Rationale Healthcare providers’ beliefs, attitudes, experiences and knowledge, which guide the care they deliver, are the key factors influencing the quality of palliative care. Education and coaching innovation are needed to translate research outcomes and adopt evidence‐based nursing care into practice. Objectives To evaluate the impact of an advanced educational and coaching programme in a family systems’ nursing approach for palliative care nurses in a home‐care setting. Methods A quasi‐experimental study using qualitative data from open‐ended questions to augment the quantitative outcome study that included a single‐group, pre‐ and post‐test design. A total population sample of nurses was recruited from a specialised palliative home care unit at a university hospital. The study utilised two self‐reported questionnaires. Results There was a statistically significant increase in the nurses’ critical appraisal of clinical nursing practice related to family nursing after participation in the educational programme than before. No statistical difference was found in items related to nurses’ experience of the interaction and reciprocity in the nurse–family relationship after participation in the programme than compared to before or in nurses’ cancer‐related beliefs. However, there was an overall significant positive change found in attitudes towards families in the total score of the Family Practice Scale. Nurses were also more positive about the further development of their knowledge and skills in advanced family nursing evident in the qualitative data. Conclusion An advanced educational intervention programme was successful in improving the nurses’ knowledge, skills, satisfaction and confidence in relation to applied family nursing approach within the context of caring for families affected by advanced/final stage cancer. However, further refinement of the implementation process is needed to enhance family care improvement and the nurses’ professional development in advanced family nursing in specialised palliative care.
Recent guidelines by the European Society for Clinical Nutrition and Metabolism (ESPEN) have advocated increased attention to nutritional support in all patients with cancer: however, little is known about the optimal type of nutritional intervention. The aim of this review was to assess the current evidence for nutrition support in patients with incurable cancer. Methods: This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. EMBASE, Medline and CINAHL were searched from 1990-2018. Evidence was appraised using a modified risk of bias table, based on guidance from the Cochrane Handbook for Systematic Reviews of Interventions. Results: Sixty studies were assessed of which twelve met the eligibility criteria. Eleven studies examined body composition, with six studies reporting improvements in weight. Six studies examined nutritional status with three studies reporting an improvement. Nine studies examined nutritional intake with six showing improvements including significant improvements in dietary and protein intake. Ten studies examined quality of life, with six studies reporting improvements following intervention. The most common nutritional interventions examined were nutrition counselling and dietary supplementation. Conclusions: There is moderate quality evidence to support the need for increased attention to nutrition support in patients with incurable cancer; however, despite some statistically significant results being reported the clinical effects of them were small. Key questions remain as to the optimal timing for these interventions to be implemented (e.g. cachexia stage, illness stage, timing with anticancer therapy) and the most appropriate endpoint measures.
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