Effectiveness of Educational Programs on Palliative and End-of-life Care in Promoting Perceived Competence Among Health and Social Care Professionals

Background: There is a growing need for palliative care for patients near the end of life and their caregivers. Palliative and end-of-life care (EoLC) education are recommended for all health care (e.g., physicians, nurses, and allied health practitioners) and social care professionals (e.g., social workers) to ensure the quality of services. However, less attention has been afforded to generic, in contrast to specialized, EoLC education. This study evaluated the effectiveness of a series of short-term generic EoLC educational programs for health and social care professionals. Method: A pre-post survey design was adopted, focusing on different EoLC core competences. Results: Significant improvement was observed in all perceived competences after the educational programs, regardless of participants’ occupation or EoLC experience. Perceived competence in self-care was rated significantly higher than all other competences prior to the programs. Healthcare professionals rated significantly higher on competence in symptom management than social workers. Scores on communication skill and self-care competences were significantly higher following longer (i.e., 16-24 hours) than shorter (i.e., 4-8 hours) programs. Conclusion: Generalist palliative/EoLC educational programs may enable health and social care professionals to refresh and extend their knowledge and skills and enhance their perceived competence in providing EoLC. Further research on generalist palliative/EoLC education is needed to examine the impact of continuing training on professionals’ actual practice in EoLC and palliative care.

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Information sharing challenges in end-of-life care: a qualitative study of patient, family and professional perspectives on the potential of an Electronic Palliative Care Co-ordination System

BMJ Open ◽

10.1136/bmjopen-2020-037483 ◽

2020 ◽

Vol 10 (10) ◽

pp. e037483

Author(s):

Holly Standing ◽

Rebecca Patterson ◽

Mark Lee ◽

Sonia Michelle Dalkin ◽

Monique Lhussier ◽

...

Keyword(s):

Palliative Care ◽

Qualitative Study ◽

Information Sharing ◽

End Of Life ◽

End Of Life Care ◽

Social Care ◽

Hospital Admissions ◽

Sufficient Information ◽

Life Care ◽

Health And Social Care

ObjectivesTo explore current challenges in interdisciplinary management of end-of-life care in the community and the potential of an Electronic Palliative Care Co-ordination System (EPaCCS) to facilitate the delivery of care that meets patient preferences.DesignQualitative study using interviews and focus groups.SettingHealth and Social Care Services in the North of England.Participants71 participants, 62 health and social care professionals, 9 patients and family members.ResultsFour key themes were identified: information sharing challenges; information sharing systems; perceived benefits of an EPaCCS and barriers to use and requirements for an EPaCCS. Challenges in sharing information were a source of frustration for health and social care professionals as well as patients, and were suggested to result in inappropriate hospital admissions. Current systems were perceived by participants to not work well—paper advance care planning (ACP) documentation was often unavailable or inaccessible, meaning it could not be used to inform decision-making at the point of care. Participants acknowledged the benefits of an EPaCCS to facilitate information sharing; however, they also raised concerns about confidentiality, and availability of the increased time and resources required to access and maintain such a system.ConclusionsEPaCCS offer a potential solution to information sharing challenges in end-of-life care. However, our findings suggest that there are issues in the initiation and documentation of end-of-life discussions that must be addressed through investment in training in order to ensure that there is sufficient information regarding ACP to populate the system. There is a need for further qualitative research evaluating use of an EPaCCS, which explores benefits and challenges, uptake and reasons for disparities in use to better understand the potential utility and implications of such systems.

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Using administrative health data for palliative and end of life care research in Ireland: potential and challenges

HRB Open Research ◽

10.12688/hrbopenres.13215.2 ◽

2021 ◽

Vol 4 ◽

pp. 17

Author(s):

Maria Kelly ◽

Katie M O'Brien ◽

Ailish Hannigan

Keyword(s):

Palliative Care ◽

Health System ◽

End Of Life ◽

Data Protection ◽

End Of Life Care ◽

Social Care ◽

Data Access ◽

Life Care ◽

Health And Social Care ◽

Data Collections

Background: This study aims to examine the potential of currently available administrative health and social care data for palliative and end-of-life care (PEoLC) research in Ireland. Objectives include to i) identify data sources for PEoLC research ii) describe the challenges and opportunities of using these and iii) evaluate the impact of recent health system reforms and changes to data protection laws. Methods: The 2017 Health Information and Quality Authority catalogue of health and social care datasets was cross-referenced with a recognised list of diseases with associated palliative care needs. Criteria to assess the datasets included population coverage, data collected, data dictionary and data model availability, and mechanisms for data access. Results: Nine datasets with potential for PEoLC research were identified, including death certificate data, hospital episode data, pharmacy claims data, one national survey, four disease registries (cancer, cystic fibrosis, motor neurone and interstitial lung disease) and a national renal transplant registry. The ad hoc development of the health system in Ireland has resulted in i) a fragmented information infrastructure resulting in gaps in data collections particularly in the primary and community care sector where much palliative care is delivered, ii) ill-defined data governance arrangements across service providers, many of whom are not part of the publically funded health service and iii) systemic and temporal issues that affect data quality. Initiatives to improve data collections include introduction of i) patient unique identifiers, ii) health entity identifiers and iii) integration of the Eircode postcodes. Recently enacted general data protection and health research regulations will clarify legal and ethical requirements for data use. Conclusions: Ongoing reform initiatives and recent changes to data privacy laws combined with detailed knowledge of the datasets, appropriate permissions, and good study design will facilitate future use of administrative health and social care data for PEoLC research in Ireland.

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Priorities and opportunities for palliative and end of life care in United Kingdom health policies: a national documentary analysis

BMC Palliative Care ◽

10.1186/s12904-021-00802-6 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Katherine E. Sleeman ◽

Anna Timms ◽

Juliet Gillam ◽

Janet E. Anderson ◽

Richard Harding ◽

...

Keyword(s):

Palliative Care ◽

End Of Life ◽

National Health ◽

End Of Life Care ◽

Social Care ◽

Health Policies ◽

Life Care ◽

Policy Documents ◽

Health And Social Care ◽

National Health Policies

Abstract Background Access to high-quality palliative care is inadequate for most people living and dying with serious illness. Policies aimed at optimising delivery of palliative and end of life care are an important mechanism to improve quality of care for the dying. The extent to which palliative care is included in national health policies is unknown. We aimed to identify priorities and opportunities for palliative and end of life care in national health policies in the UK. Methods Documentary analysis consisting of 1) summative content analysis to describe the extent to which palliative and end of life care is referred to and/or prioritised in national health and social care policies, and 2) thematic analysis to explore health policy priorities that are opportunities to widen access to palliative and end of life care for people with serious illness. Relevant national policy documents were identified through web searches of key government and other organisations, and through expert consultation. Documents included were UK-wide or devolved (i.e. England, Scotland, Northern Ireland, Wales), health and social care government strategies published from 2010 onwards. Results Fifteen policy documents were included in the final analysis. Twelve referred to palliative or end of life care, but details about what should improve, or mechanisms to achieve this, were sparse. Policy priorities that are opportunities to widen palliative and end of life care access comprised three inter-related themes: (1) integrated care – conceptualised as reorganisation of services as a way to enable improvement; (2) personalised care – conceptualised as allowing people to shape and manage their own care; and (3) support for unpaid carers – conceptualised as enabling unpaid carers to live a more independent lifestyle and balance caring with their own needs. Conclusions Although information on palliative and end of life care in UK health and social care policies was sparse, improving palliative care may provide an evidence-based approach to achieve the stated policy priorities of integrated care, personalised care, and support for unpaid carers. Aligning existing evidence of the benefits of palliative care with the three priorities identified may be an effective mechanism to both strengthen policy and improve care for people who are dying.

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Video Intervention to Increase Knowledge About and Interest in Palliative Care Among MSW Students

Innovation in Aging ◽

10.1093/geroni/igaa057.229 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 70-70

Author(s):

Cathy Berkman

Keyword(s):

Palliative Care ◽

Social Work ◽

End Of Life ◽

Social Workers ◽

End Of Life Care ◽

Social Work Students ◽

Life Care ◽

Video Intervention ◽

Msw Students ◽

The Mean

Abstract As the population ages and more people live longer with chronic and life-limiting illnesses, more healthcare professionals with palliative care skills are needed. Social workers are part of the palliative care team, but there is little, if any, content on palliative and end-of-life care in MSW programs. A 24-minute video featuring nine palliative and hospice social workers was produced with two goals: 1) increase knowledge of social work students about palliative and end-of-life care; and 2) interest social work students in a career in palliative social work. MSW students from three schools, in NY and Alabama, viewed the video. After viewing the video, 94 students participated in the mixed methods study, completing the brief, anonymous, online survey. The mean level of understanding about what palliative social workers do, rated from 1 (no understanding) to 5 (very good understanding), was 2.96 (SD=.99) before viewing the video and 4.31 (SD=.61) after, for an increase of 1.35 points (95% CI=1.14, 1.55) (p<.001). The mean level of interest in a career in palliative care social work and working with seriously ill persons and their family members, rated from 1 (Not at all interested) to 5 (Extremely interested), was 2.52 (SD=.99) before viewing the video and 3.45 SD=.80) after, for an increase of .91 points (95% CI=.79, 1.07) (p<.001). Qualitative data supporting the quantitative findings will be presented. This study suggests that a video intervention may be an effective tool to increase knowledge and interest in palliative and end-of-life care among social work students.

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First steps: Health and social care professionals beginning to address the palliative and end of life care needs of people with diverse gender identities and sexual orientations in Lebanon

Sexualities ◽

10.1177/1363460720932380 ◽

2020 ◽

pp. 136346072093238

Author(s):

Claude Chidiac

Keyword(s):

Palliative Care ◽

End Of Life ◽

End Of Life Care ◽

Social Stigma ◽

Life Care ◽

Care Needs ◽

Mena Region ◽

Healthcare Needs ◽

Health And Social Care ◽

The Impact

The available evidence demonstrates that lesbian, gay, bisexual, and transgender (LGBT) people face challenges when accessing palliative care services, and receive suboptimal care at the end of life. This is mainly attributed to assumed heterosexuality, lack of knowledge and understanding of LGBT issues and specific healthcare needs, discrimination, homophobia, and transphobia. In Lebanon, legal and institutional support for LGBT individuals is minimal, and palliative care provision remains scarce and fragmented. This compounds the impact of social stigma and marginalisation, and results in unrecognised palliative and end of life care needs for the LGBT individual. This short commentary discusses the development of an LGBT palliative care workshop in Lebanon, which was the first initiative of its kind in the Middle East and North Africa (MENA) region. It also explores how this initiative has led to further developments, and how these efforts can be replicated in other countries in the MENA region.

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Development and evaluation of an LGBT+ education programme for palliative care interdisciplinary teams

Palliative Care and Social Practice ◽

10.1177/26323524211051388 ◽

2021 ◽

Vol 15 ◽

pp. 263235242110513

Author(s):

Claude Chidiac ◽

Kate Grayson ◽

Kathryn Almack

Keyword(s):

Mental Health ◽

Palliative Care ◽

End Of Life ◽

Cultural Change ◽

End Of Life Care ◽

Healthcare Access ◽

Interdisciplinary Teams ◽

Life Care ◽

Educational Work ◽

Health And Social Care

Background: Despite national policy recommendations to enhance healthcare access for LGBT+ (lesbian, gay, bisexual, transgender, and those who do not identify as cisgender heterosexual) people, education on LGBT+ issues and needs is still lacking in health and social care curricula. Most of the available resources are focused on primary care, mental health, and sexual health, with little consideration to broader LGBT+ health issues and needs. The limited available educational programmes pertaining to LGBT+ individuals outside the context of sexual or mental health have mainly focused on cancer care or older adults. Aim: To support palliative care interdisciplinary teams to provide LGBT+ affirmative care for people receiving and needing palliative and end-of-life care. Methods: A 1½-h workshop was developed and evaluated using Kotter’s eight-step process for leading change. Across four hospices, 145 health and social professionals participated in the training. A quasi-experimental non-equivalent groups pre–post-test design was used to measure self-reported levels of knowledge, confidence, and comfort with issues, and needs and terminology related to LGBT+ and palliative care. Results: There was a significant increase in the reported levels of knowledge, confidence, and comfort with issues, needs, and terminology related to LGBT+ and palliative care after attending the training. Most participants reported that they would be interested in further training, that the training is useful for their practice, and that they would recommend it to colleagues. Conclusion: The project illustrates the importance of such programmes and recommends that such educational work is situated alongside wider cultural change to embed LGBT+-inclusive approaches within palliative and end-of-life care services.

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Development and psychometric validation of a comprehensive end-of-life care competence scale: A study based on three-year surveys of health and social care professionals in Hong Kong

Palliative & Supportive Care ◽

10.1017/s1478951520000723 ◽

2020 ◽

pp. 1-10

Author(s):

Daiming Xiu ◽

Amy Y.M. Chow ◽

Iris K.N. Chan

Keyword(s):

Hong Kong ◽

End Of Life ◽

Health Care Professionals ◽

End Of Life Care ◽

Social Care ◽

Life Care ◽

Internal Reliability ◽

Health And Social Care ◽

Competence Scale ◽

Bereavement Care

Abstract Objective This study aimed to develop an assessment tool measuring comprehensive interdisciplinary competence in end-of-life care (EoLC) and investigate its content, construct validity, reliability, and their correlates. Method Items of the Comprehensive End-of-Life Care Competence Scale (CECCS) were developed according to a comprehensive core competence framework in EoLC and refined by a multi-disciplinary panel of experts. The psychometric properties were further tested through region-wide surveys of self-administered questionnaires completed by health and social care professionals in Hong Kong. Results Participants comprised social workers, nurses, physicians, and allied health care professionals (445 participants in 2016, 410 in 2017, and 523 in 2018). Factor analysis validated the construct of the questionnaire which encompassed 26 items describing EoLC core competences in seven domains with satisfactory internal reliability (confirmatory factor analysis: χ2/df = 3.12, GFI = 0.85, TLI = 0.93, CFI = 0.94, RMSEA = 0.07; Cronbach's alphas ranged from 0.89 to 0.97): overarching value & knowledge, communication skills, symptom management, psychosocial and community care, end-of-life decision-making, bereavement care, and self-care. Higher perceived levels in these competences were correlated with a higher level of job meaningfulness and satisfaction (r ranged from 0.17 to 0.39, p < 0.01) and correlated with lower perceived stress (r ranged from –0.11 to –0.28, p < 0.05). Regression analysis found that age and work involvement in EoLC were positively associated with the perceived competences in all domains; professionals working in hospices reported higher levels of competence than workers in other settings; social workers showed lower perceived competences in symptom management, but higher levels in bereavement care than other health care professionals. Significance of results The validity and internal reliability of CECCS were demonstrated. The levels of perceived competences working in EoLC were significantly associated with professionals’ job-related well-being. Practically, there is still room for improvement in comprehensive competences among health and social care workers in Hong Kong.

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