Professional Caregiver Survey Research Articles

Adaptation and psychometric testing of the end-of-life professional caregiver survey in Jamaica

BackgroundUsing a validated instrument to measure palliative care (PC) educational needs of health professionals is an important step in understanding how best to educate a well-versed PC workforce within a national health system. The End-of-life Professional Caregiver Survey (EPCS) was developed to measure U.S. interprofessional PC educational needs and has been validated for use in Brazil and China. As part of a larger research project, this study aimed to culturally adapt and psychometrically test the EPCS among physicians, nurses, and social workers practicing in Jamaica.MethodsFace validation involved expert review of the EPCS with recommendations for linguistic item modifications. Content validation was carried out by six Jamaica-based experts who completed a formal content validity index (CVI) for each EPCS item to ascertain relevancy. Health professionals practicing in Jamaica (n = 180) were recruited using convenience and snowball sampling to complete the updated 25-item EPCS (EPCS-J). Internal consistency reliability was assessed using Cronbach’s alpha coefficient and McDonald’s phi. Construct validity was examined through confirmatory factor analysis (CFA) and exploratory factor analysis (EFA).ResultsContent validation led to elimination of three EPCS items based on a CVI < 0.78. Cronbach’s alpha ranged from 0.83 to 0.91 and McDonald’s phi ranged from 0.73 to 0.85 across EPCS-J subscales indicating good internal consistency reliability. The corrected item-total correlation for each EPCS-J item was > 0.30 suggesting good reliability. The CFA demonstrated a three-factor model with acceptable fit indices (RMSEA = 0.08, CFI = 0.88, SRMR = 0.06). The EFA determined a three-factor model had the best model fit, with four items moved into the effective patient care subscale from the other two EPCS-J subscales based on factor loading.ConclusionsThe psychometric properties of the EPCS-J resulted in acceptable levels of reliability and validity indicating that this instrument is suitable for use in measuring interprofessional PC educational needs in Jamaica.

The Effect of a Multidisciplinary Blended Learning Program on Palliative Care Knowledge for Health Care Professionals Involved in the Care for People with Parkinson's Disease.

Parkinson's disease (PD) is an increasingly prevalent and progressive degenerative disease. Palliative care for PD should be integrated into the routine care for people with PD. However, PD health care professionals typically lack knowledge of palliative care, highlighting the necessity of educational programs in this field. To determine the effectiveness of a multidisciplinary blended learning program for health care professionals specialized in PD in the Netherlands. We used a pre-posttest intervention design. The intervention consisted of an e-learning in combination with an online network meeting in which the participating health care professionals discussed palliative care for PD with specialists from the field of palliative care. Outcome variables included self-rated level of knowledge (scale 1-10), familiarity with specialized palliative care services (5-point Likert scale) and the validated End-of-Life Professional Caregiver Survey (EPCS). A total of 1029 participants from sixteen different disciplines, all active in the care for people with PD, with a mean age of 45 years and 13 years of working experience, followed the blended learning program. Self-rated level of knowledge improved from 4.75 to 5.72 (0.96; p < 0.001; 95% CI change = [0.85 . . . 1.08]. Familiarity with palliative care services also increased by 1.06 (from 1.85 to 2.90; p=<0.001; 95% CI change = [1.00 . . . 1.12]). A blended learning program can improve self-rated knowledge about palliative care and its services. Such programs might be a first step towards optimal integration of palliative care expertise and services within PD-care.

Implementation of a palliative care intervention for patients with COPD – a mixed methods process evaluation of the COMPASSION study

ObjectivesLittle direction exists on how to effectively implement palliative care for patients with COPD. In the COMPASSION study, we developed, executed, and evaluated a multifaceted implementation strategy to improve the uptake of region-tailored palliative care intervention components into routine COPD care. We evaluated the implementation strategy and assessed the implementation process, barriers, and facilitators.MethodsA mixed methods process evaluation was performed. Primary and secondary healthcare providers in four hospital regions in the Netherlands were trained. Patients identified during hospitalisation for an acute exacerbation received palliative care and were followed for a year. Various sources were used: process data, questionnaires including the End-of-life Professional Caregiver Survey (EPCS), medical records, monitoring meetings, and interviews. The Consolidated Framework of Implementation Research (CFIR) was used to categorize implementation determinants.ResultsThe training sessions with roleplay were positively evaluated and increased professionals’ self-efficacy in providing palliative care statistically significantly. Of 98 patients identified, 44 (44.9%) received one or more palliative care conversations at the outpatient clinic. Having those conversations was highly valued by healthcare providers because it led to clarity and peace of mind for the patient and higher job satisfaction. Coordination and continuity remained suboptimal. Most important barriers to implementation were time constraints, the COVID-19 pandemic, and barriers related to transmural and interdisciplinary collaboration. Facilitators were the systematic screening of patients for palliative care needs, adapting to the patient’s readiness, conducting palliative care conversations with a pulmonologist and a COPD nurse together, and meeting regularly with a small team led by a dedicated implementation leader.ConclusionsProviding integrated palliative care for patients with COPD is highly valued by healthcare providers but remains challenging. Our findings will guide future implementation efforts. Future research should focus on how to optimize transmural and interdisciplinary collaboration.Trial registrationThe COMPASSION study is registered in the Netherlands Trial Register (NTR): NL7644. Registration date: 07/04/2019.

Identifying, exploring and integrating the spiritual dimension in proactive care planning: A mixed methods evaluation of a communication training intervention for multidisciplinary palliative care teams

Background: Patients receiving palliative care value attention given to their spiritual needs. However, these needs often remain unexplored as healthcare professionals lack the skills to identify and explore them and to integrate this information into care plans. Aim: To evaluate the effects of an interactive communication training intervention for palliative care teams in order to identify and explore the spiritual dimension and integrate it in patients’ care plans. Design: A mixed methods pre-post study, including self-assessment questionnaires, evaluation of videos with simulated consultations (applied competence) and medical record review (implementation). Setting/participants: Three palliative care teams including nurses (N = 21), physicians (N = 14) and spiritual caregivers (N = 3). Results: The questionnaires showed an improvement on ‘Patient and family-centred communication’ of the End-of-life professional caregiver survey (+0.37, p < 0.01; the 8-item S-EOLC (+0.54, p < 0.01) and regarding the Spiritual Care Competence Scale, on the three subscales used (+0.27, p < 0.01, +0.29, p < 0.01 and +0.32, p < 0.01). Video evaluations showed increased attention being paid to patient’s aims and needs. The medical record review showed an increase in anticipation on the non-somatic dimension (OR: 2.2, 95% CI: 1.2–4.3, p < 0.05) and, using the Mount Vernon Cancer Network assessment tool, addressing spiritual issues (OR: 10.9, 95% CI: 3.7–39.5, p < 0.001). Conclusions: Our training intervention resulted in increased palliative care professionals’ competence in identifying and exploring patients’ spiritual issues, and their integration in multidimensional proactive palliative care plans. The intervention directly addresses patients’ spiritual concerns and adds value to their palliative care plans.

Let's Talk About Dying: An Educational Pilot Program to Improve Providers' Competency in End-Of-Life Discussions.

Advance care planning (ACP) conversations occur infrequently due to lack of provider confidence-level, education, and workplace support for gaining skills in initiating goals of care and end-of-life discussions. A 3-month quality improvement project was carried out between October 2021 to January 2022 using a short, accessible virtual presentation on provider initiation of goals of care conversations. A pre-test/post-test design was implemented using the End-of-Life Professional Caregiver Survey and frequency of ACP documentation of surgical intensive care unit providers. Over the study period, 17 providers reviewed the virtual presentation. The End-of-Life Professional Caregiver Survey sum score increased significantly from pre-to post-test (P < .001) reflecting increased provider confidence in initiating goals of care conversations. There was also significant increase in ACP documentation from pre-intervention to the third and final monthly cycle. Structured education increased ICU providers confidence in having goals of care conversations and improved the frequency of ACP documentation.

Perceived end-of-life educational needs by clinical trials nurses at a comprehensive cancer center

ObjectiveDetermine palliative care end-of-life (EOL) educational needs among clinical trials nurses (CTNs) at an urban comprehensive cancer center. MethodsThe End-Of-Life Professional Caregiver Survey (EPCS) was used to determine the EOL educational needs of CTNs and collect demographics on years of experience, education, past EOL-specific training, and possession of their own advanced directive. The “Surprise Question” was also asked to explore the percent of patients on clinical trials who may be nearing EOL. ResultsTwenty-nine CTNs completed the survey. Mean years of experience as an RN and CTN was 10.45 and 2.5, respectively. 79% and 17% held a bachelors or master's degree, respectively. Twenty-seven percent reported previous End-of-Life Nursing Education Consortium (ELNEC) or similar training and 20% stated they had their own advanced directive. Mean total score for the EPCS was 94.83, with subscale means of 42.41 for the Patient and Family Centered Communication (PFCC), 26.9 for Cultural and Ethical Values (CEV), and 25.52 for the Effective Care Delivery (ECD). Highest scoring items included confidence in communicating with colleagues about EOL care, being present with dying patients, and recognizing patients who are appropriate for hospice referral. Lowest scoring items included participating in code status discussions, resolving ethical issues and family conflicts at EOL, and addressing requests for assisted suicide. Responses to the Surprise Question indicated that 27.5% of the CTNs would not be surprised if half or more of their patients died within the next 12 months. ConclusionsMany patients with cancer on clinical trials may be nearing EOL. CTNs perceive the need for education to increase confidence in handling difficult communication.

Knowledge of Critical Care Nurses about End-of-Life Care towards Terminal Illnesses: Levels and Correlating Factors.

IntroductionThe preparedness of nurses in relation to providing palliative care is not always adequate, indeed, it is sometimes unsatisfactory; this may be caused by lack of knowledge and limited experience in end-of-life care (EOLC). Thus, this study purposed to assess the levels of registered nurses' knowledge about EOLC, examine the relationships between EOLC knowledge and some demographic variables, and explore predictors of EOLC knowledge.MethodsA cross-sectional design survey was conducted with Jordanian registered nurses in critical care units (N = 175) in different heath sectors in Jordan. The End-of Life Professional Caregiver Survey (EPCS) was used.ResultsFindings showed that nurses had moderate/quite a lot of knowledge (M (SD) = 2.58 (.48)) about EOLC. The cultural and ethical values was the highest subscale of knowledge about EOLC (M (SD) = 2.74 (.52)), while effective care delivery subscale was the lowest one ((M (SD) = 2.33 (.66). Knowledge about EOLC was correlated with age (r = .145, P < .05), work experience (r = .173, P < .05), and training course in palliative or EOLC (r = .217, P < .01). The main predictor of EPCS was training courses in palliative or EOLC (B = .190, P < .05).ConclusionThe nurses need to enhance their knowledge about EOLC and correlating factors should be taken into consideration when developing any intervention program. Nurses need palliative care training courses; also more attention is required in palliative care education particularly in clinical skills in effective care delivery.

Palliative and End-of-Life Care Self-perceived Educational Needs of Physicians and Nurses in Rwanda.

Palliative care access is an urgent and ethical imperative to effectively manage the increasing burden of serious health-related suffering worldwide. Understanding the palliative care educational needs of health care professionals is critical to support evidence-based clinical practice in Rwanda and other low- and middle-income countries. A cross-sectional study was conducted at 5 hospitals in Kigali, Rwanda, to assess the palliative/end-of-life educational needs of nurses and physicians. The End-of-Life Professional Caregiver Survey and a demographic form were used to collect data. Descriptive analyses and independent t tests were conducted. A total of 420 health care professionals participated in the study (response rate, 72%). Participants perceived their knowledge and skills in providing palliative/end-of-life care as low. Those who received palliative/end-of-life care training in the past 5 years, third- and fourth-year residents, and health care providers with 5 years of experience or more had significantly higher (P ≤ .05) mean scores on the End-of-Life Professional Caregiver Survey. Nurses scored higher than physicians in the patient- and family-centered communication (P = .049) and cultural and ethical values (P = .037) subscales. Pain management was identified as an educational need by 77% of participants. Our survey suggests the need for increased governmental investments in palliative/end-of-life care education among nurses and physicians in Rwanda.

Cultural adaptation and psychometric evaluation of the Chinese version of the nurse-specific end-of-life professional caregiver survey: a cross-sectional study

BackgroundNurses’ palliative and hospice care-specific education is associated with the quality of palliative and hospice care that influences health outcomes of patients with life-limiting illnesses and their caregivers. However, China lacks measures available to assess nurses’ educational needs in palliative and hospice care. The End-of-Life Professional Caregiver Survey (EPCS) is a psychometrically reliable self-reporting scale to measure multidisciplinary professionals’ palliative and hospice care educational needs. This study was performed to explore the psychometric properties of the Chinese version of the EPCS (EPCS-C) among Chinese nurses.MethodsWe translated and culturally adapted the EPCS into Chinese based on Beaton and colleagues’ instrument adaptation process. A cross-sectional study design was used. We recruited 312 nurses from 1482 nurses in a tertiary hospital in central China using convenience sampling to complete the study. Participants completed the EPCS-C and a demographic questionnaire. Exploratory and confirmatory factor analysis was carried out to test and verify the construct validity of the nurse-specific EPCS-C. Cronbach’s alpha coefficient was used to appraise the reliability of the nurse-specific EPCS-C.ResultsA three-factor structure of EPCS-C was determined, including cultural, ethical, and national values; patient- and family-centered communication; and effective care delivery. The exploratory factor analysis explained 70.82% of the total variances. The 3-factor solution of the nurse-specific EPCS-C had a satisfactory model fit: χ2 = 537.96, χ2/df = 2.96, CFI = 0.94, RMSEA = 0.079, IFI = 0.94, and GFI = 0.86. Cronbach’s alpha coefficient of the overall questionnaire was 0.96.ConclusionsThe nurse-specific EPCS-C showed satisfactory reliability and validity to assess nurses’ palliative and hospice care educational need. Further research is required to verify the reliability and validity of the EPCS-C in a larger sample, especially the criterion-related validity.

Palliative Care Conversations for Heart Failure Nurses: A Pilot Education Intervention.

IntroductionHeart failure is a progressive condition affecting 6.2 million Americans. The use of palliative and supportive care for symptom management and improved quality of life is recommended for persons with heart failure. However, 91% of nurses believe they need further training to have palliative care conversations. The purpose of this pilot education intervention was to determine if providing nurses with education on the timing and content of palliative care conversations would improve their perceived skill and knowledge.MethodsThis was a pilot study of an online educational intervention. Data were electronically collected from 13 participants using validated questionnaires delivered via Qualtrics. Participants completed a demographic survey and End-of-Life Professional Caregiver Survey (EPCS) before and after completing an online, asynchronous education module.ResultsMean scores were higher on all posttest measures. Independent samples t-tests revealed statistically significant differences on the Effective Care Delivery (ECD) scale (t[32] = −2, p = .05) and total EPCS scale scores (t[32] = −2.2, p = .03) from pre- to posttest.ConclusionScores increased on all dimensions pretest to posttest with statistically significant differences in ECD and total scores. Providing asynchronous online education on timing and content of palliative care conversations to nurses caring for people with heart failure is a feasible and effective way to improve perceived knowledge and skill of palliative care conversations.

Effectiveness of an End-of-Life Nursing Education Consortium Training on Registered Nurses' Educational Needs in Providing Palliative and End-of-Life Patient Care.

Registered nurses play a critical role in delivering effective palliative and end-of-life patient care. Previous literature has cited that registered nurses report a lack of adequate palliative care training in academic and continuing education programs. Providing care to patients at the end of life requires knowledge in a variety of areas such as nonpharmacologic symptom management, cultural considerations, and pain management. This study aimed to investigate the impact of a professional development intervention among registered nurses on their educational needs in providing palliative care. Using a 1-group pretest-posttest design, a convenience sample of registered nurses completed an electronic survey containing demographic questions and the End-of-Life Professional Caregiver Survey. The professional development intervention consisted of an 8-hour training conducted by a content expert on palliative patient care addressing the competencies developed by the End-of-Life Nursing Education Consortium. The results revealed a significant increase in participant knowledge in providing quality palliative care to patients (P < .001). Education programs on quality palliative and end-of-life patient care can effectively improve the care delivered to this patient population.

Self-Perceived Knowledge and Comfort Discussing Palliative Care and End-of-Life Issues among Professionals Managing Neuroinflammatory Diseases

Background: The growing trend in providing palliative care and end-of-life services has dictated that healthcare providers be adequately trained to care for people with serious illnesses, such as multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD). These progressive inflammatory diseases lead to physical, cognitive and emotional deficits and have exceptionally high care demands leading to high levels of distress. Because the impact on the delivery of patient care is influenced by the specialists' knowledge and comfort discussing end-of-life issues, it is concerning that interventions to address unmet palliative care needs in MS and NMOSD rarely include clinician-patient dyads. Objectives: To evaluate the neurology clinicians' knowledge and level of comfort discussing palliative care and end-of-life issues. Design: A cross sectional survey was conducted. The statistical analyses included frequencies, chi square statistics and logistic regression. Setting/Subjects: 414 MS specialists answered an online anonymous survey. The survey was conducted using email distributions to MS professionals through the Consortium of MS Centers (CMSC), the International Organization of MS Nurses (IOMSN) and the UK Nurses' MS Organization. Measurement: The "End of Life Professional Caregiver Survey" (EPCS) was used to collect data. Results: The majority of the multidisciplinary professionals were female, white, nurses, and older than 40 years of age. 41% had their own advance directives and 57.6% had end-of-life basic training. There was a statistically significant association between end-of-life training or having advance directives and comfort discussing palliative care and end of life issues. Professionals that had basic end-of-life training and their own advance directives had higher comfort discussing code status, specific end-of-life issues, and advance directive planning. Conclusions: Basic end-of-life training and having advance directives among MS professionals were associated with better communication of palliative care and end-of-life domains with patients and their care partners.

Improving Nurse Knowledge and Confidence in End-of-Life Care Utilizing the End-of-Life Nursing Education Consortium Curriculum: A Pilot Project (QI615)

•Describe the need for integrating palliative care education into hospital training for nurses.•Analyze the effect that the End-of-Life Nursing Education Consortium (ELNEC) Core course has on nurse ability to provide palliative care and its implications for nursing practice. Due to the sensitive nature of palliative care (PC), many nurses are overwhelmed by PC and underprepared to manage its intricacies. Because PC is a relatively new field, nurses who graduated in the past several decades likely did not receive any PC education. Despite recent inclusion of PC in undergraduate programs, coverage in textbooks is marginal. Faculty lack sufficient time and training to prepare nursing students to provide PC; this translates into nurses having insufficient preparation in PC. This pilot project's purpose was to introduce the ELNEC curriculum to staff nurses at a Midwestern Level 1 Trauma Center in order to increase nurses' knowledge and confidence in providing PC. An ELNEC course was held and its effectiveness evaluated via the End-of-Life Professional Caregiver Survey (EPCS) given prior to and at the conclusion of the workshop. Nine nurses attended the course; six participants attended both days and completed both surveys. The survey data indicates that the ELNEC Core curriculum contributed to a statistically significant improvement (P=0.026) in EPCS scores. Paired t-tests were completed for each domain of questions in the EPCS. Mean scores from the Patient and Family Centered Care (PFCC) domain improved significantly (p=0.01), as did Effective Care Delivery (ECD) scores (p=0.01); the change in Culture and Ethical Values (CEV) was not statistically significant (p=0.27). As a pilot project, this study highlights the potential of PC education via the ELNEC curriculum to increase nurse confidence in communicating with patients and families and providing effective care for patients requiring PC. This poster will discuss the lack of education for practicing nurses and examine how the ELNEC Core curriculum can be integrated in hospitals to improve nursing knowledge and confidence regarding provision of PC.

Translation, cultural adaptation, and validation of the Brazilian Portuguese version of the End-of-Life Professional Caregiver Survey.

The aim of this study was to translate, culturally adapt, and psychometrically evaluate the Brazilian version of the "End-of-Life Professional Caregiver Survey" (BR-EPCS). This is an observational cross-sectional study. The sample was composed of 285 Brazilian healthcare professionals who work or worked in the palliative care area. A minimum number of 280 participants were established, following the recommendation of 10 subjects for each instrument item. The European Organisation for Research and Treatment of Cancer - Quality of Life Group Translation Procedure protocol was used for the translation and the cultural adaptation. For the precise/reliable evaluation of factors measured by the BR-EPCS, Cronbach's alpha (α) and composite reliability coefficients were used. The factorial analyses were made by means of the exploratory structural equation modeling methods and confirmatory factor analysis. We have conducted a multiple linear regression analysis to evaluate the sociodemographic variables' capabilities in the result prediction measured by BR-EPCS factors. The factorial analysis showed the relevance of two factors: Factor 1 - "Given care effectiveness" (18 items; Cronbach's α = 0.94; Composite Reliability = 0.95) and Factor 2 - "Mourning and ethical and cultural values" (10 items; Cronbach's α = 0.89; Composite Reliability = 0.88). Multiple linear regression analyses revealed that the working time, sex, palliative care training, and its own advance directives are predictors of the constructs assessed by the BR-EPCS. The BR-EPCS is a reliable, valid, and culturally appropriate tool to identify the educational needs of healthcare professionals who work with palliative care. This instrument can be used for educational and research reasons.

Connecting Personal Experiences of Loss and Professional Practices in Advance Care Planning and End-of-Life Care: A Survey of Providers.

Although practitioners overwhelmingly agree on the importance of advance care planning (ACP) and preparing for the end of life (EOL), the process is fraught with barriers. The goal of this research was to explore potential connections between providers' own personal experiences and current professional practices in ACP and EOL care. A cross-sectional survey design, gathering voluntary, anonymous responses from participants between August and December 2016. The survey sought information from providers in 3 distinct areas: (1) personal experiences of loss, (2) personal ACP, and (3) professional practices related to ACP and EOL care. One hundred and ninety health-care professionals (primarily physicians, nurses, and social workers) participated in the survey across a greater, Metropolitan area in the Midwest. Questions for professional practices were subscales from the End-of-Life Professional Caregiver Survey: Patient- and Family-Centered Communication (PFCC) and Effective Care Delivery (ECD). Questions developed by the research team were evaluated by judges chosen for clinical and/or research expertise. Numerous connections were found between professionals' histories of loss, personal ACP, and professional practices. For example, both clinicians with personal experience caring for someone who is dying and clinicians who had completed their own ACP scored higher in both PFCC and ECD and were more likely to refer patients to hospice and palliative care. Results support educational interventions involving opportunities for reflection and completion and communication about ACP. Additionally, educational opportunities for students in health care should focus on incorporating both ACP and greater exposure to hospice and palliative care.

How skilled do Israeli nurses perceive themselves to be in providing palliative care? Results of a national survey.

In Israel, palliative care (PC) services are limited. This study assessed Israeli nurses' perceived competencies and educational needs in providing PC. Online administration of the End-of-Life Professional Caregiver Survey (EPCS). Oncology and PC nurses were identified through the Israel Ministry of Health and Oncology Nurses' Society. Demographic and practice data were analysed using analysis of variance tests to determine differences between nurse characteristics by EPCS domains. The sample (n=105) was 94% female, had a mean age of 48 years (SD=10.5) and 83% were Jewish Israeli. Thirty-nine percent reported PC training in nursing school and 42% felt their workplace provided little to no PC education and resources to nurses. Those with advanced degrees and those who received post-graduate PC training had higher mean scores across EPCS domains (p<0.05 for all). Nursing education and workplace support in PC for Israeli nurses are limited. It is hoped that these findings may inform future PC nursing education and policy in Israel.

Assessing Palliative and End-of-Life Educational Needs of Pediatric Health Care Professionals

Children with serious, complex medical or life-threatening conditions and their families often fail to receive effective, consistent, timely, and competent care that meets their physical, emotional, and spiritual needs. Enhancing both basic education and advanced skills in pediatric palliative and end-of-life care education is recommended so that health care providers will enter practice with some form of formal preparation. In this quantitative descriptive study, we used the End-of-Life Professional Caregiver Survey to assess unmet palliative and end-of-life educational needs of pediatric health care providers in the state of Connecticut. Participants who received palliative care education in the past 5 years had higher mean scores on all 3 factors of the End-of-Life Professional Caregiver Survey, which may reflect the evolvement and depth of current pediatric palliative care education. Future palliative educational programs for pediatric providers in Connecticut should include sharing pediatric palliative care principles and national guidelines, describing services provided by pediatric hospice and timing of referral, developing systems to ensure continuity of care crossing all settings, addressing request for assisted suicide, meeting needs of staff and providers caring for the dying child (self-care), and describing cultural and ethical values specific to diverse populations in Connecticut.

What are the differences among occupational groups related to their palliative care-specific educational needs and intensity of interprofessional collaboration in long-term care homes?

BackgroundThe purpose of this study was to compare the differences across occupational groups related to their end-of-life care-specific educational needs and reported intensity of interprofessional collaboration in long-term care (LTC) homes.MethodsA cross-sectional survey, based on two questionnaires, was administered at four LTC homes in Ontario, Canada using a modified Dilman’s approach. The first questionnaire, End of Life Professional Caregiver Survey, included three domains: patients and family-centered communication, cultural and ethical values, effective care delivery. The Intensity of Interprofessional Collaboration Scale included two subscales: care sharing activities, and interprofessional coordination. In total, 697 LTC staff were given surveys, including personal support workers, support staff (housekeeping, kitchen, recreation, laundry, dietician aids, office staff), and registered staff (licensed nurses, physiotherapists, social workers, pharmacists, physicians).ResultsA total of 317 participants completed the survey (126 personal support workers, 109 support staff, 82 registered staff) for a response rate of 45%. Significant differences emerged among occupational groups across all scales and subscales. Specifically, support staff rated their comfort of working with dying patients significantly lower than both nurses and PSWs. Support staff also reported significantly lower ratings of care sharing activities and interprofessional coordination compared to both registered staff and personal support workers.ConclusionsThese study findings suggest there are differing educational needs and sense of interprofessional collaboration among LTC staff, specific to discipline group. Both the personal support workers and support staff groups appeared to have higher needs for education; support staff also reported higher needs related to integration on the interdisciplinary team. Efforts to build capacity within support staff related to working with dying residents and their families are needed. Optimal palliative care may require resources to increase the availability of support for all staff involved in the care of patients.

Teaching End-of-Life Care Using Interprofessional Simulation.

Competency in end-of-life (EOL) care is a growing expectation for health professions students. This study assessed the impact of four EOL care scenarios, using high-fidelity simulation, on the perceived learning needs and attitudes of pharmacy and nursing students. On three campuses, pharmacy students (N = 158) were exposed to standard paper EOL case scenarios, while a fourth campus exposed eight graduate nursing and 37 graduate pharmacy students to simulated versions of the same cases. The paper-based groups produced similar pre-post changes on the End of Life Professional Caregiver Survey. Results were pooled and compared with the simulation-only group, revealing significantly higher changes in pre-post scores for the simulation group. Students participating in the simulation group showed some significant differences in attitudes toward EOL care, compared with students in the classroom setting. [J Nurs Educ. 2017;56(4):205-210.].

Burnout en cuidadores profesionales y calidad de vida en residentes de centros institucionalizados

Partiendo de estudios previos en cuidadores profesionales de personas con demencia y otras enfermedades en centros institucionalizados de distintas comunidades autónomas, el objetivo de este estudio ha sido comparar los niveles de burnout que presentan los trabajadores en función del centro, crear un perfil del cuidador con una alta realización profesional y describir la calidad de vida que perciben los residentes de Murcia y Barcelona. Los instrumentos utilizados fueron el Inventario de Burnout de Maslach (MBI), la Encuesta elaborada ad hoc para Cuidadores Profesionales y el Cuestionario Breve de Calidad de Vida (CUBRECAVI) en los residentes. Los resultados reflejan, por un lado, que los niveles de realización profesional pueden ser paradójicamente más altos en situación de catástrofe y, por otro lado, que el 98.2% de los usuarios se encuentra satisfecho con la residencia en la cual se encuentra y el 81.8% con la forma en la que ocupan el tiempo. Las conclusiones que se extrapolan del estudio arrojan luz sobre el panorama actual de los trabajadores y de los residentes y la influencia que un terremoto puede tener sobre ellos.