An instrument to measure nurses' knowledge in palliative care: Validation of the Spanish version of Palliative Care Quiz for Nurses

Nurses' knowledge about palliative care in a critical care unit

INTRODUCTION AND OBJECTIVE

Patients admitted to the Critical Care Unit (CCU) have a high mortality rate due to their complexity. Palliative care (PC) is a key aspect that can improve patient care. Because of the essential role of the nurse in providing this care, training, and including it in daily practice are needed. Our objective was to review the level of knowledge among the nurses in the CCU regarding PC and assess whether there is an association between each of the study variables.

METHODOLOGY

We performed a descriptive observational cross-sectional study in the CCU of a tertiary level university hospital. The questionnaire Palliative Care Quiz for Nurses, previously validated and translated into Spanish, was used. This is a self-administered questionnaire consisting of 20 multiple-choice questions (True/False/Do not know-Do not answer) which evaluates three aspects of PC: philosophy, psychosocial and control of pain and other symptoms. In addition, sociodemographic data was collected. Descriptive and inferential statistics were used, a p < .05 was considered statistically significant in all cases.

RESULTS

The questionnaire was administered to 68 nursers, with an average age of 34.98 ± 12.12 years, and 13.00 ± 11.75 years of professional experience. Twelve nurses have Master studies and 28 nurses have received training in PC. The percent of correct answers of the questionnaire was 56.98%. There were no statistically significant differences between the total average score and the variables studied. However, looking at each aspect on the scale, an association was found between PC training and control of pain and other symptoms (p = .033).

CONCLUSION

Critical care nurses have a basic knowledge of PC, it being insufficient in the psychological sphere. Developing a training programme which identifies misconceptions and training deficits might improve the management of symptom control in palliative care patients, quality of care and its application.

Knowledge and Attitudes towards Palliative Care: Validation of the Spanish Version of Questionnaire on Palliative Care for Advanced Dementia

Background: Palliative care is essential in the care of people with advanced dementia, due to the increasing number of patients requiring care in the final stages of life. Nurses need to acquire specific knowledge and skills to provide quality palliative care. The Questionnaire on Palliative Care for Advanced Dementia (qPAD) is useful for assessing knowledge and attitudes toward palliative care, but its adaptation to the Spanish language and analysis of its effectiveness and usefulness for the Spanish culture is lacking. Objective: To report on the Spanish language adaptation and psychometric analysis of the qPAD. Methods: The Questionnaire on Palliative Care for Advanced Dementia Spanish version (qPAD-SV) was obtained from a process that included translation, back-translation, comparison with other language versions, expert review, and pilot study. Content validity, criterion validity, and reliability of the questionnaire were analyzed. The difficulty and discrimination indices of items composing the knowledge subscale were also calculated. Results: Adequate content validity index obtained after the analysis of qPAD-SV by a heterogeneous group of experts was found (overall CVI = 0.96; 0.95 for the Knowledge subscale and 0.99 for the Attitudes subscale). Significant correlations with the Palliative Care Knowledge test (rho = 0.368, p < 0.001) and Self-Efficacy in Palliative Care Scale (rho = 0.621, p < 0.001) show an adequate criterion validity. Cronbach’s alpha coefficients for the Knowledge subscale (0.60) and the Attitudes subscale (0.91) supported the reliability of the qPAD-SV. The questionnaire had an overall difficulty index of 0.71, with three items that could be considered difficult or very difficult, and eleven items that could be considered very easy. Discussion: Although it shows internal consistency, validity, and difficulty indices similar to those obtained by qPAD versions in other languages, a reformulation of the items with lower content validity or discrimination indices and those that show difficulties in their comprehension is an aspect to be taken into account to improve this tool. Conclusions: The qPAD-SV is a useful instrument in Spanish to measure the knowledge of Spanish nurses in palliative care and is suitable for international comparisons.

The Palliative Care Knowledge Questionnaire-Basic (PCKQ-B): Development and Validation of a Tool to Measure Knowledge of Health Professionals about Palliative Care in India

Objectives:

A well-educated and aware staff are the needed to overcome barriers to palliative care provision in the face of ever-increasing needs of palliative care in developing countries like India. Lack of a standardised and locally validated need assessment tool is felt as one of the important requirements for any successful educational program. This project is to develop and validate a basic palliative care knowledge needs assessment questionnaire.

Materials and Methods:

Development of Palliative Care Knowledge Questionnaire-Basic (PCKQ-B) for Indian nurses working in a tertiary care hospital in Delhi-NCR, India was undertaken with four basic processes, that is, item generation, content validity, pilot testing and field testing. Literature search helped us to find appropriate domains and items; content validity obtained with a panel of seven experts, pilot testing and finally field testing was done on 102 nurses working in 6 branches of Max Super Specialty Hospital, Delhi-NCR, India. The field study data were used to do item analyses including item difficulty, item discrimination and calculate reliability indicators including test-retest correlation and KR-20.

Results:

Content Validity index (CVI) of all the items was >0.78 (except 1 item) and Scale-CVI was 0.98 (excellent content validity). Items were selected on the basis of item difficulty index of 0.1 to 0.9 and an item discrimination index greater than 0.2. A total of 25 questions were selected that elicited KR-20 value of 0.65 and intra class correlation (test-retest reliability) of 0.52.

Conclusion:

Overall, PCKQ-B is a 25 item questionnaire with a moderate reliability. Although validated for nurses in tertiary care hospitals, this tool might find utility in education of primary health workers, community health workers, social workers, or physiotherapists in palliative care teams.

Design and Validation of the INCUE Questionnaire: Assessment of Primary Healthcare Nurses' Basic Training Needs in Palliative Care

Many instruments have been created to measure knowledge and attitudes in palliative care. However, not only is it important to acquire knowledge, but also that this knowledge should reach patients and their relatives through application in clinical practice. This study aimed to develop and psychometrically test the INCUE questionnaire (Investigación Cuidados Enfermeros/Investigation into Nurses’ Care Understanding of End-of-Life) to assess the basic training needs of primary or home healthcare nurses in palliative care. A questionnaire was developed based on the classical theory of tests and factor analysis models. Initially, 18 experts developed 67 items in two blocks and determined content validity by two rounds of expert panels. Exploratory factor analysis and reliability testing were conducted with a non-probabilistic sample of 370 nurses. Some items were observed to have very low homogeneity indices or presented convergence problems and were eliminated. Questionnaire reliability was 0.700 in the theoretical block (KR20 Index) and 0.941 in the practical block (Cronbach’s alpha). The model converges and shows an adequate fit, specifically CFI = 0.977, TLI = 0.977 and RMSEA = 0.05. The correlation between the two factors in the model is ρ = 0.63. The questionnaire objectively evaluates primary or home healthcare nurses’ knowledge of palliative care and its practical application, thereby facilitating more efficient training plans.

Understanding Nurses' Experiences and Perceptions of End-of-Life Care for Cancer Patients in Korea: A Scoping Review

BACKGROUND

Quality end-of-life care for cancer patients is a global health priority, and nurses are instrumental in providing this care. However, little is known about nurses' experiences and perceptions in end-of-life care settings in Korea. Aims: This scoping review examined Korean nurses' end-of-life care experiences and assessed the state of research in this area.

METHODS

Systematic searches were conducted using 7 electronic databases (PubMed, CINAHL, Scopus, Embase, WPRIM, KCI, and RISS), and 17 studies were selected for review.

FINDINGS

Most studies were limited to cross-sectional, descriptive designs. Outcomes regarding end-of-life care measured in the studies were categorized into cognitive variables, emotional variables, participation/performance, and educational needs. Study results suggested low nurse knowledge and self-efficacy with regard to provision of end-of-life care. Perceived barriers to quality end of life care included difficulties in meeting family members' needs. In addition, emotional outcomes associated with end-of-life care included high levels of nurse stress and burnout. Predictors of elevated stress included inability to provide adequate pain control, inability to reconcile patient requests with physician orders, and heavy workload. Although most nurses had end-of-life care experience, fewer than half reported receiving related education. The lack of knowledge and skill related to end of life care was a primary contributor to stress.

CONCLUSIONS

Korean nurses providing end-of-life care for cancer patients need additional education and support to help them manage high stress levels. Further study is needed to identify strategies for meeting nurses' end-of-life care education needs and of improving their overall performance in such practice.

Physicians' and Nurses' Knowledge in Palliative Care: Multidimensional Regression Models

The increase in life expectancy has led to a growth in the number of people in need of palliative care. Health professionals must possess appropriate knowledge and skills. This study aimed to assess knowledge in palliative care through the Palliative Care Knowledge Test Spanish Version (PCKT-SV)^®. A cross-sectional analytical study was conducted in 40 primary care health services. A total of 600 PCKT-SV questionnaires were distributed among health professionals; 561 of them (226 nurses and 335 physicians) were properly filled up. Sociodemographic information, education, and work experience were also recorded. A total of 34.41% of the nurses and 67.40% of the physicians showed good or excellent knowledge of palliative care. Physicians' scores for pain, dyspnea, and psychiatric disorders were higher than those of the nurses. Nurses scored significantly better in philosophy. Professionals with continuous training in palliative care showed a higher level of knowledge. Age and work experience of physicians and undergraduate training in nurses had significant weight in knowledge. Developing continuous training and enhancing undergraduate training in palliative care will lead to improved patient care at the end of life.

Important factors for planning nurse staffing in the emergency department: A consensus study

INTRODUCTION

Planning adequate nurse staffing in the emergency department (ED) is challenging. Although there are models to determine nurse staffing in EDs, these models do not consider all the factors. Inadequate nurse staffing causes overcrowding, poor quality of patient care, increased hospital costs, poor patient outcomes and high levels of burnout amongst nurses. In this paper, we report stakeholders' perceptions of important factors to be considered when planning ED nursing ratios.

METHODS

We applied a consensus research design. The data was generated from modified nominal group techniques followed by an e-Delphi with two rounds. The factors were generated during two nominal groups by 19 stakeholders which included management and healthcare professionals working in EDs. The generated factors were then put on a survey format for use in an e-Delphi. Using purposive and snowball sampling the survey was distributed to 74 national and international experts for consensus.

RESULTS

Ultimately, 43 experts agreed (a validity index of ≥ 80%) on four categories namely: hospital, staff, patient and additional categories which included 17 related factors.

CONCLUSION

Ideal nurse staffing ratios are influenced by the complexity of the environment and interactions between multiple factors. The categories and factors identified emphasised the need for extensive further research to ensure a financially viable model that will be accepted by both staff and patient, and thus promote optimal outcomes.

Analysis of Spanish nursing students' knowledge in palliative care. An online survey in five colleges

Along their professional career, nurses can find patients who require palliative care (PC). It is necessary to have at least a basic education in this area, that should be acquired during their university education. The objective of this descriptive online-survey set in five nursing Colleges was to analyze Spanish nursing students' knowledge in PC, offering an image of the status of education in PC. 619 students took an online questionnaire with the Spanish version of the Palliative Care Quiz for Nurses (PCQN-SV), which also collected information about their education in the field of PC. Univariate and bivariate analyses were performed, and a predictive binary logistic regression model was developed. Students obtained an average 45.65% of right answers in PCQN-SV, with differences related to the college and academic year in which they were enrolled and to their education in PC. In the regression model having theoretical education in PC (OR = 1.70) and academic year (OR = 1.35) showed to be both predictors of getting a result in PCQN-SV over 45% of correct answers. This study showed that Spanish nursing students have a medium-low level of knowledge in PC, and it also supports the need to develop a common framework for nurses' education in PC.

Knowledge and Attitude Toward Geriatric Palliative Care among Health Professionals in Vietnam

This study assessed the knowledge and attitude toward palliative care for the elderly among health professionals in a tertiary geriatric hospital in Vietnam and explored their determinants. Cross-sectional data were obtained on 161 geriatric health professionals at the National Geriatric Hospital. Modified-Palliative Care Knowledge Test and Frommelt Attitudes Toward Care of the Dying instruments were used to measure knowledge and attitude toward geriatric palliative care. As a result, 40.5% physicians and 74.2% nurses showed insufficient knowledge about geriatric palliative care (p < 0.05). The lowest score was for dyspnea, following by gastrointestinal and pain problems. No significant difference was found regarding the attitude between physicians and nurses (p > 0.05). Health professional category, age, and years of experience were found to be associated with knowledge about palliative care. Meanwhile, only knowledge score had correlations with total attitude score (Coef. = 0.2; 95%CI = 0.1–0.3), attitude toward patients (Coef. = 0.1; 95%CI = 0.0–0.1) and toward patients’ family (Coef. = 0.1; 95%CI = 0.0–0.1). This study highlights a significant knowledge gap and preferable attitude toward palliative care for the elderly among physicians and nurses in the geriatric hospital. Intensive training about geriatric palliative care, focusing on pain, dyspnea and gastrointestinal issue management, should be performed to ensure the quality of palliative care services, especially in nurses.

Utility of social networks and online data collection in nursing research: Analysis of Spanish nurses' level of knowledge about palliative care

INTRODUCTION

Internet-based social networks are used by nurses with different purposes, including the creation of working groups and to share and create knowledge.

PURPOSE

To evaluate the utility of social networks in the dissemination of an online questionnaire and to measure Spanish RNs' knowledge about palliative care.

METHODS

A descriptive cross-sectional study was carried out. Using social networks we distributed an online questionnaire with the Spanish version of Palliative Care Quiz for Nurses (PCQN-SV) throughout August 2015.

RESULTS

A direct relationship between the number of responses and the questionnaire's apparitions in each social network was found. Comparing the results obtained by the 446 RNs participating in this study with those obtained in the study to pilot the PCQN-SV we identify that differences found are related to the participants' features (years of experience and hours of training in palliative care) and not to the type of questionnaire they answered.

CONCLUSIONS

Social networks have shown to be a useful tool for nursing research by its ability, to recruit participants as well as to collect data, so their role as an instrument of research should be considered.