Educational needs of nursing home staff: does a needs-based palliative care course make a difference?

2020 ◽  
pp. bmjspcare-2020-002690
Author(s):  
Gillian Li Gek Phua ◽  
Hui Jin Toh ◽  
Laurence Tan ◽  
James Alvin Yiew Hock Low
Keyword(s):  
Palliative Care ◽  
Communication Skills ◽  
Knowledge Score ◽  
Positive Change ◽  
Semistructured Interviews ◽  
Care Training ◽  
Trained Staff ◽  
Resultant Increase ◽  
Item Knowledge ◽  
Care Course

ObjectiveIn Singapore, more elderly are living in nursing homes (NHs), with a resultant increase in deaths occurring in NHs. However, palliative care training is limited in Singapore’s core nursing curriculum, and many NHs rely on foreign-trained staff who may not have previous palliative care training. Our study aimed to evaluate whether a needs-based course can improve the palliative care knowledge and attitudes of NH nurses in Singapore.MethodsTwenty-five nurses participated in the study. The intervention was an 8-week palliative care course developed based on needs assessment and led by a multidisciplinary faculty. A 50-item knowledge test was administered at baseline and 0 day and 3 and 6 months postcourse. Semistructured interviews were conducted at 3 months to assess for changes in attitudes and nursing practices.ResultsThe mean knowledge score increased significantly from 31.4 (±4.4) precourse to 35.1 (±5.1) at 3 months. Knowledge scores in end-of-life care increased up to 6 months, and scores for pain and symptom management increased significantly at 3 months. Participants reported a positive change with improved communication skills and increased compassion. There was a lack of opportunities to apply some new knowledge and skills due to regulations and perceived residents’ preferences to engage more local senior staff.ConclusionThe multidisciplinary needs-based palliative care course using various teaching modalities with follow-up knowledge tests helped to increase knowledge and improve communication skills and attitudes of NH nurses towards palliative care. The increase in knowledge and positive change in attitudes was noted to be sustained for at least 3 months postcourse.

Attitudes towards the dying and death anxiety in acute care nurses – can a workshop make any difference? A mixed-methods evaluation

2019 ◽  
Vol 18 (2) ◽  
pp. 164-169
Author(s):  
Chin Yee Cheong ◽  
Ngoc Huong Lien Ha ◽  
Laurence Lean Chin Tan ◽  
James A. Low
Keyword(s):  
Palliative Care ◽  
Death Anxiety ◽  
Core Curriculum ◽  
Knowledge Score ◽  
Positive Change ◽  
Fear Of Death ◽  
Nurse Training ◽  
Attitudes And Practices ◽  
Significant Difference ◽  
Eol Care

AbstractObjectivesIn Singapore, the core curriculum for end-of-life (EOL) care used in nurse training courses is limited. Only 45% of nurses indicated familiarity with inpatient palliative care. Nurses who lack skills in palliative care may develop anxiety and negative attitudes towards caring for dying patients. We explored whether a two-day, multimodal EOL care workshop could reduce nurses’ death anxiety and improve nurses’ skills, knowledge, and attitude towards palliative care.MethodsForty-five nurses participated in the workshop. At baseline before and at six weeks after, a 20-item knowledge-based questionnaire and the Death Attitude Profile-Revised (DAP-R) were administered. Six weeks post-workshop, in-depth interviews were conducted. We employed descriptive statistics, student paired samples t-test and inductive thematic analysis.ResultsThere was a significant improvement in nurses’ knowledge score (p < 0.01) and reduction in their death anxiety score (p < 0.01). Fear of Death (p = 0.025) and Death Avoidance (p = 0.047) sub-scores decreased significantly. However, the remaining domains such as Neutral Acceptance, Approach Acceptance, and Escape Acceptance did not show any significant difference, although Escape Acceptance showed a trend towards a reduced score (p = 0.063). After the workshop, more nurses adopted the Neutral Acceptance stance (76.2%), and none of them fell into the Fear of Death subdomain. Most nurses interviewed reported a positive change in their knowledge, attitudes, and practice even after the workshop.Significance of resultsThe multimodal palliative care workshop was useful in improving nurses’ EOL knowledge and reducing their anxiety towards death. The positive change in nurses’ attitudes and practices were noted to be sustained for at least six weeks after the intervention.

scholarly journals Lessons in Stories: Why Narrative Medicine Has a Role in Pediatric Palliative Care Training

Children ◽  
2021 ◽  
Vol 8 (5) ◽  
pp. 321
Author(s):  
Natalie Lanocha
Keyword(s):  
Palliative Care ◽  
Reflective Practice ◽  
Communication Skills ◽  
Medical Training ◽  
Community Building ◽  
Narrative Medicine ◽  
Cultural Humility ◽  
Pediatric Palliative Care ◽  
Care Training ◽  
Potential Tool

Narrative medicine is introduced and explored as a potential tool for developing competency in medical training, including reduction of burnout, sustaining empathy, and allowing for reflective practice. Developing cultural humility, communication skills, ethics, community building, and advocacy are also reviewed as domains that may be bolstered by training in narrative. Applications specific to pediatric palliative care are suggested, along with avenues for further research.

Can sharing stories change practice? A qualitative study of an interprofessional narrative-based palliative care course

2010 ◽  
Vol 25 (2) ◽  
pp. 105-111 ◽  
Author(s):  
Charles Campion-Smith ◽  
Helen Austin ◽  
Sue Criswick ◽  
Beryl Dowling ◽  
Graham Francis
Keyword(s):  
Palliative Care ◽  
Qualitative Study ◽  
Care Course

scholarly journals Creative Solution for Implementation of Experiential, Competency-Based Palliative Care Training for Internal Medicine Residents

2011 ◽  
Vol 26 (3) ◽  
pp. 436-443 ◽  
Author(s):  
Douglas D. Ross ◽  
Deborah W. Shpritz ◽  
Susan D. Wolfsthal ◽  
Ann B. Zimrin ◽  
Timothy J. Keay ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Palliative Care ◽  
Internal Medicine Residents ◽  
Competency Based ◽  
Care Training

Of dilemmas and tensions: a qualitative study of palliative care physicians’ positions regarding voluntary active euthanasia in Quebec, Canada

2018 ◽  
Vol 45 (1) ◽  
pp. 48-53 ◽  
Author(s):  
Emmanuelle Bélanger ◽  
Anna Towers ◽  
David Kenneth Wright ◽  
Yuexi Chen ◽  
Golda Tradounsky ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life Care ◽  
Patient Autonomy ◽  
Research Question ◽  
Interpretive Description ◽  
Active Euthanasia ◽  
Semistructured Interviews ◽  
Voluntary Active Euthanasia ◽  
Research Questions ◽  
Insight Into

ObjectivesIn 2015, the Province of Quebec, Canada passed a law that allowed voluntary active euthanasia (VAE). Palliative care stakeholders in Canada have been largely opposed to euthanasia, yet there is little research about their views. The research question guiding this study was the following: How do palliative care physicians in Quebec position themselves regarding the practice of VAE in the context of the new provincial legislation?MethodsWe used interpretive description, an inductive methodology to answer research questions about clinical practice. A total of 18 palliative care physicians participated in semistructured interviews at two university-affiliated hospitals in Quebec.ResultsParticipants positioned themselves in opposition to euthanasia. Their justifications were framed within their professional commitment to not hasten death, which sat in tension with the value of patients’ autonomy to choose how to die. Participants described VAE as unacceptable if it impeded opportunities to evaluate and alleviate suffering. Further, they contested government rhetoric that positioned VAE as a way to improve end-of-life care. Participants felt that VAE would diminish the potential of palliative care to relieve suffering. Dilemmas were apparent in their narratives, about reconciling respect for patient autonomy with broader palliative care values, and the value of accompanying and not abandoning patients who make requests for VAE while being committed to neither prolonging nor hastening death.ConclusionsThis study provides insight into nuanced positions of experienced palliative care physicians in Quebec and confirms expected tensions between an important stakeholder and the practice of VAE as guided by the new legislation.

Palliative care clinicians and online education in India: a survey

2018 ◽  
pp. bmjspcare-2018-001546
Author(s):  
Tayler Kiss-Lane ◽  
Odette Spruijt ◽  
Thomas Day ◽  
Vivian Lam ◽  
Kavitha J Ramchandran ◽  
...  
Keyword(s):  
Palliative Care ◽  
Online Education ◽  
Tamil Nadu ◽  
Ageing Population ◽  
Electronic Survey ◽  
Education In India ◽  
E Learning ◽  
Care Training ◽  
High Level ◽  
Case Based

BackgroundWhether online resources can facilitate spread of palliative care knowledge and skills in India is an urgent question given few providers and a large, ageing population.ObjectivesWe surveyed needs and feasibility regarding e-learning.MethodsIndian, Australian and North American palliative care experts developed an electronic survey using Qualtrics, emailed to all registrants of the 2017 Indian Association of Palliative Care (IAPC) conference and distributed during the conference.ResultsOf 60 respondents (66% men, 60% doctors), most worked in hospitals and had oncology backgrounds, and 35% were from Kerala and Tamil Nadu. Most (90.9%) received palliative care training in India or overseas with 41% trained in a Trivandrum Institute of Palliative Sciences residential course (4–6 weeks). 17% completed the IAPC essential certificate and 22% had undertaken various distance learning courses. Interest in online training was substantial for most aspects of palliative care.ConclusionThere was a high level of interest and reported feasibility in taking a case-based online course. This pilot survey provides support for online case-based education in India, particularly among physicians.

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