Evaluation of an Interdisciplinary Training Program in Palliative Care: Addressing the Needs of Rural and Northern Communities

1997 ◽  
Vol 13 (3) ◽  
pp. 5-12 ◽  
Author(s):  
Linda Kristjanson ◽  
Deborah Dudgeon ◽  
Fred Nelson ◽  
Paul Henteleff ◽  
Lynda Balneaves

Our study was a pilot test of an interdisciplinary training program in palliative care to improve the quality of care to terminally ill cancer and AIDS patients in rural and northern communities in Manitoba. The program involved two weeks of intense palliative care training for nurses, social workers, physicians, and volunteers. Four teams were trained during a six-month period. A repeated measures design was used to assess the effectiveness of the program. Results indicated that health professionals’ knowledge about care of the dying, care of individuals with HIV/AIDS, and attitudes toward care of the dying improved upon completion of the training program and remained improved three months following the program. Improvements in use of medications, increased attention to family care, increased discussion of DNR orders, and increased consultation related to symptom management were evident following the training program. The parallel training program for volunteers was also judged to be effective.

2016 ◽  
Vol 15 (4) ◽  
pp. 434-443 ◽  
Author(s):  
Grace Meijuan Yang ◽  
Yung Ying Tan ◽  
Yin Bun Cheung ◽  
Weng Kit Lye ◽  
Sock Hui Amy Lim ◽  
...  

ABSTRACTObjective:Physicians and nurses do not assess spirituality routinely, even though spiritual care is a vital part of palliative care for patients with an advanced serious illness. The aim of our study was to determine whether a training program for healthcare professionals on spirituality and the taking of a spiritual history would result in improved patient quality of life (QoL) and spiritual well-being.Method:This was a cluster-controlled trial of a spiritual care training program for palliative care doctors and nurses. Three of seven clinical teams (clusters) received the intervention, while the other four served as controls. Included patients were newly referred to the palliative care service, had an estimated survival of more than one month, and were aware of their diagnosis and prognosis. The primary outcome measure was the Functional Assessment of Chronic Illness Therapy–Spiritual Well-Being (FACIT–Sp) patient-reported questionnaire, which patients completed at two timepoints. Total FACIT–Sp score includes the Functional Assessment of Cancer Therapy–General (FACT–G) questionnaire, which measures overall quality of life, as well as a spiritual well-being score.Results:Some 144 patients completed the FACIT–Sp at both timepoints—74 in the control group and 70 in the intervention group. The change in overall quality of life, measured by change in FACT–G scores, was 3.89 points (95% confidence interval [CI95%] = –0.42 to 8.19, p = 0.076) higher in the intervention group than in the control group. The difference between the intervention and control groups in terms of change in spiritual well-being was 0.32 (CI95% = –2.23 to 2.88, p = 0.804).Significance of results:A brief spiritual care training program can possibly help bring about enhanced improvement of global patient QoL, but the effect on patients' spiritual well-being was not as evident in our participants. Further study with larger sample sizes is needed to allow for more definite conclusions to be drawn.


2005 ◽  
Vol 21 (1) ◽  
pp. 44-48 ◽  
Author(s):  
Susan E. McClement ◽  
Dean Care ◽  
Ruth Dean ◽  
Mary Cheang

Our study was an evaluation of a pilot course in palliative nursing care designed to improve practising nurses’ knowledge regarding cancer pain management and attitudes toward care of the dying patient. The course involved 12 weeks (36 hours) of systematic classroom instruction for registered nurses, and a one-day observational experience on a designated palliative care unit. A total of 16 nurses participated in the study. A repeated measures design was used to evaluate the effectiveness of the course. Attitudes toward care of the dying patient and his/her family were also evaluated. Results showed that nurses’ attitudes improved significantly from Time 1 (first day of course) to Time 2 (last day of course) (p=0.0007), and that this improvement was maintained at Time 3 (three months later) (p=0.064). The observational experience on a palliative care unit held in conjunction with the course was reported to be helpful to students in consolidating theoretical instruction.


2022 ◽  
Vol 21 (1) ◽  
Author(s):  
Jacqueline Resende Boaventura ◽  
Juliana Dias Reis Pessalacia ◽  
Aridiane Alves Ribeiro ◽  
Fabiana Bolela de Souza ◽  
Priscila Kelly da Silva Neto ◽  
...  

Abstract Background An integrated care network between emergency, specialized and primary care services can prevent repeated hospitalizations and the institutionalized death of terminally ill patients in palliative care (PC). To identify the perception of health professionals regarding the concept of PC and their care experiences with this type of patient in a pre-hospital care (PHC) service in Brazil. Methods Study with a qualitative approach, of interpretative nature, based on the perspective of Ricoeur’s Dialectical Hermeneutics. Results Three central themes emerged out of the professionals’ speeches: (1) unpreparedness of the team, (2) decision making, and (3) dysthanasia. Conclusions It is necessary to invest in professional training associated with PC in the home context and its principles, such as: affirming life and considering death as a normal process not rushing or postponing death; integrating the psychological and spiritual aspects of patient and family care, including grief counseling and improved quality of life, adopting a specific policy for PC that involves all levels of care, including PHC, and adopt a unified information system, as well as more effective procedures that favor the respect for the patients’ will, without generating dissatisfaction to the team and the family.


2020 ◽  
pp. bmjspcare-2020-00239
Author(s):  
Sandra Kurkowski ◽  
Johannes Radon ◽  
Annika R Vogt ◽  
Martin Weber ◽  
Stephanie Stiel ◽  
...  

BackgroundPalliative care strives to improve quality of life for patients with incurable diseases. This approach includes adequate support of the patients’ loved ones. Consequently, loved ones have personal experiences of providing end-of-life care for their next. This is a resource for information and may help to investigate the loved ones’ perspectives on need for improvements.AimTo identify further quality aspects considered important by loved ones to improve the quality of care at the end of life as an addition to quantitative results from the Care of the Dying Evaluation for the German-speaking area (CODE-GER) questionnaire.DesignWithin the validation study of the questionnaire ‘Care of the Dying Evaluation’ (CODETM) GER, loved ones were asked to comment (free text) in parallel on each item of the CODE-GER. These free-text notes were analysed with the qualitative content analysis method by Philipp Mayring.Setting/participantsLoved ones of patients (n=237), who had died an expected death in two university hospitals (palliative and non-palliative care units) during the period from April 2016 to March 2017.Results993 relevant paragraphs were extracted out of 1261 free-text notes. For loved ones, important aspects of quality of care are information/communication, respect of the patient’s and/or loved one’s will, involvement in decision-making at the end of life (patient’s volition) and having the possibility to say goodbye.ConclusionsIt is important for loved ones to be taken seriously in their sorrows, to be informed, that the caregivers respect the patients’ will and to be emotionally supported.Trial registration numberThis study was registered at the German Clinical Trials Register (DRKS00013916).


2018 ◽  
Vol 26 (0) ◽  
Author(s):  
Cristiana Araújo Guiller Ferreira ◽  
Flávia Simphronio Balbino ◽  
Maria Magda Ferreira Gomes Balieiro ◽  
Myriam Aparecida Mandetta

ABSTRACT Objective: to develop and validate instruments to identify health professionals’ beliefs related to the presence of the child’s family in invasive procedures and in cardiopulmonary resuscitation. Method: study based on Psychometrics to conduct the theoretical, empirical and analytical stages, developed in a neonatal unit of a university hospital. The two instruments were constructed based on the literature and applied to 96 health professionals. Results: the Cronbach’s Alpha of the instrument related to the professionals’ beliefson invasive procedures was 0.863 and the instrument on cardiopulmonary resuscitation was 0.882. In both instruments, the tests performed indicated a correlation between the items. From the factorial analysis, four factors were generated: (1) benefits of the presence of the family; (2) impairment for professional practice; (3) strategies for the inclusion of the family; and (4) limitation of learning and decision making by the professional. Conclusion: the instruments analyzed obtained a good internal consistency and are indicators of the professionals’ beliefs with the potential to evaluate the quality of family care in this context.


Author(s):  
Rebecca McLaughlan ◽  
Kieran Richards ◽  
Ruby Lipson-Smith ◽  
Anna Collins ◽  
Jennifer Philip

Objective: To contribute staff perspectives on the design of palliative care facilities to better align with the philosophy of palliative care, in support of patient, family, and staff well-being. Background: The receipt of palliative care differs from other inpatient experiences owing to its distinct philosophy of care, longer lengths of stay, a greater presence of family members, and more frequent end-of-life events. While research regarding the optimal design of palliative care environments recognizes these differences, this knowledge has been slow to exert change on the guidelines and procurement processes that determine the design solutions possible within these settings. Sustained research attention is required. Methods: An online survey, comprising a series of open-ended questions, elicited the perceptions of palliative care staff regarding the relationship between the physical environment and the distinct philosophy of palliative care. Results: Responses from 89 Australian-based palliative care professionals confirmed the high value that staff place on environments that offer privacy, homeliness, safety, and access to gardens to assist the delivery of optimum care. Conclusions: Our findings illustrate that the implications of privacy and homeliness extend far beyond the patient room and that homeliness is about more than an aesthetic of comfort. This highlights a broader capacity for design to better support the philosophy of palliative care. Importantly, the data reveal a key relationship between staff well-being and the environments in which they work; environments that are unable to match the quality of care that staff aspire to deliver can engender frustration and distress.


2019 ◽  
Vol 170 (2) ◽  
pp. 251-276
Author(s):  
Nicole Ziegler ◽  
Huy Phung

Abstract This exploratory study examines the extent to which mode differentially impacts the quantity and quality of interactional features in second language (L2) task-based interaction. Following a within-subject, repeated measures design, intermediate adult learners (n = 20) completed four (counter-balanced) tasks with a confederate interlocutor in the following conditions: audio-chat, video-chat, text-chat, and multimodal chat (in which participants could interact using more than one form of communication). Quantitative analyses examined the quality of learners’ interactions, including negotiation, recasts, and LREs. Data regarding learners’ perceptions of type of technology were also collected to provide a more holistic perspective. The results demonstrate differences in terms of interactional features and learners’ preference based on mode of technology.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Piret Paal ◽  
Cornelia Brandstötter ◽  
Johannes Bükki ◽  
Frank Elsner ◽  
Anna Ersteniuk ◽  
...  

Abstract Background A multi-professional, post-graduate, one-week palliative care training program was piloted in November 2019 at the University of Ivano-Frankivsk, Ukraine. A formal evaluation of this program was performed. Methods This is a comparative, retrospective outcome-based evaluation of an educational intervention. Participants completed evaluation forms at the end of the course (post-intervention = T1), covering demographics, comparative retrospective self-assessment (40 items, 6-point Likert scale), organizational aspects, and general feedback (free text). At T1, the responses represent actual self-assessment, pre-interventional (T0) scores were generated by retrospective self-assessment. The Retrospective Performance Gain (RPG) was calculated on group level for the comparative self-assessment, demographic and organizational variables were analyzed by descriptive statistics, and free text answers were processed by qualitative methodology (content analysis). Results Fifty-three of 56 attendants from all professions relevant to palliative care completed the evaluation forms (response 94,6%), with mean age 39y (22–64) and mean working experience 13,6y (1–44). Overall ratings of the program were very positive. Comparative retrospective self-assessment demonstrated a marked RPG from T0 to T1 on all items. Free text comments emphasized the need for regular nation-wide educational programs and for further education in bereavement care; inter-professional practice; communication; palliative care philosophy; professional self-care; specific nursing skills; dementia care; and advocacy, while the general contribution of the program to palliative care development in Ukraine was acknowledged. Conclusions Systematic evaluation of a post-graduate international training program in palliative care may provide a mutual learning experience and map country-specific barriers and facilitators that have to be addressed when setting up palliative care services.


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