Supporting in an existential crisis: A mixed-methods evaluation of a training model in palliative care.

Abstract

Palliative care staff often report that they lack the skills and confidence to provide support during an existential crisis. Consequently, there is a definite need for a training program in this area. Our aim was to investigate whether a training model could give palliative care staff increased knowledge, awareness, and preparedness-all useful tools for providing support. A mixed-methods research design was used. Data were collected in four hospital-based palliative homecare teams in the Stockholm area. In total, 34 staff participated, representing different palliative care team professions. Before and after the intervention, a questionnaire with a 9-point Likert-type scale was completed (n = 34). Qualitative focus group discussions were conducted a month after the intervention (25 participants). These were recorded, transcribed, and analyzed using qualitative content analysis with a manifest focus. In the quantitative part of our study, the participants showed significantly increased perceived knowledge, awareness, and preparedness in every aspect (p < 0.001 for all items). The focus group discussions revealed a process that made it possible to apply new knowledge and insight. The process began with theoretical knowledge and, through care-related reflection and self-reflection, the knowledge base gradually developed and provided useful skills and increased job satisfaction. The team-based "TrainingModel Sand/TER" can be performed without excessive effort and contribute to improved competence in providing support during an existential crisis. It is particularly useful for staff working in clinical palliative care.