Measuring and exploring the barriers to translating palliative care knowledge into clinical practice in rural and regional health-care settings.

Abstract

This study aims to measure and explore the barriers to translating theoretical knowledge of palliative care into clinical practice. A mixed-method study, combining a cross-sectional survey and key interviews was conducted. The quantitative data were obtained from 173 nurses and the key interviews were conducted with 42 health professionals drawn from multiple settings. For quantitative data analysis, Statistical Package for the Social Sciences software were conducted, and a thematic analysis supported with NVivo software were used for analyzing qualitative data. Of the 220 nurses invited, 173 completed the survey (79%). Most (78%) had a bachelor's degree in nursing. Fewer than half, 69 (40%) scored 75% or more for the knowledge test; 173 (100%) scored 50% or greater for attitude; and only 32 (18.5%) scored 75% or greater for self-reported practice. While there was a small, positive correlation between palliative care attitudes and self-reported practice (r=0.22, p=0.003), the qualitative findings indicated that nurses had significant challenges in translating their theoretical knowledge into clinical practice. Limited clinical practice was linked to inadequate knowledge resulting from insufficient integration of palliative care content in undergraduate curricula and a lack of follow-up training. This was further exacerbated by shortages of medicine, staff, and financial resources and was linked to limited attention accorded to palliative care by the government. While the results showed the majority held positive views toward palliative care, improving palliative care practices requires, and enhancing nurses' knowledge of palliative care. This requires changing teaching methods and engaging policymakers.