Effect of palliative care training on perceived self-efficacy of the nurses

Patient-Centered Care for Adolescents and Young Adults with an Uncertain or Poor Cancer Prognosis: A Secondary Analysis of What Is Needed According to Patients, Caregivers, and Healthcare Providers

Patient-centered care focuses on aligning healthcare with a person's values and preferences to support their health and life goals. This approach is especially crucial among adolescents and young adults (AYAs-with a primary cancer diagnosis between the ages of 18 and 39) facing an uncertain or poor cancer prognosis (UPCP), whose care needs differ from those undergoing curative treatment. This study aims to gain insights from AYAs with a UPCP, their informal caregivers, and healthcare professionals (HCPs) to define optimal patient-centered care and identify barriers to its implementation. We conducted semi-structured interviews with 46 AYAs, 39 informal caregivers, and 49 HCPs from various clinical backgrounds. Findings highlighted the need of AYAs for an equal relationship with HCPs and active involvement in decision-making, alongside tailored information addressing their unique challenges. Informal caregivers expressed the need for information to support patients while preferring a minimal focus on themselves. HCPs noted the necessity for specialized training to meet the specific needs of AYAs with a UPCP, reporting difficulties in providing tailored support due to the disease's uncertainties. This study's results can lead to improved healthcare for this population and enhance educational modules for HCPs, equipping them to better support AYAs facing a UPCP.

Levels of Competence and Need for Continuing Education in Nonspecialist Palliative Care Settings-A Qualitative Study of Views from Finnish Health Care Professionals

Background

The need for palliative care (PC) is increasing due to the growing number of chronic diseases and an aging population. As such, the requirement to ensure the provision of PC is evident. This calls for PC competence for nurses working in nonspecialist PC settings.

Objective

The aim was to describe the views of Finnish health care professionals relating to PC competencies and the development needs for continuing education in nonspecialist PC settings.

Design

A qualitative study design.

Setting/subjects

The data were compiled via an e-survey from health care professionals working in nonspecialist PC settings in Finland; 281 participants answered the open question: "Tell us what you think about the competencies in palliative care."

Measurements

The data were analyzed using inductive content analysis.

Results

The description of PC competence was categorized into four main categories, including 64 subcategories. The main category containing the largest number of reduced expressions (f = 303) was "Perceived level of PC competence and development needs." The competence in PC was also identified as "Perceived need for continuing education in different palliative care competencies" (f = 243), "Building the foundations of one's own competence" (f = 133), and "Factors related to the work organization and connected to the competence enhancement" (f = 84).

Conclusion

The health care professionals in nonspecialist PC settings recognize the importance of ensuring competence and the need for continuous and regular education. The results of this study can be utilized in the planning of continuing education and in targeting it correctly.

Motivations behind end-of-life care: a qualitative study of Iranian nurses' experiences

BACKGROUND

Providing high-quality end-of-life care is currently a paramount health priority. Given that the standard of care is intrinsically linked to nurses' motivations, it is becoming too imperative to explore the contributing factors Consequently, this study was undertaken to elucidate the experiences of Iranian nurses regarding their motivation for delivering end-of-life care.

METHODS

This research is a qualitative, descriptive inquiry employing conventional content analysis, carried out at two governmental hospitals in Gorgan, northern Iran, from February to July 2023. 12 nurses were purposefully selected to participate in the study, ensuring maximal diversity. The data were collected through semi structured interviews and analyzed using Graneheim and Lundman's five-step method. The coding process was facilitated by the useof MAXQDA version 10 software. To establish rigor, the four criteria outlined by Guba and Lincoln were applied.

RESULTS

the participants included eight women and four men with an average age of 39.6 ± 6.31 years. The data analysis yielded five main categories and fifteen subcategories. The main categories were: "The Foundations of professional care in nursing", "Core Drivers in Optimal End-of-Life Care", "Family Involvement in End-of-Life Care", "Incorporating Spiritualism in Care" and "Dominant motivational Issues Within the Caregiving Atmosphere".

CONCLUSIONS

This study delineates the experiences that influence the provision of end-of-life care from the perspective of Iranian nurses. Innate traits such as empathy and a passion for nursing, in addition to nurses' moral compass and spiritual beliefs, serve as pivotal motivational stimuli. Leveraging these findings can be instrumental in shaping healthcare practices and policies to enhance the quality of end-of-life care.

Rasch analysis of a palliative care self-efficacy instrument for nursing assistants

This study used Rasch models to evaluate the psychometric properties of a self-efficacy instrument focused on psychosocial aspects of palliative care developed for nursing assistants (NAs). NAs from 6 skilled nursing facilities in Illinois, U.S. (n=102) were divided into intervention and control groups and answered 16 questions at baseline and 1-month follow-up. A total of 84 NAs completed assessments at both times. The rating scale structure improved when 3 instead of 5 response categories were used. After removing 4 items, the instrument demonstrated unidimensionality and local independence. A person-item threshold map indicated a ceiling effect. For the intervention group, 2 items and 1 item became easier and more difficult respectively post-training. With adjustments, the 12-item instrument became an adequate measure of palliative care self-efficacy. By using PCSE-NA as a tool to assess palliative care self-efficacy of NAs, geriatric nurses can identify weaknesses of and ways to improve training for NAs.

Palliative care knowledge and self-efficacy: a comparative study between intensive care units and general units nurses

BACKGROUND AND OBJECTIVES

The growing number of terminally ill patients has underscored the importance of equipping healthcare workers with adequate palliative care knowledge and self-efficacy. This study aimed to compare the palliative care knowledge and self-efficacy of nurses in intensive care units (ICUs) with those in general wards at hospitals affiliated with Kerman University of Medical Sciences in 2023.

METHODS

This descriptive-comparative cross-sectional study involved nurses from intensive care units and general wards of three hospitals affiliated with Kerman University of Medical Sciences, for a total sample size of 300 nurses (150 in each group). The samples were selected using convenience sampling. The data collection tools included a demographic information questionnaire, the Palliative Care Knowledge Test (PCKT), and the Palliative Care Self-Efficacy Scale (PCSES). Convenience Sampling method was used. The data were analyzed using SPSS 23. Descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics (independent t-test, Mann-Whitney U test and multivariate stepwise regression) were employed. Statistical significance was determined by a p-value of ≤ 0.05.

FINDINGS

The mean score for palliative care knowledge was 10.59 (± 2.10) for nurses in intensive care units and 10.43 (± 2.33) for nurses in general wards, with no significant difference between the two groups (P = 0.53). Similarly, the mean score for palliative care self-efficacy was 28.01 (± 10.29) for nurses in intensive care units and 27.98 (± 10.33) for nurses in general wards, with no significant difference between the groups (P = 0.98). Variables such as the history of caring for dying patients in the hospital (P = 0.004) or at home (P = 0.01), workplace (P = 0.002), and work experience (P = 0.03) were identified as the main predictors of palliative care knowledge and palliative care self-efficacy was affected by age (P < 0.001), history of participation in palliative care training courses (P = 0.008), and palliative care knowledge score (P = 0.01).

DISCUSSION AND CONCLUSION

This study revealed no significant difference in total scores of palliative care knowledge or self-efficacy between nurses in intensive care units and general wards It is suggested that more efforts be made to increase the knowledge and self-efficacy of all nurses, especially nurses in ICU departments, till providing a standard palliative care setting.

Physiotherapists' perspectives on factors affecting the scope of in-home palliative care treatments: a qualitative study

BACKGROUND

Physiotherapy has demonstrated significant benefits in enhancing quality of life and managing symptoms of people in need of palliative care (PC). Despite these benefits, palliative physiotherapy is infrequently integrated into community-based care, where most PC services are delivered. The limited prevalence of these treatments highlights the need to explore the factors influencing their delivery in home settings.

OBJECTIVES

This study‎ aimed to elucidate the factors that influence the scope of occasional in-home palliative physiotherapists' interventions as perceived by the physiotherapists who provide these treatments.

METHODS

A qualitative study was conducted, involving 15 physiotherapists (nine women and six men), all employed by a Health Maintenance Organization (HMO), who typically work in community-based clinics but occasionally provide palliative physiotherapy treatments outside of their regular working hours. Data were collected via in-depth, semi-structured interviews, using an interview guide and analyzed using reflective thematic analysis.

RESULT

Two main themes emerged: (1) External factors influencing the scope of palliative physiotherapy treatments. These include patients' characteristics and their disposition toward palliative physiotherapy treatments, family dynamics amongst each other and with the physiotherapists, and interactions of the physiotherapists with the palliative multidisciplinary team; (2) Physiotherapists‎'‎ inclination to provide PC treatments. This theme encompasses the physiotherapists' knowledge, role perception, emotional experiences, and coping strategies during the provision of PC.

CONCLUSION

External and personal factors shape the scope of in-home PC treatments. Improving communication and addressing emotional challenges and coping strategies could enhance care delivery.

Deciphering the global research trends and significance of moral intelligence via bibliometric analysis

Introduction

Moral Intelligence (MI) as a concept has gained importance in recent years due to its wide applicability in individual, organizational, and clinical settings or even policy making. The present study employed Bibliometric analysis to understand the emerging topics associated with MI and its global research trend. This paper's primary aim was (i) to explore the temporal and geographic growth trends of the research publication on MI. (ii) to identify the most prolific countries, institutions, and authors, working on MI, (iii) to identify the most frequent terminologies, (iv) to explore research topics and to provide insight into potential collaborations and future directions, and (v) to explore the significance of the concept of moral intelligence.

Method

Bibliometric analysis was used to understand the emerging topics associated with MI and its global research trend using the SCOPUS database. VOS viewer and R were employed to analyze the result. Through the analysis conducted, the development of the construct over time was analyzed.

Results

Results have shown that Iran and the United States and these two combined account for 53.16% of the total country-wise publications. Switzerland has the highest number of Multi-county publications. Authors from Iran and Switzerland have the most number of publications. Emerging topics like decision-making, machine ethics, moral agents, artificial ethics, co-evolution of human and artificial moral agents, green purchase intention etc were identified.

Discussion

The application of MI in organisational decision-making, education policy, artificial intelligence and measurement of moral intelligence are important areas of application as per the results. Research interest in MI is projected to increase according to the results delineated in this article.

The effect of combined training (theoretical-practical) of palliative care on perceived self-efficacy of nursing students

BACKGROUND

Nurses and researchers emphasize the importance of adding educational content of palliative care to nursing curricula in Iran as a means to improve the quality of care at the end of life and self-efficacy is considered as an important determinant in palliative care nursing. However, undergraduate nursing students are not sufficiently trained to achieve the qualifications required in palliative care. The aim of this study was to determine the effect of combined training (theoretical-practical) of palliative care on the perceived self-efficacy of nursing students.

METHODS

This is a semi-experimental study with a pretest-posttest design. Sampling was nonrandomized with convenience method and included 23 seventh-semester students. The intervention consisted of palliative care training for ten theoretical sessions and three practical sessions. Data were collected using demographic and the perceived self-efficacy questionnaires completed before and after the intervention. Data were then analyzed in the statistical SPSS 23 software using descriptive and analytical statistics.

RESULTS

The mean age of the samples was 22.78 (SD1.17). Most of the participants were male (56.5%) and single(91.3%). The findings showed that, perceived self-efficacy, psycho-social support and symptom management improved significantly after the intervention (p<0.05).

CONCLUSION

Palliative care training can increase the nursing students perceived self-efficacy. Since nursing students are the future nurses of the care system, therefore, managers and planners can take a step towards improving the quality of nursing care by using palliative care training programs. Since nursing students will be future nurses in health care system, therefore, managers and planners can take steps to improve the quality of nursing care by using palliative care education programs.

Sense of failure in end of life care: Perspectives from physicians and nurses

Limited knowledge exists regarding sensed failure resulting provision of end-of-life (EOL) care. Among medical health professionals (MHP), a sense of failure is associated with impaired patientcare and reduced worker wellbeing, including higher rates of burnout and secondary traumatic stress. As part of a larger mixed-methods study on the effects of EOL-care provision on MHP in general hospitals, semi-structured in-depth interviews were conducted with 22 physicians and nurses at three tertiary Israeli hospitals, representing a wide range of medical specialties, training, experience, and cultural backgrounds. Qualitative thematic analysis of the interviews led to the identification of the theme 'sense of failure' with the sub-themes 'sources' and 'lived meanings' of the sensed failure. Apart from the source 'losing a patient' all other identified sources were recognized as work-related risk factors, including 'unsupportive environments' and 'shortcomings of the medical practice.' Two of the lived meaning 'sense of personal responsibility' and 'moral injury' were also recognized as work-related risk factors. Surprisingly, albeit the adverse context of EOL-care, the two remaining lived meanings 'learning from failure' and 'sense of purpose' were recognized as protective resilience factors. Changes in workplace norms by focusing on leadership and mentoring programs and implementation of evidence based interventions aimed at reducing the sense of failure and enhancing feelings of purpose are recommended. Finally, the findings described in the study would benefit from continued studies on larger scales.

Translation and validation of the Chinese version of Palliative Care Self-Efficacy Scale

OBJECTIVES

Accurately assessing the self-efficacy levels of palliative care professionals' is crucial, as low levels of self-efficacy may contribute to the suboptimal provision of palliative care. However, there is currently lacking a reliable and valid instrument for evaluating the self-efficacy of palliative care practitioners in China. Therefore, this study aimed to translate, adapt, and validate the Palliative Care Self-Efficacy Scale (PCSS) among Chinese palliative care professionals.

METHODS

This study involved the translation and cross-cultural adaptation of the PCSS, and the evaluation of its psychometric properties through testing for homogeneity, content validity, construct validity, known-groups validity, and reliability.

RESULTS

A total of 493 palliative care professionals participated in this study. The results showed the critical ratio value of each item was >3 (p < 0.01), and the corrected item-total correlation coefficients of all items ranged from 0.733 to 0.818, indicating a good homogeneity of the items with the scale. Additionally, the scale was shown to have good validity, with item-level content validity index ranged from 0.857 to 1.000, and scale-level content validity index/Ave was 0.956. The exploratory factor analysis and confirmatory factor analysis (CFA) confirmed the 2-factor structure of the Chinese version of PCSS (C-PCSS), explaining 74.19% of the variance. CFA verified that the 2-factor model had a satisfactory model fit, with χ2/df = 2.724, RMSEA = 0.084, GFI = 0.916, CFI = 0.967, and TLI = 0.952. The known-groups validity of C-PCSS was demonstrated good with its sensitive in differentiating levels of self-efficacy between professionals with less than 1 year of palliative care experience (p < 0.001) or without palliative care training (p = 0.014) and their counterparts. Furthermore, the C-PCSS also exhibited an excellent internal consistency, with the Cronbach's α for the total scale of 0.943.

SIGNIFICANCE OF RESULTS

The findings from this study affirmed good validity and reliability of the C-PCSS. It can be emerged as a valuable and reliable instrument for assessing the self-efficacy levels of palliative care professionals in China.

Development of an Institution-Wide Pediatric End-of-Life Summit

End-of-life (EOL) care in pediatrics is a unique subspecialty lacking adequate provider education and training. Patient and family outcomes may improve when clinicians are provided with training in this care. Recognizing the need for this specialized education, a small group of bereavement coordinators created an institution-wide pediatric EOL summit at a large urban pediatric teaching hospital. One hundred forty-five clinicians from 14 diverse disciplines attended the first annual pediatric EOL summit. A survey was sent to the participants for feedback. The survey results suggested an overwhelmingly positive response to the summit. Continuing to provide this educational conference is critical to improving care for patients and families, particularly at the end of life.

The moderating effect of attitudes in the relationship between knowledge and self-efficacy in palliative care among nurses: A cross-sectional, correlational study

Provision of palliative care to patients with advanced chronic diseases or old populations is suboptimal, which results in unnecessary suffering of and burden to patients, caregivers, and society. Low self-efficacy in palliative care among nurses is a factor affecting suboptimal utilization of palliative care. Poor knowledge is a factor affecting low self-efficacy in palliative care of nurses. Attitudes may contribute to the relationship between knowledge and self-efficacy in palliative care, but these relationships have been rarely examined in nurses. This study aimed to determine whether nurses' attitudes moderate the relationship between knowledge and self-efficacy in palliative care. In a cross-sectional, correlational study, online or offline survey on self-efficacy, knowledge, attitudes, and covariates was conducted from 282 nurses in South Korea. PROCESS v4.1 for SPSS was used to address the study aim. Higher levels of knowledge (p = .048) and attitudes (p < .001), and the interaction term of knowledge and attitudes (p = .025) were significantly associated with higher levels of self-efficacy (F = 6.12, p < .001, R2 = .152), indicating the moderating effects of attitudes. The relationships between higher levels of knowledge and self-efficacy were significant only in nurses with highly and moderately positive attitudes (R2 change = .016, F = 5.11, p = .025), but not nurses with lack of positive attitudes. Our results supported the moderating role of nurses' attitudes in the relationship between knowledge and self-efficacy. To improve self-efficacy in palliative care in nurses, improvement in knowledge and facilitation of positive attitudes are needed.

Arabic version of the Palliative Care Self-Efficacy Scale: Translation, adaptation, and validation

OBJECTIVES

A lack of confidence among oncology nurses might be problematic when providing palliative care. No valid and reliable tool is currently available in Saudi Arabia to assess oncology nurses' confidence in providing palliative care. This study aims to explain the process of translation, adaptation, and validation of the Palliative Care Self-Efficacy Scale (PCSS) to support its use in the Saudi context.

METHODS

This was a methodological study of translation, cultural adaptation, and content validation of PCSS. The process of translation and adaptation was conducted according to the World Health Organization guidelines, including forward and backward translations, an expert panel review, and pretesting and cognitive interviewing, resulting in a final version. Two independent bilingual oncology nurses familiar with palliative care terminology translated the PCSS from English to Modern Standard Arabic. Next, the concise PCSS translation developed from the 2 translations was back-translated to English by 2 English-speaking translators and then compared to the original PCSS. The Arabic version PCSS was evaluated by Saudi professionals (N = 5) in oncology and palliative care nursing using a Likert scale for essentiality, relevance, clarity, and appropriateness. The content validity was examined using the calculation of the content validity ratio, item-level content validity index (I-CVI), and modified kappa statistics. The thinking aloud method was also used to interview Saudi oncology nurses (N = 8) who had palliative care experience.

RESULTS

The relevance, clarity, and appropriateness of the first Arabic version PCSS were validated. It had a level of content validity index of 1.00 for all items after improvements were made based on the recommendations of experts and oncology nurses.

SIGNIFICANCE OF RESULTS

The PCSS demonstrated face and content validity in the assessment of oncology nurses' confidence in providing palliative care. The PCSS is suitable for use in palliative cancer care units in Saudi Arabia to identify the educational needs of nurses to promote their confidence and improve the quality of care. Additional reliable and valid language versions of the PCSS allow for international and national comparisons, which may be useful for oncology nursing administrators or managers who are accountable for the quality of palliative care during the strategic health-care planning process in cancer services.

Pediatric Nurses' Perceived Competencies toward Palliative Care for Terminally Ill Children

INTRODUCTION

Paediatric palliative care involves the physical, psychological, and spiritual well-being of terminally ill children and their families. Competency in palliative care centred on personal traits and attributes, key abilities to satisfy professional duty through practise, and knowledge of palliative care.

OBJECTIVE

Is to identify paediatric nurses' perceived Competencies toward Palliative Care for Terminally Ill Children.

METHOD

Used was a descriptive research design. The sample included 72 nurses who worked at neonatal, pediatric intensive care units ( NICU, PICU) in four hospitals affiliated to Universal Health Insurance (UHI) in Port Said City, namely ( El Nasr, El Salam, El Hayah, and pain outpatient clinic at El Tadamon) hospital. The structured questionnaire and the nursing palliative care quiz are the first tools used to evaluate sociodemographic characteristics. Data were gathered using a second tool, the Nurses' Core Competencies in Palliative Care questionnaire.

RESULTS

Based on the study, 56.9% of nurses had adequate knowledge, and 47.2% of paediatric nurses agreed that they had some extendable palliative care competences.It can be summarized  that more than sighlty half of the studied sample have adequate knowledge while the rest of the studied sample have inadequate knowledge,with statistically significant relationship between nurses' overall perceived competence and overall knowledge.

CONCLUSION

The relationship between nurses' overall perceived competence and overall knowledge was very statistically significant. The Recommendation study's findings highlight the urgent need of creating an evidence-based programme for competency training in palliative care, which should be available in every hospital and adhered to all paediatric nurses.

Development of a bilingual interdisciplinary scale assessing self-efficacy for participating in Medical Assistance in Dying

Medical Assistance in Dying (MAiD) is a complex process involving the person seeking care and their relatives. MAiD involves physical, psychosocial and spiritual needs, and consequently the involvement of an interdisciplinary team is beneficial. Therefore, updating the knowledge and skills of healthcare and social services professionals is critical. An interdisciplinary team from Laval University (Quebec, Canada) has developed a continuous training program for all health care and social services professionals who could be involved in the care of persons who request MAiD and their loved ones. It is crucial to assess whether the objectives of the continuous training program are being met, especially since this new training addresses several complex issues (legal, ethical, and clinical). Bandura's self-efficacy theory has been widely used to develop scales for assessing the impact of training programs and identifying knowledge gaps. Bandura's theory states that feeling secure in one's self-efficacy leads to self-determined motivation. Although there are various scales intended to measure self-efficacy in palliative care, none include self-efficacy for participating in the process surrounding MAiD. As a result, we aim to create a bilingual (English-French) interdisciplinary scale to assess self-efficacy for participating in the process surrounding MAiD. The scale will allow decision-makers and researchers to identify current knowledge gaps. It will also be useful for assessing the impact of current and future training programs addressing this end-of-life practice. In this work in progress, we briefly introduce the training program and the future steps in the development and validation of the scale.

The validity and reliability of Turkish version of the self-efficacy scale in nursing care of children with epilepsy

PURPOSE

This study was conducted to the Turkish validity and reliability study of the 'Scale of Self-efficacy in Nursing Care of Children with Epilepsy' (SSENCCE).

DESIGN AND METHODS

The construct validity of the scale was evaluated with explanatory factor analysis (EFA) and confirmatory factor analysis. The reliability of the scales used in the research was examined with composite reliability and Cronbach's alpha coefficients.

RESULTS

A total of 144 nurses participated in the study. The variance explained in the 12-item scale was 53.6%, and the eigenvalue was found as 6.442. The commonality values of the scale items ranged from 0.304 to 0.712, and the factor loads ranged from 0.552 to 0.844. Cronbach's α of the SSENCCE was calculated as 0.907.

CONCLUSION

The Turkish version of the ESSENCE is a valid, reliable, and appropriate tool for assessing the self-efficacy of nurses providing care for children with epilepsy.

PRACTICE IMPLICATIONS

Considering that there is no scale that is used to evaluate the self-efficacy of nurses who provide care for children with epilepsy in Turkey, it is thought that this study will guide future research on the subject and the improvement of the clinical experience of nurses.

Implementation and evaluation of an end-of-life care education program for oncology nurses working in medical-surgical wards: A quasi-experimental study

Background

The issue of a good death for cancer patients is becoming more prevalent. Hence, nurses' end-of-life work performance and stress levels in medical-surgical wards can significantly impact the quality of life of cancer patients and their caregivers. This study aimed to develop an end-of-life care education program for nurses taking care of cancer patients in medical-surgical ward and verify the program's preliminary effect.

Method

Quasi-experimental research using a one-group pretest-posttest design was carried out for this study. The end-of-life care manual for nurses in general wards were developed through expert validation. Initial in-person and follow-on online self-education sessions were conducted based on the end-of-life care manual. A total of 70 nurses participated in the end-of-life care education program. End-of-life care stress and end-of-life care performance were measured as preliminary program effects. An online survey was conducted before the initial in-person education and after the follow-up online education.

Results

The end-of-life care education program effectively improved general ward nurses' end-of-life care performance. This performance was improved in the physical and psychological domains. However, this program did not improve the nurses' performance in end-of-life care in the spiritual domain. Furthermore, it did not effectively reduce the stress on end-of-life care, indicating that improvements should be made.

Conclusions

The improvement of effective end-of-life care education programs for nurses caring for cancer patients in general wards is required. Most importantly, efforts at the hospital organization level are necessary to reduce the stress of end-of-life care by improving the working environment. Additionally, it is necessary to conduct preemptive tailored intervention programs for nurses, such as a resilience improvement program.

Improving Critical Care Nurses Perceived Self-Efficacy in Providing Palliative Care: A Quasi-Experimental Study

BACKGROUND

Palliative care is a service that focuses on quality of life and symptom management. It is particularly important for patients with chronic disease. Palliative care in general is an underutilized service for various reasons. Many nurses have only learned about palliative care from experience and express a need for more education.

PURPOSE

This study focused on educating critical care nurses on palliative care through online training videos. This quasi-experimental study aims to determine if an online palliative care educational program improves critical care nurses' self-efficacy in providing palliative care.

PROCEDURES

The study was conducted using a pre-survey and post-survey that was created with a validated tool called the Palliative Care Self-Efficacy Scale. In between the surveys, the respondents were directed to online education.

MAIN FINDINGS

The overall Palliative Care Self-Efficacy Scale showed a median score of the Palliative Care Self-Efficacy Scale increased from pre education (Md=38) to post-education (Md = 43.5), z = -4.868, p <.001, with a large effect size (r = -.76).

PRINCIPAL CONCLUSIONS

The majority of critical care nurses have received some form of palliative care education. Online resources similar to the VitalTalk videos and handouts provide added education and improve perceived self-efficacy in providing palliative care in both psychosocial and symptom management aspects of care. The data suggests that improvements to access to education can be done by employers. Further studies can be done to assess current access to palliative care education in undergraduate nursing programs.

Confidence in carrying out palliative care among intensive care nurses

BACKGROUND

Nurses in intensive care units (ICUs) play a crucial role in providing palliative care. Effective provision of palliative care in the ICU requires nurses' active engagement, yet little is known about the confidence for palliative care that ICU nurses hold in China.

AIM

To explore confidence in performing palliative care among ICU nurses in China and factors related to nurses' level of confidence.

STUDY DESIGN

A cross-sectional design was implemented.

METHODS

This study utilized convenience sampling to recruit ICU nurses from nine hospitals in Wuhan, China. Data were collected via an online survey. Multiple regression was conducted to identify the predictors of the ICU nurses' confidence in performing palliative care.

RESULTS

A total of 231 ICU nurses participated in the study, resulting in a response rate of 78% (231/296). Participants reported a relatively low level of confidence for carrying out palliative care (mean score = 2.60 ± 0.53; range = 1-4). Nurses who had more positive attitudes toward palliative care communication (P < .001), higher levels of formal training on palliative care (P < .001), more years of working as an ICU nurse (P < .05) and those working in integrated ICU (P < .001) showed a higher level of confidence in carrying out palliative care.

CONCLUSION

Participants' lack of confidence in performing palliative care makes for increased challenges, particularly in uncertainty about family assessments, palliative care discussions and lack of palliative care training. Strengthening palliative care curricula in nursing education and professional training is imperative to enhance ICU nurses' confidence.

RELEVANCE TO CLINICAL PRACTICE

Strengthening palliative care education and training, particularly in relation to palliative care communication, is critical. Implementing and tailoring culturally relevant palliative care call for attention to practice and for policy changes in palliative care delivery in China.

Psychometric Properties of the Albanian Version of the Nursing Self-Efficacy Scale

There are few tools to ascertain self-efficacy, which is a valuable component of nursing skills. This study has tested the psychometric properties of an Albanian translation of the Nursing Profession Self-Efficacy Scale (NPSES), which is based on Bandura's theory of social cognition. Data were collected using questionnaires which were filled out by 423 nurses from the twelve provinces of the Albanian health system. The scale's content, face, and construct validity were evaluated. Reliability was verified using Cronbach's α and test-retest and by calculating the intraclass correlation coefficients. The original NPSES has two factors; for the A-NPSES analyzed in this study, four factors emerged from the factorial analysis of our reference sample: nursing care procedure situation, nursing research situation, nursing ethics situation, and nursing practice situation. Cronbach's α was 0.91, indicating that the tool is reliable. The results of this study demonstrate the validity and reliability of the Albanian version of the NPSES. This scale is a valuable tool for self-assessing nurses' self-efficacy. An adequate scale for measuring nurses' self-efficacy can be used to improve the quality of clinical nursing care.

Death-coping self-efficacy and its influencing factors among Chinese nurses: A cross-sectional study

Background

Nurses are the main caregivers of dying patients. Facing or dealing with death-related events is inevitable. Death-coping self-efficacy (DCS) is very important, as it can reduce the risk of nursing staff to adverse emotional distress, help them participate in end-of-life care and improve the quality of care of patients.

Methods

Using the convenient sampling method, this study included a total of 572 nurses from a tertiary hospital in Hangzhou, China. The status and influencing factors of the DCS of nurses were explored using a general information questionnaire and DCS scale.

Results

The scores of each parameter, ranging from low to high, were in the order of coping with grief, preparation for death and hospice care. Factors influencing nurses’ DCS included attendance in hospice care education courses within the previous year, experience of accompanying the family members of the deceased and attitude towards death.

Conclusions

The overall self-efficacy of nurses in palliative care was at a medium level. Moreover, their self-efficacy in coping with grief and preparation for death should be strengthened. Managers of medical institutions can assess the death-coping ability of nurses, which helps provide corresponding support and training for nurses at an early stage. Nurses should receive guidance in grief adjustment and emotion regulation. Medical units should provide nurses with a platform for continuous training and education, use of death-related theoretical models and frameworks to guide nurses in dealing with death-related events, reduce nurses’ negative mood and jointly promote their mental health.

General Ward Nurses' Self-Efficacy, Ethical Behavior, and Practice of Discharge Planning for End-Stage Cancer Patients: Path Analysis

General ward nurses play a key role in discharge planning for end-stage cancer patients. It is necessary to assess the factors regarding their practice to promote discharge planning in accordance with end-stage cancer patients' wishes. This study aimed to investigate the relationships between general ward nurses' practice of discharge planning for end-stage cancer patients, self-efficacy, ethical behavior, attitude, knowledge and experience, perceived skills, and perceived barriers. A total of 288 general ward nurses from nine hospitals in a city in Japan completed the questionnaire. Path analysis was conducted to test the hypotheses. The results showed that nurses' self-efficacy, ethical behavior (do-no-harm, do-good), knowledge (experience of attending home care seminars), and perceived skills (assertiveness) were positively and directly related to the practice of discharge planning. Nursing experience and perceived skills (assertiveness) were positively associated with discharge planning practice, while perceived barriers (death discussion) and attitude (degree of leaving it to discharge planning nurses (DPNs)) were negatively associated, with self-efficacy acting as a mediator. Thus, our findings show that it is important to enhance self-efficacy and nursing ethical behavior to improve the practice of discharge planning. Accordingly, education regarding home care, assertive communication skills, death discussion, and ethics is needed for general ward nurses.

Translation, adaptation, and validation of the Self-efficacy in Palliative Care scale (SEPC) for use in Swedish healthcare settings

Background

One challenge for healthcare professionals when delivering palliative care can be their lack of confidence. The Self-efficacy in Palliative Care Scale (SEPC) is considered a valid and reliable assessment scale to evaluate confidence when delivering palliative care. Currently, there is not a reliable instrument aimed to measure healthcare professionals’ confidence in palliative care in Swedish. Therefore, this study aimed to translate, culturally adapt, and validate the SEPC-scale for use in a Swedish healthcare context.

Methods

This study applied the World Health Organization’s (WHO) guidelines for translating and adapting instruments, using forward and back-translation, an expert panel, and cognitive interviews. Swedish experts in palliative care (n = 6) assessed the Swedish version of the SEPC-scale based on its relevance, understandability, clarity, and sensitivity on a Likert scale. Methods involved calculation of content validity index (CVI) with modified kappa statistics and cognitive interviewing with healthcare professionals (n = 10) according to the “think-aloud” method.

Results

Calculation of I-CVI (Item-CVI) showed that the Swedish SEPC-scale was considered relevant but needed some modifications to improve its understandability and clarity. The experts recognized an absence of precision in some items that affected clarity and understanding. Likewise, the healthcare professionals highlighted some challenges with understandability and clarity. They indicated that the scale was relevant, but a few items needed adjustment to fit a broader range of healthcare professionals. Items that referred to death and dying could be sensitive but were considered relevant.

Conclusions

The SEPC-scale is considered valid for use in Swedish healthcare practice, for a broad range of healthcare professionals, and for diagnoses other than cancer. This study shows that cultural adaptation is necessary for establishing relevance and enabling acceptance to various healthcare professionals and contexts in the target country.

Translation, Cultural Adaptation, and Content Validation of the Palliative Care Self-Efficacy Scale for Use in the Swedish Context

The Palliative Care Self-Efficacy Scale (PCSE) is a valid instrument in English for assessing healthcare professionals’ self-efficacy in providing palliative care; it has not been translated into Swedish. The aim of this study was to describe the translation, cultural adaptation, and content-validation process of the PCSE scale. In this study, forward and backward translations, pretesting including an expert panel (n = 7), and cognitive interviewing with possible healthcare professionals (physicians, nurses, and assistant nurses) (n = 10) were performed. Experts in palliative care rated items on a Likert scale based on their understandability, clarity, sensitivity, and relevance. The item-level content validity index (I-CVI) and modified kappa statistics were calculated. Healthcare professionals were interviewed using the think-aloud method. The translation and validation process resulted in the final version of the PCSE scale. The average I-CVI for sensitivity was evaluated and approved. Most of the items were approved for clarity, some items lacked understandability, but a majority of the items were considered relevant. The healthcare professionals agreed that the items in the questionnaire evoked emotions, but were relevant for healthcare professionals. Thus, the Palliative Care Self-Efficacy scale is relevant for assessing healthcare professionals’ self-efficacy in palliative care in a Swedish care context. Further research using psychometric tests is required.

Impact of an online spiritual care course on perceived competency in spiritual care of students in social and health care professions / Wirksamkeit eines Online-Spiritual Care-Seminars auf die wahrgenommene Spiritual Care-Kompetenz bei Studierenden in Sozial- und Gesundheitsberufen

This study examines the impact of an online spiritual care course on perceived spiritual care competency of students in social and health care professions. A quasi-experimental, pre-post-test study using questionnaires was conducted in Bavaria, Southern Germany, with a sample of 78 participants and 67 respondents in a comparison group. A repeated measures ANOVA was performed, with time and group as factors. Statistically significant increases were found in participants' perceived knowledge, skills, and attitudes concerning spiritual care, in different facets of spiritual care competency, in spiritual awareness, and in general self-efficacy (p < .05). Results suggest the effectiveness of online spiritual care training, which can help prepare future caregivers in providing holistic care.

Effectiveness of Educational Programs on Palliative and End-of-life Care in Promoting Perceived Competence Among Health and Social Care Professionals

BACKGROUND

There is a growing need for palliative care for patients near the end of life and their caregivers. Palliative and end-of-life care (EoLC) education are recommended for all health care (e.g., physicians, nurses, and allied health practitioners) and social care professionals (e.g., social workers) to ensure the quality of services. However, less attention has been afforded to generic, in contrast to specialized, EoLC education. This study evaluated the effectiveness of a series of short-term generic EoLC educational programs for health and social care professionals.

METHOD

A pre-post survey design was adopted, focusing on different EoLC core competences.

RESULTS

Significant improvement was observed in all perceived competences after the educational programs, regardless of participants' occupation or EoLC experience. Perceived competence in self-care was rated significantly higher than all other competences prior to the programs. Healthcare professionals rated significantly higher on competence in symptom management than social workers. Scores on communication skill and self-care competences were significantly higher following longer (i.e., 16-24 hours) than shorter (i.e., 4-8 hours) programs.

CONCLUSION

Generalist palliative/EoLC educational programs may enable health and social care professionals to refresh and extend their knowledge and skills and enhance their perceived competence in providing EoLC. Further research on generalist palliative/EoLC education is needed to examine the impact of continuing training on professionals' actual practice in EoLC and palliative care.

Big Five Personality Model-based study of death coping self-efficacy in clinical nurses: A cross-sectional survey

Background

Specific personality traits may affect the ability of nurses to deal with patient death. The relationship between personality and death coping self-efficacy (DCS) has rarely been investigated in the palliative care setting. In this study, we explored the associations between different personality profiles and DCS in clinical nurses from general wards and ICU.

Methods

A cross-sectional survey of 572 Chinese nurses was conducted between August and September 2020, by way of a self-administered questionnaire.

Results

Among the Big Five Personality Traits, in nurses the score was highest for conscientiousness and lowest for neuroticism. With regard to DCS, nurses scored highly on the intention of hospice care. The Big Five Personality Traits were found to explain 20.2% of the overall variation in DCS. Openness, agreeableness and conscientiousness were significantly associated with DCS in nurses.

Conclusions

Nursing managers should pay attention to differences in personality characteristics and provide personalized and targeted nursing education. This should improve nurses’ DCS, enrich their professional development and promote high quality palliative care for patients and their families.