. We also aimed to capture self-reported barriers, confidence and satisfaction in providing palliative care. DESIGN A prospective cross-sectional study surveying Australasian geriatricians was conducted. SETTING/PARTICIPANTS This was a voluntary anonymous online survey, distributed to all full members of the Australian and New Zealand Society of Geriatric Medicine. RESULTS A total of 168 completed responses were received; 58.3% were female and 36.6% had over 20 years of clinical experience. Most geriatricians (85%) reported caring for patients in their last 12 months of life represented a substantial aspect or most of their practice. Geriatricians overwhelmingly believed they should coordinate care (84%) and derived satisfaction from providing palliative care (95%). The majority (69%) believed all patients with advanced illness should receive concurrent specialist palliative care. Regarding knowledge, participants scored an average of 13.5 correct answers out of 18 in a Modified Palliative Care Knowledge Test. CONCLUSIONS Geriatricians find reward in providing generalist palliative care to their patients; however, potential exists for improved collaborations with specialist palliative care services. An evidence base for geriatric patients who benefit most from specialist palliative care services is needed to improve resourcing, collaborative practice and ultimately palliative care delivery.
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Affiliation(s)
- Fiona Runacres
- Supportive and Palliative Care Unit, Monash Health, Clayton 3168, Victoria, Australia
- School of Clinical Sciences, Monash University, Clayton 3168, Victoria, Australia
- Department of Palliative Medicine, Calvary Health Care Bethlehem, Parkdale, Victoria, Australia
- The University of Notre Dame, Darlinghurst, New South Wales, Australia
| | - Peter Poon
- Supportive and Palliative Care Unit, Monash Health, Clayton 3168, Victoria, Australia
- School of Clinical Sciences, Monash University, Clayton 3168, Victoria, Australia
| | - Scott King
- Supportive and Palliative Care Unit, Monash Health, Clayton 3168, Victoria, Australia
- School of Clinical Sciences, Monash University, Clayton 3168, Victoria, Australia
- Palliative Medicine, Healthecare, Noble Park, Victoria, Australia
| | - Julie Lustig
- Rehabilitation and Aged Care Service, Monash Health, Clayton 3168, Victoria, Australia
| | - Anna Ugalde
- School of Nursing and Midwifery, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
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Assessing Medical Students' Confidence towards Provision of Palliative Care: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158071. [PMID: 34360364 PMCID: PMC8345455 DOI: 10.3390/ijerph18158071] [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: 07/20/2021] [Accepted: 07/22/2021] [Indexed: 11/24/2022]
Abstract
Under a surging demand for palliative care, medical students generally still show a lack of confidence in the provision in abroad studies. This cross-sectional study aims to investigate the confidence and its association with knowledge, attitude and exposure on providing palliative care among medical undergraduates with a self-administered questionnaire to improve the international phenomenon. Full-time local medical undergraduates were recruited to obtain information regarding the demographics, confidence, knowledge, attitude and exposure on palliative care; the information was collected from July 2020 to October 2020. Questions on confidence (10-items), knowledge (20-items), attitude (10-items) and exposure were referenced from validated indexes and designed from literature review. Confidence level was categorized into “Confident” and “Non-confident” as suggested by studies to facilitate data analysis and comparison. Of the 303 participants, 59.4% were “Non-confident” (95% C.I.: 53.8% to 65.0%) in providing palliative care on average. Among medical students, knowledge (p = 0.010) and attitude (p = 0.003) are significantly positively associated with the confidence to provide palliative care, while exposure to death of family/friends (p = 0.024) is negatively associated. This study begins an investigation on the research area in Hong Kong primarily. The confidence of local medical students should be enhanced to provide palliative care in their future. It thus highlights the importance of the medical curriculum and provides insights to remove barriers responsively to improve the overall confidence and the quality of palliative care.
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Kurnia TA, Trisyani Y, Prawesti A. The relationship between nurses' knowledge and self-confidence in implementing palliative care in an intensive care unit. Int J Palliat Nurs 2021; 26:183-190. [PMID: 32378490 DOI: 10.12968/ijpn.2020.26.4.183] [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
BACKGROUND This quantitative study aimed to analyse the relationship between knowledge and nurses' self-confidence (or self-efficacy) in applying palliative care (PC) in the intensive care unit (ICU). This study was a correlational study with a cross-sectional approach. The sampling technique used was total sampling, and the sample included all nurses who were actively working at the general hospital in Bandung, West Java, Indonesia, during the study. There were 127 people in total. Data were collected using questionnaires. The Pearson correlation test was used for bivariate analysis. The results of univariate analysis showed that the majority of respondents had high self-confidence but had less knowledge related to PC in the ICU. Based on the results of the bivariate analysis, there was a significant relationship between knowledge and self-confidence variables. The results showed that a high number of respondents had less knowledge in implementing PC in the ICU. Therefore, familiarisation sessions and training related to this are needed, focusing on nurses' beliefs in their abilities.
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Affiliation(s)
| | - Yanny Trisyani
- Faculty of Nursing, Padjadjaran University, Bandung, West Java, Indonesia
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Physicians' and Nurses' Knowledge in Palliative Care: Multidimensional Regression Models. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18095031. [PMID: 34068622 PMCID: PMC8126108 DOI: 10.3390/ijerph18095031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 05/06/2021] [Accepted: 05/07/2021] [Indexed: 11/17/2022]
Abstract
The increase in life expectancy has led to a growth in the number of people in need of palliative care. Health professionals must possess appropriate knowledge and skills. This study aimed to assess knowledge in palliative care through the Palliative Care Knowledge Test Spanish Version (PCKT-SV)®. A cross-sectional analytical study was conducted in 40 primary care health services. A total of 600 PCKT-SV questionnaires were distributed among health professionals; 561 of them (226 nurses and 335 physicians) were properly filled up. Sociodemographic information, education, and work experience were also recorded. A total of 34.41% of the nurses and 67.40% of the physicians showed good or excellent knowledge of palliative care. Physicians' scores for pain, dyspnea, and psychiatric disorders were higher than those of the nurses. Nurses scored significantly better in philosophy. Professionals with continuous training in palliative care showed a higher level of knowledge. Age and work experience of physicians and undergraduate training in nurses had significant weight in knowledge. Developing continuous training and enhancing undergraduate training in palliative care will lead to improved patient care at the end of life.
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Menekli T, Doğan R, Erce Ç, Toygar İ. Effect of educational intervention on nurses knowledge about palliative care: Quasi-experimental study. Nurse Educ Pract 2021; 51:102991. [PMID: 33610970 DOI: 10.1016/j.nepr.2021.102991] [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: 01/29/2020] [Revised: 02/04/2021] [Accepted: 02/06/2021] [Indexed: 10/22/2022]
Abstract
The aim of the study was to determine the level of knowledge of registered nurses about palliative care and to determine the effect of educational intervention on this level of knowledge in Turkey. The study was a quasi-experimental study and consists of 136 nurses. The study was conducted between April and June 2019 in a university hospital in Malatya, Turkey. Nurse are educated on the definition, history, and philosophy of palliative care, the responsibilities of palliative care nurses, symptom management, and end of life care. The education was applied in five sessions. Each session took approximately 40 min and sessions were conducted once a week. Data were collected before and after the education via nurse identification form developed by the research team and the Palliative Care Knowledge Test. It was determined that the nurses received 8.9 ± 1.1 out of 20 points before and 17.5 ± 1.9 points after the education. There was a statistically significant difference between the mean scores of nurses before and after training (p < 0.001). It was found that educational intervention has a large effect (Cohen's d = 5.540) on nurses' knowledge about palliative care. It was determined that educational intervention was an effective way to improve nurses' knowledge about palliative care.
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Affiliation(s)
- Tuğba Menekli
- Department of Nursing, Malatya Turgut Özal University, Faculty of Health Sciences, Malatya, Turkey
| | - Runida Doğan
- Department of Surgical Nursing, Inonu University, Faculty of Nursing, Malatya, Turkey
| | - Çiğdem Erce
- Palliative Care Unit, Malatya State Hospital, Malatya, Turkey
| | - İsmail Toygar
- Department of Internal Medicine Nursing, Ege University, Faculty of Nursing, İzmir, Turkey.
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Ioshimoto T, Shitara DI, do Prado GF, Pizzoni R, Sassi RH, de Gois AFT. Education is an important factor in end-of-life care: results from a survey of Brazilian physicians' attitudes and knowledge in end-of-life medicine. BMC MEDICAL EDUCATION 2020; 20:339. [PMID: 33008366 PMCID: PMC7531127 DOI: 10.1186/s12909-020-02253-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 09/23/2020] [Indexed: 06/08/2023]
Abstract
BACKGROUND According to the Latin America Association for palliative care, Brazil offers only 0.48 palliative care services per 1 million inhabitants. In 2012, no accredited physicians were working in palliative care, while only 1.1% of medical schools included palliative care education in their undergraduate curricula. As a reflection of the current scenario, little research about end-of-life care has been published so that studies addressing this subject in the Brazilian setting are crucial. METHODS A cross-sectional study study conducted with students applying for the medical residency of the Federal University of São Paulo were invited to voluntarily participate in an anonymous and self-administered questionnaire survey. The latter included demographic information, attitudes, prior training in end-of-life care, prior end-of-life care experience, the 20-item Palliative Care Knowledge Test (PCKT) and a consent term. RESULTS Of the 3086 subjects applying for residency, 2349 (76%) answered the survey, 2225 were eligible for analysis while 124 were excluded due to incomplete data. Although the majority (99,2%) thought it was important to have palliative care education in the medical curriculum, less than half of them (46,2%) reported having received no education on palliative care. The overall performance in the PCKT was poor, with a mean score of 10,79 (± 3). While philosophical questions were correctly answered (81,8% of correct answers), most participants lacked knowledge in symptom control (50,7% for pain, 57,3% for dyspnea, 52,2% for psychiatric problems and 43,4% for gastrointestinal problems). Doctors that had already concluded a prior residency program and the ones that had prior experience with terminal patients performed better in the PCKT (p < 0,001). The high-performance group (more than 50% of correct answers) had received more training in end-of-life care, showed more interest in learning more about the subject, had a better sense of preparedness, as well as a higher percentage of experience in caring for terminal patients (p < 0,001). CONCLUSIONS Our study showed that Brazilian physicians lack not only the knowledge, but also training in end-of-life medicine. Important factors to better knowledge in end-of-life care were prior training, previous contact with dying patients and prior medical residency. Corroborating the literature, for this group, training showed to be a key factor in overall in this area of knowledge. Therefore, Brazilian medical schools and residency programs should focus on improving palliative training, especially those involving contact with dying patients.
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Affiliation(s)
- Thais Ioshimoto
- Departamento de Medicina. Rua Pedro de Toledo, Universidade Federal de São Paulo (UNIFESP), 719, São Paulo, SP, Brazil
- Hospital Israelita Albert Einstein (HIAE), São Paulo, SP, Brazil
| | - Danielle Ioshimoto Shitara
- Departamento de Medicina. Rua Pedro de Toledo, Universidade Federal de São Paulo (UNIFESP), 719, São Paulo, SP, Brazil
| | - Gilmar Fernades do Prado
- Departamento de Medicina. Rua Pedro de Toledo, Universidade Federal de São Paulo (UNIFESP), 719, São Paulo, SP, Brazil
| | - Raymon Pizzoni
- Departamento de Medicina. Rua Pedro de Toledo, Universidade Federal de São Paulo (UNIFESP), 719, São Paulo, SP, Brazil.
| | - Rafael Hennemann Sassi
- Departamento de Medicina. Rua Pedro de Toledo, Universidade Federal de São Paulo (UNIFESP), 719, São Paulo, SP, Brazil
| | - Aécio Flávio Teixeira de Gois
- Departamento de Medicina. Rua Pedro de Toledo, Universidade Federal de São Paulo (UNIFESP), 719, São Paulo, SP, Brazil
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Lopez-Garcia M, Rubio L, Gomez-Garcia R, Sanchez-Sanchez F, Miyashita M, Medina-Abellan MD, Perez-Carceles MD. Palliative care knowledge test for nurses and physicians: validation and cross-cultural adaptation. BMJ Support Palliat Care 2020; 12:324-331. [DOI: 10.1136/bmjspcare-2019-002182] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 02/24/2020] [Accepted: 04/04/2020] [Indexed: 11/03/2022]
Abstract
BackgroundPalliative care knowledge is essential in primary healthcare due to the increasing number of patients who require attention in the final stage of their life. Health professionals (physicians and nurses) need to acquire specific knowledge and abilities to provide high-quality palliative care. The development of education programmes in palliative care is necessary. The Palliative Care Knowledge Test (PCKT) is a questionnaire that evaluates the basic knowledge about palliative care, but it has not been adapted into Spanish, and its effectiveness and utility for Spanish culture have not been analysed.ObjectiveThe aim of this study was to report the translation into Spanish and a psychometric analysis of the PCKT.MethodsThe questionnaire survey was validated with a group of 561 physicians and nurses. The PCKT Spanish Version (PCKT-SV) was obtained from a process, including translation, back translation and revision by experts and a pilot study. The content validity and reliability of the questionnaire were analysed.ResultsThe results showed internal consistency and reliability indexes similar to those obtained by the original version of PCKT.ConclusionThe PCKT-SV is a useful instrument for measuring Spanish-speaking physician and nurse knowledge of palliative care, and it is suitable to evaluate the effectiveness of training activities in palliative care.
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Wong KY, Li WTV, Yiu PY, Tong TK, Ching OH, Leung LY, Cheung TY, Chan SC, Law HY, Cheng CH. New Directions in Pediatric Palliative Care Education for Preclinical Medical and Nursing Students. MEDICAL SCIENCE EDUCATOR 2020; 30:445-455. [PMID: 34457688 PMCID: PMC8368940 DOI: 10.1007/s40670-020-00928-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVES Since insufficient education has partially contributed to challenges in providing pediatric palliative care (PPC), a cross-sectional questionnaire study was conducted to explore the knowledge, attitudes, and educational needs of preclinical medical and nursing students in Hong Kong. METHODS Pretested self-administered 44-item questionnaires with written informed consent were distributed to 241 medical and nursing students at Li Ka Shing Faculty of Medicine, the University of Hong Kong, between February and March 2019. This questionnaire covered eleven categories related to participants' knowledge of and attitudes towards PPC. A convenience sampling method was used. Data analysis was performed with descriptive statistics, chi-squared, and Fisher's exact test. RESULTS Only 38.3% of participants had heard of PPC before, but 73.5% advocated for its local commencement. A large number, with more in nursing, misunderstood fundamental palliative concepts and pain assessment methods. Many reported that undergraduate curricula should include PPC since they were not prepared to deal and cope with dying children. More medical students identified multidisciplinary approaches in PPC while less believed that they were mentally prepared to discuss death and dying. The majority indicated family as the final decision maker, even for teenage patients. Although a large proportion agreed that PPC should be delivered at home since the diagnosis of a life-limiting illness, only a few were aware of the suggested referral structure. CONCLUSIONS Most healthcare students were supportive of PPC despite their limited exposure. PPC education on palliative principles, pain management, multidisciplinary approaches, and emotional coping skills is needed and welcomed among students.
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Affiliation(s)
- Kan Yin Wong
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Wai Tak Victor Li
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Pui Yu Yiu
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Tsz Kiu Tong
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - On Hang Ching
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Lok Yin Leung
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Tsz Yau Cheung
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Sze Chai Chan
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Hoi Ying Law
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Cheuk Hei Cheng
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
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Towell-Barnard A, Coventry L, Foster L, Davis S, Twigg DE, Bharat C, Boston J. The psychometric validation of the quality practical experience (QPE) instruments (nurses and student nurse) to evaluate clinical supervision of undergraduate student nurses. Nurse Educ Pract 2020; 43:102697. [PMID: 31981971 DOI: 10.1016/j.nepr.2020.102697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 12/09/2019] [Accepted: 01/13/2020] [Indexed: 11/22/2022]
Abstract
It is important to evaluate stakeholder feedback regarding any change to a clinical supervision model to maintain quality. The Quality Practical Experience (QPE) instruments offer both the nurse on the ward involved with supervising student learning and the student nurse the opportunity to evaluate their satisfaction with the supervision model. This paper reports on the evaluation of the construct validity and the reliability of the QPE instruments measuring nurse and nursing student satisfaction with the clinical supervision model. Methodological design for the reliability and validation of a measuring instrument. The nurse and the student QPE instruments were tested with convenience samples of 488 nurses and 1116 student nurses, respectively. Psychometric tests included internal reliability, test-retest reliability and factor analyses. Exploratory factor analysis for both QPEs supported a three-factor solution; the nurse QPE explained 48% and student nurse QPE 45% of variance. Internal reliability and test-retest reliability were stable over time (nurse QPE ICC = 0.82; student nurse QPE ICC = 0.71). Both QPE instruments were found to be valid and reliable. Feedback from all stakeholders involved with supporting student nurses during clinical placement is important.
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Affiliation(s)
- Amanda Towell-Barnard
- School of Nursing & Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia, 6027, Australia; Sir Charles Gairdner Hospital Centre for Nursing Research, Hospital Avenue, Nedlands, Western Australia, 6009, Australia.
| | - Linda Coventry
- School of Nursing & Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia, 6027, Australia; Sir Charles Gairdner Hospital Centre for Nursing Research, Hospital Avenue, Nedlands, Western Australia, 6009, Australia.
| | - L Foster
- Sir Charles Gairdner Hospital Centre for Nursing Research, Hospital Avenue, Nedlands, Western Australia, 6009, Australia.
| | - Susan Davis
- Sir Charles Gairdner Hospital Centre for Nursing Research, Hospital Avenue, Nedlands, Western Australia, 6009, Australia.
| | - Dianne E Twigg
- School of Nursing & Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia, 6027, Australia; Sir Charles Gairdner Hospital Centre for Nursing Research, Hospital Avenue, Nedlands, Western Australia, 6009, Australia.
| | - Chrianna Bharat
- Sir Charles Gairdner Hospital Centre for Nursing Research, Hospital Avenue, Nedlands, Western Australia, 6009, Australia; National Drug and Alcohol Research Centre (UNSW), Australia.
| | - J Boston
- School of Nursing & Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia, 6027, Australia; Sir Charles Gairdner Hospital Centre for Nursing Research, Hospital Avenue, Nedlands, Western Australia, 6009, Australia.
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Soikkeli‐Jalonen A, Stolt M, Hupli M, Lemetti T, Kennedy C, Kydd A, Haavisto E. Instruments for assessing nurses’ palliative care knowledge and skills in specialised care setting: An integrative review. J Clin Nurs 2020; 29:736-757. [DOI: 10.1111/jocn.15146] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 10/12/2019] [Accepted: 11/24/2019] [Indexed: 12/29/2022]
Affiliation(s)
| | - Minna Stolt
- Department of Nursing Science Finland and Researcher Turku University Hospital University of Turku Turku Finland
| | - Maija Hupli
- Department of Nursing Science University of Turku Turku Finland
| | - Terhi Lemetti
- Department of Nursing Science Helsinki University Hospital University of Turku Turku Finland
| | - Catriona Kennedy
- School of Nursing and Midwifery Robert Gordon University Aberdeen UK
- Department of Nursing and Midwifery The University of Limerick Limerick Ireland
| | - Angela Kydd
- School of Nursing and Midwifery Robert Gordon University Aberdeen UK
| | - Elina Haavisto
- Department of Nursing Science Satakunta Central Hospital University of Turku Turku Finland
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Thiel M, Harden K, Brazier LJ, Marks AD, Smith MA. Evaluation Tools for Interdisciplinary Palliative Care Learning Experiences: A Literature Review. J Palliat Med 2019; 23:698-702. [PMID: 31618093 DOI: 10.1089/jpm.2019.0394] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: An interdisciplinary palliative care team began exploring evaluation tools used to assess changes in the knowledge, skills, and attitudes of learners participating in clinical learning experiences on an interdisciplinary palliative care consult service. This article will review existing evaluation tools, examine the themes that emerge, discuss their strengths and limitations, and make recommendations for continued development in the field. Methods and Findings: A literature search was performed using the MEDLINE database. Search terms included combinations of the following: interdisciplinary education, assessment/evaluation, and palliative care or palliative care assessment/test. Four hundred eighty-seven articles were captured during the initial search. Articles that focused on student readiness for interdisciplinary education and team self-assessments of current interdisciplinary collaboration practices were excluded. Nine articles were included in the review. Evaluation tools varied in terms of learner type, assessment type, and frequency. No tool was comprehensive in the assessment of knowledge, skills, and attitudes or truly interdisciplinary. Conclusions: There is a lack of comprehensive and interdisciplinary evaluation tools in the published literature. Further research should be conducted to develop a tool that meets the needs of learners in clinical experiences within an interdisciplinary service.
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Affiliation(s)
- Meghan Thiel
- Department of Social Work, University of Michigan, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Karen Harden
- University of Michigan School of Nursing, Ann Arbor, Michigan, USA
| | - Lori-Jene Brazier
- Department of Spiritual Care, University of Michigan, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Adam D Marks
- Department of Internal Medicine, Division of Geriatric and Palliative Medicine, University of Michigan, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Michael A Smith
- College of Pharmacy, University of Michigan, Ann Arbor, Michigan, USA
- Department of Pharmacy Services, University of Michigan, Michigan Medicine, Ann Arbor, Michigan, USA
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Abstract
This study examines the experiences and beliefs of university students which affect attitudes toward palliative care. A total of 322 students responded to a survey on palliative care and end-of-life attitudes. Almost 40% of the students reported not having enough knowledge about options at the end of life. Results of multiple regression indicate students who have more negative attitudes toward palliative care did not believe in end-of-life care planning. Female students and those who had a family member or friend who used palliative care had more positive attitudes toward palliative care. Understanding student perceptions of palliative care allows for developing curriculum sensitive to learners' needs and addressing misconceptions.
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Affiliation(s)
- Helen B Miltiades
- Gerontology Program, College of Health and Human Services, California State University, Fresno, CA, USA
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Vu HTT, Nguyen LH, Nguyen TX, Nguyen TTH, Nguyen TN, Nguyen HTT, Nguyen AT, Pham T, Tat Nguyen C, Tran BX, Latkin CA, Ho CSH, Ho RCM. Knowledge and Attitude Toward Geriatric Palliative Care among Health Professionals in Vietnam. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16152656. [PMID: 31349576 PMCID: PMC6696323 DOI: 10.3390/ijerph16152656] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 07/17/2019] [Accepted: 07/22/2019] [Indexed: 11/25/2022]
Abstract
This study assessed the knowledge and attitude toward palliative care for the elderly among health professionals in a tertiary geriatric hospital in Vietnam and explored their determinants. Cross-sectional data were obtained on 161 geriatric health professionals at the National Geriatric Hospital. Modified-Palliative Care Knowledge Test and Frommelt Attitudes Toward Care of the Dying instruments were used to measure knowledge and attitude toward geriatric palliative care. As a result, 40.5% physicians and 74.2% nurses showed insufficient knowledge about geriatric palliative care (p < 0.05). The lowest score was for dyspnea, following by gastrointestinal and pain problems. No significant difference was found regarding the attitude between physicians and nurses (p > 0.05). Health professional category, age, and years of experience were found to be associated with knowledge about palliative care. Meanwhile, only knowledge score had correlations with total attitude score (Coef. = 0.2; 95%CI = 0.1–0.3), attitude toward patients (Coef. = 0.1; 95%CI = 0.0–0.1) and toward patients’ family (Coef. = 0.1; 95%CI = 0.0–0.1). This study highlights a significant knowledge gap and preferable attitude toward palliative care for the elderly among physicians and nurses in the geriatric hospital. Intensive training about geriatric palliative care, focusing on pain, dyspnea and gastrointestinal issue management, should be performed to ensure the quality of palliative care services, especially in nurses.
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Affiliation(s)
- Huyen Thi Thanh Vu
- Gerontology department, Hanoi Medical University, Hanoi 100000, Vietnam.
- Scientific Research Department, National Geriatric Hospital, Hanoi 100000, Vietnam.
| | - Long Hoang Nguyen
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 770000, Vietnam
| | - Thanh Xuan Nguyen
- Gerontology department, Hanoi Medical University, Hanoi 100000, Vietnam
- Scientific Research Department, National Geriatric Hospital, Hanoi 100000, Vietnam
- Dinh Tien Hoang Institute of Medicine, Hanoi 100000, Vietnam
| | - Thu Thi Hoai Nguyen
- Gerontology department, Hanoi Medical University, Hanoi 100000, Vietnam
- Scientific Research Department, National Geriatric Hospital, Hanoi 100000, Vietnam
| | - Tam Ngoc Nguyen
- Gerontology department, Hanoi Medical University, Hanoi 100000, Vietnam
- Scientific Research Department, National Geriatric Hospital, Hanoi 100000, Vietnam
| | - Huong Thi Thu Nguyen
- Gerontology department, Hanoi Medical University, Hanoi 100000, Vietnam
- Scientific Research Department, National Geriatric Hospital, Hanoi 100000, Vietnam
| | - Anh Trung Nguyen
- Gerontology department, Hanoi Medical University, Hanoi 100000, Vietnam
- Scientific Research Department, National Geriatric Hospital, Hanoi 100000, Vietnam
| | - Thang Pham
- Gerontology department, Hanoi Medical University, Hanoi 100000, Vietnam
- Scientific Research Department, National Geriatric Hospital, Hanoi 100000, Vietnam
| | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam
| | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Carl A Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Cyrus S H Ho
- Department of Psychological Medicine, National University Hospital, Singapore 119074, Singapore
| | - Roger C M Ho
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 770000, Vietnam
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore 119077, Singapore
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Al-Ansari AM, Suroor SN, AboSerea SM, Abd-El-Gawad WM. Development of palliative care attitude and knowledge (PCAK) questionnaire for physicians in Kuwait. BMC Palliat Care 2019; 18:49. [PMID: 31170968 PMCID: PMC6555752 DOI: 10.1186/s12904-019-0430-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 05/20/2019] [Indexed: 01/01/2023] Open
Abstract
Background Over the past five decades, palliative care has changed from helping patients at the end of life into a highly dedicated service focused on delivering supportive care to patients with life-limiting illnesses throughout the disease trajectory. To date there is no common agreement on universally applicable measurement tool to know the areas of weakness in physicians’ understanding of palliative care and identifying misconceptions about palliative care. This paper describes the development of a reliable and valid questionnaire to provide a measure of the attitude and knowledge of physicians toward palliative care (PCAK). Methods Item pool was generated paying particular attention to content and face validity. The initial version of the questionnaire was piloted and assessed based on psychometric criteria. Items which did not reach acceptable validity were excluded, and the final 37 item version was administered to two groups differing in their palliative care attitude and knowledge on two occasions to assess the construct validity and test-retest reliability. Two hundred thirty two physicians working in primary care clinics and general hospitals completed the questionnaire at the piloting stage. The final version (PCAK) was administered to 35 oncologists and 76 physicians. SPSS v20 was used for statistical analysis. Results Of the Pilot study, 20 items were excluded because didn’t meet the criteria for item difficulty and discrimination. Item-to-total-score correlations (r) was ranging from 0.347 up to 0.806. Internal consistency (Cronbach’s alpha) was high ranging from 0.636 to 0.824. While testing the final PCAK, oncologist scored consistently higher than the other physicians on all sections of the questionnaire (P < 0.001) suggesting good construct validity. Test to retest reliability for each section was very high, ranging from 0.879 to 0.97 and the overall reliability was 0.95. The internal consistency reliability of each section was very good ranging from 0.681 ± 0.893. Conclusion The findings demonstrate that PCAK meets psychometric criteria for reliability and construct validity. It provides a useful scale to assess the attitude and knowledge of physicians about palliative care helping in planning of educational programs for physicians. Electronic supplementary material The online version of this article (10.1186/s12904-019-0430-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | | | - Wafaa Mostafa Abd-El-Gawad
- Geriatrics and Gerontology department, Faculty of Medicine, Ain Shams University, Al- Abbasseya, Cairo, Egypt.
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Developing a Measure of End-of-Life Care Nursing Knowledge for Japanese Geriatric Nurses. J Hosp Palliat Nurs 2019; 21:E1-E9. [PMID: 30893287 DOI: 10.1097/njh.0000000000000532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study developed an end-of-life (EOL) care nursing knowledge scale for Japanese geriatric nurses (ELNKS-JG) to measure nurse knowledge of EOL care for older adults. It also was used to evaluate the quality of The End-of-Life Nursing Education Consortium-Japan Geriatric. Participants were 1168 nurses employed in 32 institutions across Japan. The items of our measure were developed to cover 8 important topics: principles of EOL care for older adults; pain management; symptom management; ethics of care; cultural and spiritual considerations; communication; loss, grief, and bereavement; and caring for final days. The measure included 51 items with an overall Cronbach α coefficient of 0.87 and an intraclass correlation coefficient of 0.81. Our measure, the ELNKS-JG, was confirmed to have good internal consistency, test-retest reliability, content validity, and known-groups validity. This scale's items included knowledge about noncancerous diseases, physical changes due to aging, family care, and multidisciplinary collaboration. The ELNKS-JG comprehensively measures a nurse's knowledge of EOL care for older adults in any EOL setting. Furthermore, this scale can evaluate educational programs aimed at improving care quality and encouraging related activities in facilities that provide EOL care.
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Mosich V, Sellner-Pogány T, Wallner J. [PKT - Palliative competence test for physicians : Design and validation of a questionnaire to assess knowledge and specific self-efficacy expectations of physicians in palliative care]. Schmerz 2018; 31:375-382. [PMID: 27975118 DOI: 10.1007/s00482-016-0180-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Providing end of life care for dying patients and those with life-threatening diseases is one of the core competences of physician. During the course of training all physicians should develop a sharpened perception of symptoms and acquire competence in the relief and therapy of pain. OBJECTIVES The Hospital of Saint John of God in Vienna, Austria, provides an educational program for residents concerning end of life care. Treatment of pain is one of the major topics. A questionnaire (PKT) was designed in order to evaluate the efficiency of this program. MATERIAL AND METHODS The Japanese PEACE questionnaire for assessing palliative knowledge of physicians was translated into German and the items checking specific self-efficacy expectations in palliative care in the Bonn palliative knowledge test (Bonner Palliativwissenstests) were transformed into physician duties. The new combination of 52 items was validated by testing groups of physicians with different levels of palliative education and experience. RESULTS The 37 physicians who had received palliative education scored better in the knowledge section than the 46 without palliative education: 21 vs. 16 correct answers out of 28 (p < 0.001). In these two groups we also found a differences in self-efficacy expectations in palliative care: 46 vs. 35 points out of 54 (p < 0.001). Having worked in a specialized palliative setting (n = 33) was associated with higher scores in palliative knowledge 23 vs. 16 points (p < 0.001) as well as in self-efficacy expectations 47 vs. 35 (p < 0.001). CONCLUSION The PKT is a German questionnaire that was validated to assess the efficiency of palliative education for physicians.
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Affiliation(s)
- V Mosich
- Krankenhaus der Barmherzigen Brüder Wien, Johannes-von-Gott-Platz 1, 1020, Wien, Österreich.
| | | | - J Wallner
- Krankenhaus der Barmherzigen Brüder Wien, Johannes-von-Gott-Platz 1, 1020, Wien, Österreich
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Nakazawa Y, Kato M, Miyashita M, Morita T, Kizawa Y. Changes in Nurses' Knowledge, Difficulties, and Self-reported Practices Toward Palliative Care for Cancer Patients in Japan: An Analysis of Two Nationwide Representative Surveys in 2008 and 2015. J Pain Symptom Manage 2018; 55:402-412. [PMID: 28919540 DOI: 10.1016/j.jpainsymman.2017.08.034] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 08/30/2017] [Accepted: 08/30/2017] [Indexed: 10/18/2022]
Abstract
CONTEXT The Cancer Control Act was passed in Japan in 2007, and various additional programs on palliative care have been implemented to improve quality of life and relieve pain and suffering in patients with cancer. However, how clinical settings have changed remains unclear. OBJECTIVES The primary aim of the present study was to determine changes in nurses' palliative care knowledge, difficulties, and self-reported practices between 2008 and 2015. METHODS This study was an analysis of two nationwide observational studies from 2008 to 2015. We conducted two questionnaire surveys for representative samples of nurses in designated cancer hospitals, community hospitals, and district nurse services. The measurements used the Palliative Care Knowledge Test (PCKT, range 1-100), the Palliative Care Difficulties Scale (PCDS, range 1-5), and the Palliative Care Self-Reported Practice Scale (PCPS, range 1-5). Comparisons were made using the nonpaired Student t-test and a multivariate linear regression model using two cohorts. RESULTS We analyzed survey results for 2707 nurses in 2008 and 3649 nurses in 2015. Significant improvements were seen in PCKT, PCDS, and PCPS total scores for nurses in every work location over the seven-year study period, with PCKT total scores of 53 vs. 65 (P < 0.001; effect size = 0.60), 47 vs. 55 (P < 0.001; effect size = 0.40), and 52 vs. 55 (P = 0.118; effect size = 0.13), PCDS total scores of 3.0 vs. 2.5 (P < 0.001; effect size = 0.76), 3.4 vs. 2.8 (P < 0.001, effect size = 0.91), and 3.2 vs. 2.9 (P < 0.001; effect size = 0.53), and PCPS total scores of 3.7 vs. 4.0 (P < 0.001; effect size = 0.13), 3.5 vs. 3.8 (P < 0.001; effect size = 0.42), and 3.8 vs. 4.0 (P < 0.011; effect size = 0.21) in designated cancer hospitals, community hospitals, and district nurse services, respectively. CONCLUSION Nurses' palliative care knowledge, difficulties, and self-reported practices improved over the seven-year study period, especially in terms of expert support in designated cancer hospitals and knowledge among nurses in designated cancer hospitals.
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Affiliation(s)
- Yoko Nakazawa
- Division of Medical Support and Partnership, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan; Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
| | - Masashi Kato
- Division of Medical Support and Partnership, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
| | - Mitsunori Miyashita
- Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Tatsuya Morita
- Department of Palliative and Supportive Care, Palliative Care Team, and Seirei Hospice, Seirei Mikatahara General Hospital, Japan
| | - Yoshiyuki Kizawa
- Division of Palliative Medicine, Department of Internal Related, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
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Arahata T, Miyashita M, Takenouchi S, Tamura K, Kizawa Y. Development of an Instrument for Evaluating Nurses' Knowledge and Attitude Toward End-of-Life Care. J Hosp Palliat Nurs 2018; 20:55-62. [DOI: 10.1097/njh.0000000000000393] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Krautheim V, Schmitz A, Benze G, Standl T, Schiessl C, Waldeyer W, Hapfelmeier A, Kochs EF, Schneider G, Wagner KJ, Schulz CM. Self-confidence and knowledge of German ICU physicians in palliative care - a multicentre prospective study. BMC Palliat Care 2017; 16:57. [PMID: 29166887 PMCID: PMC5700543 DOI: 10.1186/s12904-017-0244-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 11/14/2017] [Indexed: 11/24/2022] Open
Abstract
Background Little is known about ICU physicians’ self-confidence and knowledge related to palliative care. Our objective was to investigate self-confidence and knowledge of German ICU physicians related to palliative care, and to assess the impact of work experience, gender, specialty and additional certifications in pain or palliative medicine. Methods In a multicentre prospective observational study ICU physicians of ten hospitals were asked to rate their self-confidence and to complete a multiple choice questionnaire for the assessment of knowledge. Beyond descriptive statistics and non-parametric tests for group comparisons, linear regression analysis was used to assess the impact of independent variable on self-confidence and knowledge. Spearman‘s rank test was calculated. Results 55% of answers in the knowledge test were correct and more than half of the participants rated themselves as “rather confident” or “confident”. Linear regression analysis revealed that an additional certificate in either pain or palliative medicine significantly increased both knowledge and self-confidence, but only 15 out of 137 participants had at least one of those certificates. Relation between self-confidence and the results of the knowledge test was weak (r = 0.270 in female) and very weak (r = −0.007 in male). Conclusions Although the questionnaire needs improvement according to the item analysis, it appears that, with respect to palliative care, ICU Physicians’ self-confidence is not related to their knowledge. An additional certificate in either pain or palliative medicine was positively correlated to both self-confidence and knowledge. However, only a minority of the participants were qualified through such a certificate. Electronic supplementary material The online version of this article (10.1186/s12904-017-0244-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Veronika Krautheim
- Klinik für Anaesthesiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, Munich, Germany
| | - Andrea Schmitz
- Interdisziplinäres Zentrum für Palliativmedizin, Medizinische Fakultät Heinrich Heine Universität Düsseldorf, Düsseldorf, Germany
| | - Gesine Benze
- Klinik für Palliativmedizin, Universitätsmedizin Göttingen, Göttingen, Germany
| | - Thomas Standl
- Klinik für Anaesthesiologie, Operative Intensiv- und Palliativmedizin, Städtisches Klinikum Solingen, Solingen, Germany
| | | | - Wolfgang Waldeyer
- Klinik für Anaesthesiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, Munich, Germany
| | - Alexander Hapfelmeier
- Institut für Medizinische Statistik und Epidemiologie, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Eberhard F Kochs
- Klinik für Anaesthesiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, Munich, Germany
| | - Gerhard Schneider
- Klinik für Anaesthesiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, Munich, Germany.,Klinik für Anaesthesiologie, Helios Universitätsklinikum Wuppertal, Wuppertal, Germany
| | - Klaus J Wagner
- Klinik für Anaesthesiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, Munich, Germany
| | - Christian M Schulz
- Klinik für Anaesthesiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, Munich, Germany.
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Nakazawa Y, Yamamoto R, Kato M, Miyashita M, Kizawa Y, Morita T. Improved knowledge of and difficulties in palliative care among physicians during 2008 and 2015 in Japan: Association with a nationwide palliative care education program. Cancer 2017; 124:626-635. [DOI: 10.1002/cncr.31071] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 09/10/2017] [Accepted: 09/14/2017] [Indexed: 11/10/2022]
Affiliation(s)
- Yoko Nakazawa
- Division of Medical Support and Partnership; Center for Cancer Control and Information Services, National Cancer Center; Tokyo Japan
- Department of Palliative Nursing, Health Sciences; Tohoku University Graduate School of Medicine; Miyagi Japan
| | - Ryo Yamamoto
- Department of Palliative Medicine; Saku Central Hospital Advanced Care Center; Nagano Japan
| | - Masashi Kato
- Division of Medical Support and Partnership; Center for Cancer Control and Information Services, National Cancer Center; Tokyo Japan
| | - Mitsunori Miyashita
- Department of Palliative Nursing, Health Sciences; Tohoku University Graduate School of Medicine; Miyagi Japan
| | - Yoshiyuki Kizawa
- Division of Palliative Medicine; Kobe University Hospital, Kobe University School of Medicine; Hyogo Japan
| | - Tatsuya Morita
- Department of Palliative and Supportive Care; Palliative Care Team, and Seirei Hospice, Seirei Mikatahara General Hospital; Shizuoka Japan
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Patten YA, Ojeda MM, Lindgren CL. An assessment of palliative care beliefs and knowledge: the healthcare provider's perspective. Int J Palliat Nurs 2016; 22:436-443. [DOI: 10.12968/ijpn.2016.22.9.436] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Yvonne A. Patten
- Baptist Health of South Florida, Palliative Clinical Educator, FL
| | - Maria M. Ojeda
- Baptist Health of South Florida, Homestead Hospital Nurse Scientist, FL
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Shimizu M, Nishimura M, Ishii Y, Kuramochi M, Kakuta N, Miyashita M. Development and validation of scales for attitudes, self-reported practices, difficulties and knowledge among home care nurses providing palliative care. Eur J Oncol Nurs 2016; 22:8-22. [DOI: 10.1016/j.ejon.2016.02.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 02/08/2016] [Accepted: 02/11/2016] [Indexed: 11/29/2022]
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40
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Gu X, Cheng W. Chinese oncologists' knowledge, attitudes and practice towards palliative care and end of life issues. BMC MEDICAL EDUCATION 2016; 16:149. [PMID: 27188161 PMCID: PMC4870734 DOI: 10.1186/s12909-016-0668-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 05/12/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Oncologists` knowledge and attitudes to palliative care (PC) and end of life (EOF) should be highlighted in order to give them effective education. This study is intended to provide a descriptive analysis of oncologists' knowledge, attitudes and practice toward PC and EOF issues in Mainland China. METHODS The questionnaire survey with 24 items investigating oncologists' demographic information, knowledge and attitudes toward PC and EOF issues was conducted among Chinese Oncology clinicians. RESULTS The participants had a mean of 10.10 years practice in oncology. 43 (31.2%) participants had received PC education. 73.9% of the participants believed that PC should be considered when patients were not suitable to take surgery, radiotherapy, chemotherapy and other anti-cancer therapies. 72.5% of the participants believed that early PC integration can improve the quality of life in patients. Most of the oncology clinicians (73.9%) believed that the doctor-in-charge was the appropriate person to inform patients of the diagnosis. However, only 11 participants chose to inform the diagnosis and disease prognosis to the patients, whereas 39.9% of the participants chose to disclose it to Family/Caregivers first. Besides, Chinese oncologists were obviously unfamiliar with the concepts of euthanasia and related issues. CONCLUSIONS This study indicated the insufficient knowledge toward PC and related issues of the Chinese oncologists. More attention should be paid on the education of PC among Oncologists in Mainland China.
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Affiliation(s)
- Xiaoli Gu
- Department of Integrated Therapy, Fudan University Shanghai Cancer Center, #270, Dong An Road, Shanghai, People's Republic of China
| | - Wenwu Cheng
- Department of Integrated Therapy, Fudan University Shanghai Cancer Center, #270, Dong An Road, Shanghai, People's Republic of China.
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
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Nakazawa Y, Kato M, Yoshida S, Miyashita M, Morita T, Kizawa Y. Population-Based Quality Indicators for Palliative Care Programs for Cancer Patients in Japan: A Delphi Study. J Pain Symptom Manage 2016; 51:652-661. [PMID: 26674609 DOI: 10.1016/j.jpainsymman.2015.11.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 11/12/2015] [Accepted: 11/13/2015] [Indexed: 11/27/2022]
Abstract
CONTEXT Cancer control programs in Japan strongly endorse the dissemination of palliative care, and various policy measures have been implemented; however, indicators for evaluating palliative care programs have not been defined. OBJECTIVES The aim of this study was to develop quality indicators for palliative care programs taking a population-based view to meet the challenge of cancer control in the Japanese population. METHODS We conducted a modified Delphi survey. The panelists rated a list of indicators over three iterative rounds according to four perspectives: 1) consistency with the policy target, 2) relevance to the problem, 3) clarity of expression, and 4) measurement feasibility. The criterion for adoption of candidate indicators was set at a total mean score of 7 or more. Finally, the most relevant and important indicators were selected; consensus was defined by agreement of panelists at the panel meeting. RESULTS Among 49 panelists surveyed, 48 (98%), 39 (80%), and 43 (88%) responded over the three rounds, respectively. The 15 indicators were identified from 11 domains: patient-reported quality of life, bereaved family-reported quality at the end of life, family care, place of death, bereaved family-reported quality of palliative care, specialized palliative care services, opioid utilization, public perceptions about palliative care, palliative care education to primary care providers, specialist palliative care services, and regional palliative care. CONCLUSION Comprehensive quality indicators for palliative care programs were identified. The indicators are currently being used, and the feasibility of measuring change over time will be examined. It is expected that the indicators will be used effectively in the future. It is important to evaluate outcomes of the program, to improve weaknesses, improve outcomes, and promote the welfare of cancer patients.
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Affiliation(s)
- Yoko Nakazawa
- Division of Medical Support and Partnership, Center for Cancer Control and Information Services, National Cancer Center, Chuo-ku, Tokyo, Japan.
| | - Masahi Kato
- Division of Medical Support and Partnership, Center for Cancer Control and Information Services, National Cancer Center, Chuo-ku, Tokyo, Japan
| | - Saran Yoshida
- Division of Medical Support and Partnership, Center for Cancer Control and Information Services, National Cancer Center, Chuo-ku, Tokyo, Japan
| | - Mitsunori Miyashita
- Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Tatsuya Morita
- Department of Palliative and Supportive Care, Palliative Care Team, and Seirei Hospice, Seirei Mikatahara General Hospital, Hamamatsu, Shizuoka, Japan
| | - Yoshiyuki Kizawa
- Division of Palliative Medicine, Department of Internal Related, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
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Myotoku M, Omotani S, Hatsuda Y, Konishi H, Hirotani Y. Enhanced Understanding of the Levels of Palliative Care in Pharmacy Students Through Participating in Clinical Training in Hospitals. J Pharm Pract 2016; 30:313-317. [PMID: 26994088 DOI: 10.1177/0897190016637528] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE A palliative care knowledge survey was conducted involving pharmacy students to examine their perceived usefulness and the educational effect of clinical training in hospitals. METHODS A questionnaire sheet was distributed to fifth-year pharmacy students before and after clinical training. The questionnaire consisted of questions to clarify the details of palliative care-related training in hospitals and students' knowledge of such care. The respondents were divided into 2 groups: those who participated in palliative care team (PCT) rounds (group A: 57) and those who did not (group B: 57). RESULTS The mean total correct answer rate markedly increased after training in group A, from 37.9 to 47.1% (P < .01). Such an increase was also observed in the domains of philosophy and pain in this group ( P < .01). In contrast, group B did not show differences in the mean correct answer rate between before and after training; there was no significant increase in the rate in any domain. CONCLUSION Pharmacy students' knowledge was enhanced by participating in the PCT, confirming the usefulness of such participation during training as part of palliative care education.
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Affiliation(s)
- Michiaki Myotoku
- 1 Faculty of Pharmacy, Laboratory of Practical Pharmacy and Pharmceutical Care, Osaka Ohtani University, Tondabayashi, Osaka, Japan
| | - Sachiko Omotani
- 1 Faculty of Pharmacy, Laboratory of Practical Pharmacy and Pharmceutical Care, Osaka Ohtani University, Tondabayashi, Osaka, Japan
| | - Yasutoshi Hatsuda
- 1 Faculty of Pharmacy, Laboratory of Practical Pharmacy and Pharmceutical Care, Osaka Ohtani University, Tondabayashi, Osaka, Japan
| | - Hiroki Konishi
- 2 Faculty of Pharmacy, Laboratory of Clinical Pharmacy and Therapeutics, Osaka Ohtani University, Tondabayashi, Osaka, Japan
| | - Yoshihiko Hirotani
- 3 Faculty of Pharmacy, Laboratory of Clinical Pharmaceutics, Osaka Ohtani University, Tondabayashi, Osaka, Japan
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Karacsony S, Chang E, Johnson A, Good A, Edenborough M. Measuring nursing assistants' knowledge, skills and attitudes in a palliative approach: A literature review. NURSE EDUCATION TODAY 2015; 35:1232-1239. [PMID: 26043658 DOI: 10.1016/j.nedt.2015.05.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 05/03/2015] [Accepted: 05/14/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND Nursing assistants are the largest aged care workforce providing care to older people in residential aged care facilities. Although studies have focused on their training and development needs when providing a palliative approach, a valid and reliable instrument to evaluate their knowledge, skills and attitudes is required. AIMS To examine what instruments have been used to evaluate nursing assistants' knowledge of, skills in and attitudes towards a palliative approach in residential aged care facilities, critically evaluate development processes, and discuss the strengths and limitations of existing instruments for this population. METHODS CINAHL, the Cochrane Library, ERIC, MEDLINE, PubMed, Scopus and Web of Science were searched using key words. Selected articles were published in English in the period 2004-2014 and included instruments which evaluated nursing assistants and a palliative approach. RESULTS Ten studies using seven instruments met the inclusion criteria. One of these instruments measured nursing assistants' level of comfort in providing end-of-life care. The six remaining instruments measured palliative care knowledge, palliative care practice, self-efficacy, knowledge and attitudes towards people with advanced dementia, beliefs and attitudes to death, dying, palliative and interdisciplinary care across the aged care workforce. CONCLUSION Seven instruments have been used to evaluate nursing assistants' knowledge, skills and attitudes in a palliative approach. Instrument design and recommended psychometric processes for development limit specificity and usefulness of these instruments for nursing assistants' scope of practice. Adhering to recommended psychometric processes will increase the validity and reliability of an instrument tailored to this population and a palliative approach.
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Affiliation(s)
- Sara Karacsony
- School of Nursing and Midwifery, University of Western Sydney, Locked Bag, 1797, Penrith, NSW 2751, Australia.
| | - Esther Chang
- School of Nursing and Midwifery, University of Western Sydney, Locked Bag, 1797, Penrith, NSW 2751, Australia.
| | - Amanda Johnson
- School of Nursing and Midwifery, University of Western Sydney, Locked Bag, 1797, Penrith, NSW 2751, Australia.
| | - Anthony Good
- Centre for Complementary Medicine Research (CompleMED), University of Western Sydney, Locked Bag, 1797, Penrith, NSW 2751, Australia.
| | - Michel Edenborough
- School of Social Sciences and Psychology, University of Western Sydney, Locked Bag, 1797, Penrith NSW 2751, Australia.
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Von Ah D, Jansen CE, Allen DH. Evidence-based interventions for cancer- and treatment-related cognitive impairment. Clin J Oncol Nurs 2015; 18 Suppl:17-25. [PMID: 25427606 DOI: 10.1188/14.cjon.s3.17-25] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cancer- and cancer treatment-related cognitive impairment is a common, bothersome, and potentially debilitating symptom incurred by cancer survivors. Cognitive impairment has a significant impact on patients' day-to-day functioning and quality of life, but it remains under-recognized and undertreated. This article, which is an update from the initial Oncology Nursing Society Putting Evidence Into Practice for cancer- and cancer treatment-related cognitive impairment, provides a comprehensive critical review and summary of the evidence regarding interventions addressing cognitive impairment for cancer survivors. This article examines the effectiveness of interventions focused on cancer- and cancer treatment-related cognitive impairment, makes recommendations for practice, and identifies gaps in knowledge and areas for further research.
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Affiliation(s)
- Diane Von Ah
- Robert Wood Johnson Foundation Nurse Faculty Scholar Alumna in the School of Nursing, Indiana University, Indianapolis
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Kizawa Y, Morita T, Miyashita M, Shinjo T, Yamagishi A, Suzuki S, Kinoshita H, Shirahige Y, Yamaguchi T, Eguchi K. Improvements in Physicians' Knowledge, Difficulties, and Self-Reported Practice After a Regional Palliative Care Program. J Pain Symptom Manage 2015; 50:232-40. [PMID: 25847849 DOI: 10.1016/j.jpainsymman.2015.02.025] [Citation(s) in RCA: 9] [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: 05/06/2014] [Revised: 02/12/2015] [Accepted: 02/19/2015] [Indexed: 10/23/2022]
Abstract
CONTEXT Although several studies have explored the effects of regional palliative care programs, no studies have investigated the changes in physician-related outcomes. OBJECTIVES The primary aims of this study were to: (1) clarify the changes in knowledge, difficulties, and self-reported practice of physicians before and after the intervention, (2) explore the potential associations between the level of physicians' participation in the program and outcomes, and (3) identify the reasons and characteristics of physicians who did not participate in the program. METHODS As a part of the regional palliative care intervention trial, questionnaires were sent to physicians recruited consecutively to obtain a representative sample of each region. Physician-reported knowledge, difficulty of palliative care, and self-perceived practice were measured using the Palliative Care Knowledge Test, Palliative Care Difficulty Scale, and Palliative Care Self-Reported Practice Scale (PCPS), respectively. The level of their involvement in the program and reason for non-participation were ascertained from self-reported questionnaires. RESULTS The number of eligible physicians identified was 1870 in pre-intervention and 1763 in post-intervention surveys, and we obtained 911 and 706 responses. Total scores of the Palliative Care Knowledge Test, PCPS, and PCPS were significantly improved after the intervention, with effect sizes of 0.30, 0.52, and 0.17, respectively. Physicians who participated in workshops more frequently were significantly more likely to have better knowledge, less difficulties, and better self-reported practice. CONCLUSION After the regional palliative care program, there were marked improvements in physicians' knowledge and difficulties. These improvements were associated with the level of physicians' participation in the program.
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Affiliation(s)
- Yoshiyuki Kizawa
- Department of Palliative Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.
| | - Tatsuya Morita
- Department of Palliative and Supportive Care, Palliative Care Team, and Seirei Hospice, Seirei Mikatahara General Hospital, Hamamatsu, Shizuoka, Japan
| | - Mitsunori Miyashita
- Division of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | | | - Akemi Yamagishi
- Department of Community Health Care, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Satoshi Suzuki
- Department of Surgery, Tsuruoka Municipal Shonai Hospital, Tsuruoka, Yamagata, Japan
| | - Hiroya Kinoshita
- Department of Palliative Medicine, National Cancer Center Hospital, East, Kashiwa, Chiba, Japan
| | | | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Kenji Eguchi
- Division of Medical Oncology, Teikyo University School of Medicine, Itabashi-ku, Tokyo, Japan
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Brock KE, Cohen HJ, Popat RA, Halamek LP. Reliability and Validity of the Pediatric Palliative Care Questionnaire for Measuring Self-Efficacy, Knowledge, and Adequacy of Prior Medical Education among Pediatric Fellows. J Palliat Med 2015; 18:842-8. [PMID: 26185912 DOI: 10.1089/jpm.2015.0110] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Interventions to improve pediatric trainee education in palliative care have been limited by a lack of reliable and valid tools for measuring effectiveness. OBJECTIVE We developed a questionnaire to measure pediatric fellows' self-efficacy (comfort), knowledge, and perceived adequacy of prior medical education. We measured the questionnaire's reliability and validity. METHODS The questionnaire contains questions regarding self-efficacy (23), knowledge (10), fellow's perceived adequacy of prior medical education (6), and demographics. The survey was developed with palliative care experts, and sent to fellows in U.S. pediatric cardiology, critical care, hematology/ oncology, and neonatal-perinatal medicine programs. Measures of reliability, internal consistency, and validity were calculated. RESULTS One hundred forty-seven fellows completed the survey at test and retest. The self-efficacy and medical education questionnaires showed high internal consistency of 0.95 and 0.84. The test-retest reliability for the Self-Efficacy Summary Score, measured by intraclass correlation coefficient (ICC) and weighted kappa, was 0.78 (item range 0.44-0.81) and 0.61 (item range 0.36-0.70), respectively. For the Adequacy of Medical Education Summary Score, ICC was 0.85 (item range 0.6-0.78) and weighted kappa was 0.63 (item range 0.47-0.62). Validity coefficients for these two questionnaires were 0.88 and 0.92. Fellows answered a mean of 8.8/10 knowledge questions correctly; percentage agreement ranged from 65% to 99%. CONCLUSIONS This questionnaire is capable of assessing self-efficacy and fellow-perceived adequacy of their prior palliative care training. We recommend use of this tool for fellowship programs seeking to evaluate fellow education in palliative care, or for research studies assessing the effectiveness of a palliative care educational intervention.
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Affiliation(s)
- Katharine E Brock
- 1 Department of Pediatrics, Stanford University , Stanford, California.,2 Division of Hematology/Oncology, Stanford University , Stanford, California
| | - Harvey J Cohen
- 1 Department of Pediatrics, Stanford University , Stanford, California
| | - Rita A Popat
- 3 Department of Health Research and Policy, Division of Epidemiology, School of Medicine, Stanford University , Stanford, California
| | - Louis P Halamek
- 1 Department of Pediatrics, Stanford University , Stanford, California.,4 Division of Neonatal and Developmental Medicine, Stanford University , Stanford, California.,5 Center for Advanced Pediatric and Perinatal Education, Stanford University , Stanford, California
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Abudari G, Zahreddine H, Hazeim H, Assi MA, Emara S. Knowledge of and attitudes towards palliative care among multinational nurses in Saudi Arabia. Int J Palliat Nurs 2014; 20:435-41. [PMID: 25250548 DOI: 10.12968/ijpn.2014.20.9.435] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Palliative care is not yet integrated into the health-care system in Saudi Arabia. King Faisal Specialist Hospital and Research Centre-Riyadh (KFSH&RC-Riyadh) is a tertiary care facility and regional cancer centre in Saudia Arabia with a highly multinational nursing workforce. Little is known about these nurses' knowledge of and attitudes towards palliative care. Aim To determine the palliative care knowledge and attitudes of the nursing workforce of KFSH&RC-Riyadh and any influencing factors. Method A questionnaire including demographic data, the Palliative Care Quiz for Nurses (PCQN), and Frommelt Attitude Toward Care of the Dying scale (FATCOD) was completed by 395 staff nurses from 19 countries. Results The nurses scored a mean of 111.66 out of 150 on the FATCOD scale and of 9.06 out of 20 on the PCQN. These scores indicate moderate attitudes towards but a knowledge deficit regarding palliative care. The nurses' palliative care training and years of nursing experience significantly affected the scores. The level of palliative care integration in the nurses' home countries was the most significant factor in multiple regression tests. Conclusion Palliative care integration into the health-care system of the country in which nurses train significantly influences their knowledge of and attitudes towards palliative care. Incorporating palliative care into nursing education might promote positive attitudes towards palliative care in nurses while enhancing their knowledge and skills.
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Sato K, Inoue Y, Umeda M, Ishigamori I, Igarashi A, Togashi S, Harada K, Miyashita M, Sakuma Y, Oki J, Yoshihara R, Eguchi K. A Japanese Region-wide Survey of the Knowledge, Difficulties and Self-reported Palliative Care Practices Among Nurses. Jpn J Clin Oncol 2014; 44:718-28. [DOI: 10.1093/jjco/hyu075] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Hirooka K, Miyashita M, Morita T, Ichikawa T, Yoshida S, Akizuki N, Akiyama M, Shirahige Y, Eguchi K. Regional Medical Professionals' Confidence in Providing Palliative Care, Associated Difficulties and Availability of Specialized Palliative Care Services in Japan. Jpn J Clin Oncol 2014; 44:249-56. [DOI: 10.1093/jjco/hyt204] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Yamamoto R, Kizawa Y, Nakazawa Y, Morita T. The Palliative Care Knowledge Questionnaire for PEACE: Reliability and Validity of an Instrument To Measure Palliative Care Knowledge among Physicians. J Palliat Med 2013; 16:1423-8. [DOI: 10.1089/jpm.2013.0112] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Ryo Yamamoto
- Palliative Care Team, Saku Central Hospital, Nagano, Japan
| | | | - Yoko Nakazawa
- Department of Palliative Care Nursing, University of Tokyo, Tokyo, Japan
| | - Tatsuya Morita
- Department of Palliative and Supportive Care, Palliative Care Team and Seirei Hospice, Seirei Mikatahara General Hospital, Shizuoka, Japan
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