Abstract
BackgroundThe needs of care based on palliative principles are stressed for all people with progressive and/or life-limiting conditions, regardless of age and the place in which care is provided. Person-centred palliative care strives to make the whole person visible and prioritizes the satisfaction of spiritual, existential, social, and psychological needs to the same extent as physical needs. However, person-centred palliative care for older persons in nursing homes seems to be sparse, possibly because staff in nursing homes do not have sufficient knowledge, skills, and training in managing symptoms and other aspects of palliative care.MethodsThis study aimed to evaluate whether an educational intervention had any effect on the staff’s perception of providing person-centred palliative care for older persons in nursing homes. Methods: A knowledge-based palliative care intervention consisting of five 2-h seminars during a 6-month period was implemented at 20 nursing homes in Sweden. In total, 365 staff members were participated, 167 in the intervention group and 198 in the control group. Data were collected using two questionnaires, the Person-centred Care Assessment Tool (P-CAT) and the Person-Centred Climate Questionnaire (PCQ-S), answered before (baseline) and 3 months after (follow-up) the educational intervention was completed. Descriptive, comparative, and univariate logistical regression analyses were performed.ResultsBoth the intervention group and the control group revealed high median scores in all subscales at baseline, except for the subscale amount of organizational and environmental support in the P-CAT. The staff’s high rating level of person-centred care before the intervention provides limited space for further improvements at follow-up.ConclusionThis study shows that staff perceived that managers’ and the organization’s amount of support to them in their everyday work was the only area for improvement in order to maintain person-centred care. The experiences among staff are crucial knowledge in understanding how palliative care can be made person-centred in spite of often limited resources in nursing homes. The dose and intensity of education activities of the intervention model need to be tested in future research to develop the most effective implementation model.Trial registrationNCT02708498. Date of registration 26 February 2016.
Highlights
The needs of care based on palliative principles are stressed for all people with progressive and/or life-limiting conditions, regardless of age and the place in which care is provided
All subscales at baseline in both the intervention group and the control group revealed high median scores, except for the subscale “Amount of organizational and environmental support” (P-CAT). This subscale includes the five items “I do not have the time to provide person-centred care”, “The environment feels chaotic”, “We have to get the work done before we can worry about a homelike environment”, “The organization prevents me from providing person-centred care” and “It is hard for residents in the facility to find their way around”
Pre- and post-asessment of Person-centred Care Assessment Tool (P-CAT) The overall results of the P-CAT showed no statistically significant changes in nursing home settings concerning person-centeredness after the KUPA intervention in either of the two subscales Extent of personalizing care and Amount of organizational and environmental support (Table 2). This result was the same when exploring differences between the staff that participated in the intervention with those who did not
Summary
The needs of care based on palliative principles are stressed for all people with progressive and/or life-limiting conditions, regardless of age and the place in which care is provided. Nursing homes are common sites for older persons (> 65 years) to spend the last part of their lives, [1,2,3], when they often are suffering from complex and life-limiting conditions [4] These circumstances require various palliative care needs such as relief from distressing symptoms (pain, anxiety, nausea) to reduce discomfort and promote quality of life until death [1, 5]. According to Saunders & Kastenbaum [9], a person in a palliative care context is regarded as a human being consisting of physical, mental, social, and spiritual dimensions [9] Both palliative and person-centred care use partnership and shared decisions based on patient narratives as well as teamwork and documentation of quality of care [8, 10] for proper planning of the person’s remaining life [8]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
