Communication Skills Training for Nurses and Social Workers: An Initiative to Promote Interdisciplinary Advance Care Planning and Palliative Care in Patients on Dialysis

Objective: Quality communication is an important aspect of advance care planning (ACP). This study evaluates a certification program that trains lay people in communication skills to support community-based ACP conversations. Methods: The program was developed with an emphasis on communication skills training. The testing of the program included ACP Guides and conversation partners, who were hospice volunteers, to assess the use of communication skills in ACP conversations. The evaluation used direct observations of conversations between trained ACP Guides and conversation partners as well as semi-structured interviews with those trained to become ACP Guides and those participating in the conversation. Results: Twenty-two ACP Guides participated in the testing phase with a retention rate of 100% completing all 4 sessions. The RELATE model of communication emerged during program development and testing. Evaluation of 15 ACP Guides having ACP conversations found that trained ACP Guides could use the RELATE model of communication to support ACP conversations. Conclusion: A community–academic partnership developed an ACP Community Guides Program that trained individuals to have community-based ACP conversations. Next steps include additional testing of the program and RELATE in small numbers, especially among minority populations, to evaluate acceptability and usability of this approach. Practice Implications: Laypersons with concrete communication skills can facilitate effective peer-to-peer ACP conversations.

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What are social work students being taught about palliative care?

Palliative & Supportive Care ◽

10.1017/s1478951518001049 ◽

2019 ◽

Vol 17 (5) ◽

pp. 536-541 ◽

Cited By ~ 1

Author(s):

Gary L. Stein ◽

Cathy Berkman ◽

Bonnie Pollak

Keyword(s):

Palliative Care ◽

Social Work ◽

Social Workers ◽

Advance Care Planning ◽

The United States ◽

Care Practice ◽

Care Planning ◽

Theory Approach ◽

Online Questionnaire ◽

Advance Care

AbstractObjectivePalliative social workers have taken steps to increase the numbers of social workers trained and competent to deliver effective psychosocial palliative care. Despite these developments, masters of social work (MSW) programs have only begun to develop curricula preparing students for entry-level practice. This study sought to determine the type and extent of content areas included in MSW courses dedicated to palliative care or with content related to palliative care practice.MethodA cross-sectional study using an online questionnaire was conducted. All 248 accredited MSW programs in the United States and 32 programs in Canada were invited to participate. Participants were asked to name the courses in their MSW program that were dedicated to, or included content on, palliative care, and submit the syllabi for these courses. Data comprised course content for each class session and required readings. A grounded theory approach was used to identify the topics covered.ResultOf the 105 participating programs that responded to the survey, 42 submitted 70 syllabi for courses with at least some palliative care content. There were 29 topics identified. The most common topic was grief, loss, and bereavement, followed closely by behavioral and mental health issues, and supporting family and friends; cultural perspectives and advance care planning were also common topics. For the 10 syllabi from courses dedicated to palliative care, supporting family was the most common topical area, followed closely by interprofessional practice and advance care planning.Significance of resultsAlthough there are many challenges to introducing palliative care content into MSW programs, including unqualified faculty and competing course material and electives of equally compelling content, there are model curricula for dedicated palliative care courses. With the large growth of palliative care programs, the time is ripe to add specialty palliative care courses and to add palliative care content into existing courses.

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Social Work Involvement in Advance Care Planning: Findings from a Large Survey of Social Workers in Hospice and Palliative Care Settings

Journal of Palliative Medicine ◽

10.1089/jpm.2016.0352 ◽

2017 ◽

Vol 20 (3) ◽

pp. 253-259 ◽

Cited By ~ 13

Author(s):

Gary L. Stein ◽

John G. Cagle ◽

Grace H. Christ

Keyword(s):

Palliative Care ◽

Social Work ◽

Social Workers ◽

Advance Care Planning ◽

Care Planning ◽

Work Involvement ◽

Advance Care ◽

Hospice And Palliative Care ◽

Large Survey

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Impact of a Palliative Care Nurse Practitioner in an Oncology Clinic: A Quality Improvement Effort

JCO Oncology Practice ◽

10.1200/op.21.00046 ◽

2021 ◽

Author(s):

Sarah F. D'Ambruoso ◽

John A. Glaspy ◽

Sara A. Hurvitz ◽

Neil S. Wenger ◽

Christopher Pietras ◽

...

Keyword(s):

Palliative Care ◽

Advanced Cancer ◽

Advance Care Planning ◽

Nurse Practitioner ◽

Care Delivery ◽

Skills Training ◽

Care Planning ◽

Care Nurse ◽

Advance Care

PURPOSE: Guidelines support early integration of palliative care (PC) into standard oncology practice; however, little is known as to whether outcomes can be improved by modifying health care delivery in a real-world setting. METHODS: We report our 6-year experience of embedding a nurse practitioner in an oncology clinic (March 2014-March 2020) to integrate early, concurrent advance care planning and PC. RESULTS: Compared with patients with advanced cancer not enrolled in the palliative care nurse practitioner program, in March 2020, patients who are enrolled are more likely to have higher quality of PC (eg, goals of care note documentation [82% v 15%; P < .01], referral to the psychosocial oncology program [67% v 37%; P < .01], and referral to hospice [61% v 34%; P < .01]) and less inpatient utilization in the last 6 months of life (eg, hospital days [12 v 18; P < .01] and intensive care unit days [1.2 v 2.3; P < .01]). The program expanded over time with the support of faculty skills training for advance care planning and PC, supporting a shared mental model of PC delivery within the oncology clinic. CONCLUSION: Embedding a trained palliative care nurse practitioner in oncology clinics to deliver early integrated PC can lead to improved quality of care for patients with advanced cancer.

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Enhancing the prospects for palliative care at the end of life: A statewide educational demonstration project to improve advance care planning

Palliative & Supportive Care ◽

10.1017/s1478951516000353 ◽

2016 ◽

Vol 14 (6) ◽

pp. 641-651 ◽

Cited By ~ 8

Author(s):

Debra K. Litzelman ◽

Ann H. Cottingham ◽

Wilma Griffin ◽

Thomas S. Inui ◽

Steven S. Ivy

Keyword(s):

Palliative Care ◽

End Of Life ◽

Communication Skills ◽

Advance Care Planning ◽

Hospice Care ◽

Demonstration Project ◽

Life Goals ◽

Care Planning ◽

Goals Of Care ◽

Advance Care

AbstractObjective:Although patients want to participate in discussions and decisions about their end-of-life care, studies show that providers frequently fail to invite them to explore advanced care preferences or goals for living. The purpose of our demonstration project was to provide education and coaching to individuals, health providers, and organizations across the state of Indiana intended to facilitate these conversations, documenting and honoring individuals' life goals and preferences for care during the final stages of life.Method:Education and training engaged community members as well as healthcare providers to: (1) improve participant comfort and facility discussing end-of-life issues; (2) improve knowledge of healthcare choices, including palliative and hospice care; and (3) prepare all participants to explore and document personal values, life goals, and priorities as well as goals of care.Results:Between January of 2013 and June of 2015, the team educated close to 5,000 participants. Participants' ratings of the quality and perceived usefulness of the educational events ranged from 4 to 5 (using a 5-point scale, with 5 = most effective). Participant comments were overwhelmingly favorable and indicated an intention to put the advance care planning resources, communication skills, knowledge of palliative and hospice care, and personal renewal techniques into practice.Significance of Results:Participant motivation to foster advance care planning, discussions of palliative care, and end-of-life conversations was facilitated by the reframing of these conversations as identifying goals of care and priorities for living well during an important stage of life. Successful strategies included helping providers and patients to adopt a broader meaning for “sustaining hope” (not for cure, but for engaging in highly valued activities), developing provider communication skills and comfort in initiating potentially difficult discussions, engaging a new community health workforce who will develop trusting relationships with patients in home-based services, and fostering self-awareness and self-care among palliative care providers.

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Demenz aus palliativmedizinischer Perspektive: warum ein krankheitsspezifisches Advance Care Planning wichtig ist

Therapeutische Umschau ◽

10.1024/0040-5930/a000974 ◽

2018 ◽

Vol 75 (2) ◽

pp. 105-111 ◽

Cited By ~ 3

Author(s):

Ralf J. Jox ◽

Francesca Bosisio ◽

Eve Rubli Truchard

Keyword(s):

Palliative Care ◽

Advance Care Planning ◽

Care Planning ◽

Advance Care ◽

Menschen Mit Demenz

Zusammenfassung. Die Palliative Care muss sich im Zuge des demographischen Wandels vieler Gesellschaften rund um den Globus tiefgreifend wandeln. Sie muss mehr und mehr mit der Geriatrie zusammenarbeiten und geriatrische Expertise integrieren. Eine der zentralen Herausforderungen Geriatrischer Palliative Care ist die ethisch angemessene Therapieentscheidung für Menschen, die nicht mehr urteilsfähig sind. Nachdem der bisherige Ansatz herkömmlicher Patientenverfügungen erwiesenermassen enttäuscht hat, wird aktuell, gerade auch in deutschsprachigen Ländern, das systemische Konzept des Advance Care Planning (ACP) verfolgt. In diesem Artikel wird zunächst ACP mit seinen Zielen, Elementen und Effekten vorgestellt. Sodann wird gezeigt, weshalb es für Menschen mit Demenz eines adaptierten ACP-Programms bedarf und was ein solches demenzspezifisches ACP beinhalten muss.

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