Clinical staff perceptions of palliative care-related quality of care, service access, education and training needs and delivery confidence in an acute hospital setting

Frey, Rosemary; Gott, Merryn; Raphael, Deborah; O’Callaghan, Anne; Robinson, Jackie; Boyd, Michal; Laking, George; Manson, Leigh; Snow, Barry

doi:10.1136/bmjspcare-2012-000346

Cited by 26 publications

(34 citation statements)

References 29 publications

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“…Of these predictors, psychological empowerment and experience contributed most to predicting an increase in palliative care delivery confidence. While these results are in line with previous research (Frey, Gott, et al, ), this study goes further to describe the “social reality” (Berger & Luckman, ) shaping the identified predictors for LTCF staff.…”

Section: Discussionsupporting

confidence: 91%

“…Perceived confidence was measured for three tasks (identifying residents at the end of life, hospice referral, palliative care delivery; Frey, Boyd, Foster, Robinson, & Gott, ), on a scale from 1 “not confident at all” to 10 “extremely confident.” Cronbach's α of .82 for this 3‐item scale was previously recorded (Frey, Gott, et al, ).…”

Section: Methodsmentioning

confidence: 99%

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What factors predict the confidence of palliative care delivery in long‐term care staff? A mixed‐methods study

Frey

Balmer

Robinson

et al. 2019

Int J Older People Nursing

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Background: Research has indicated that clinical staff in long-term care often lack self-confidence in palliative care delivery, particularly at the end of life.Goals: (a) To examine the contribution of age, palliative care education, palliative care work-related experience and psychological empowerment to palliative care delivery confidence and (b) to explore the social reality shaping those factors for long-term care staff.Design: Explanatory sequential design.Setting: Twenty long-term care facilities in two district health boards in New Zealand. Participants: Phase 1:139 clinical staff. Phase 2:46 clinical staff who provided care in the last month of a residents' life. Methods: Phase 1: Cross-sectional survey. Phase 2: Individual semi-structured interviews. Results: Phase 1: Previous experience (β = .319) and psychological empowerment (β = .311) contribute most to predicting an increase in palliative care delivery confidence. Phase 2: Four factors underlay palliative care delivery confidence, (a) mentorship by hospice nurses or colleagues (b) contextual factors (organisational culture, resources and experience), (c) maturity and (d) formal education.Conclusion: Organisational leadership should use multiple strategies (e.g. powersharing, increased opportunities for mentorship) to improve staff palliative care delivery confidence. Implications for Practice:This study adds to the literature in understanding the predictors of palliative care delivery confidence specific to long-term care staff. The results indicate that educational interventions must be contextually appropriate to achieve sustainable improvements in palliative care confidence and ultimately in resident care at the end of life. K E Y W O R D Scare of older people, education, empowerment, long-term care, mixed-methods, palliative care, staff confidence

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Section: Discussionsupporting

confidence: 91%

Section: Methodsmentioning

confidence: 99%

What factors predict the confidence of palliative care delivery in long‐term care staff? A mixed‐methods study

Frey

Balmer

Robinson

et al. 2019

Int J Older People Nursing

Self Cite

View full text Add to dashboard Cite

show abstract

“…) and a study involving palliative care educational needs of clinical staff in an acute hospital in New Zealand (Frey et al . ). Generally, closed questions were incorporated into the questionnaire, employing structured responses including Likert‐type rating scales; fill in the blank and multi‐option formats.…”

Section: Methodsmentioning

confidence: 97%

What's the diagnosis? Organisational culture and palliative care delivery in residential aged care in New Zealand

Frey

Boyd

Foster

et al. 2015

Health Soc Care Community

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Organisational culture has been shown to impact on resident outcomes in residential aged care (RAC). This is particularly important given the growing number of residents with high palliative care needs. The study described herein (conducted from January 2013 to March 2014) examined survey results from a convenience sample of 46 managers, alongside interviews with a purposively selected sample of 23 bereaved family members in order to explore the perceptions of organisational culture within New Zealand RAC facilities in one large urban District Health Board. Results of the Organisational Culture Assessment Instrument (OCAI) completed by managers indicated a preference for a 'Clan' and the structured 'Hierarchy' culture. Bereaved family interviews emphasised both positive and negative aspects of communication, leadership and teamwork, and relationship with residents. Study results from both managers' OCAI survey scores and next of kin interviews indicate that while the RAC facilities are culturally oriented towards providing quality care for residents, they may face barriers to adopting organisational processes supportive of this goal.

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“…26 Topics included were drawn from the National Audit of End-of-Life Care in Hospitals in Ireland, 22 the National Audit Office Value for Money study on Endof-Life Care Nurses' survey instrument, 27 as well as a staff survey of end-of-life care study in Manchester, UK. 28 Topics and measures included:…”

Section: Staff Questionnairementioning

confidence: 99%

Burnout matters: The impact on residential aged care staffs’ willingness to undertake formal palliative care training

Frey¹,

Boyd²,

Foster³

et al. 2014

Progress in Palliative Care

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Introduction: Palliative care delivery has become integral to the role of healthcare staff in residential aged care (RAC) internationally. Challenges within this work environment (e.g. workload, staffing levels, resources) may impact on healthcare staffs' willingness to undertake formal palliative care education. The study described herein explored factors (socioenvironmental and psychological) that influence staff willingness to engage in palliative care education. Methods: The predictors of palliative care education uptake for healthcare staff (n = 431) from 52 New Zealand RAC facilities in one large urban District Health Board were assessed. Logistic regression was used to explore willingness to engage in education. Results: Higher scores for burnout predicted a decreased likelihood of engaging in palliative care education (odds ratio (OR) 0.41, P = 0.01). The identified predictor of willingness to engage in education was previous palliative care experience (OR 1.59, P = 0.027). Discussion: These results can inform the design and delivery of future palliative care education programmes within RAC.

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Clinical staff perceptions of palliative care-related quality of care, service access, education and training needs and delivery confidence in an acute hospital setting

Cited by 26 publications

References 29 publications

What factors predict the confidence of palliative care delivery in long‐term care staff? A mixed‐methods study

What factors predict the confidence of palliative care delivery in long‐term care staff? A mixed‐methods study

What's the diagnosis? Organisational culture and palliative care delivery in residential aged care in New Zealand

Burnout matters: The impact on residential aged care staffs’ willingness to undertake formal palliative care training

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