Effects and Challenges Regarding Supervision in Palliative Care Teams: Results of a 5-Year Study in South Tyrol (Italy)

Abstract

Objective: Evaluating a solution-oriented clinical supervision to improve the quality of care. Design: We performed a randomized, longitudinal controlled trial. A total of 32 health districts were involved in the study. For the evaluation of the intervention, the following dimensions were collected as indicators of the quality of supervision: Quality of life (FACT-G, SF12, POS), psychological stress, depression, burn-out (HADS, BDI-II, VAS scales, HPS), sense of coherence (SOC-13), satisfaction with care, communication and support from the patients and relatives (VAS scales) and working conditions (COPSOQ) from the nursing staff and family doctors. Results: Of the 85 subscales, the SOC Nursing Sum Score (p=0.017), the SF-12 Nursing Sum Scale (p=0.036), and the COPSOQ Scales of General Practitioners showed significant differences in developmental opportunities (p=0.020), leadership (p=0.003), social support (p=0.001) and community spirit (p=0.024). At the second point time of the study, significant differences were found in the subscales of the Palliative Care Outcome Scale (POS) and the subscale of the test instrument Functional Assessment of Cancer Therapy - General (FACT-G) FUNCTIONAL WELL-BEING of the patients. The satisfaction values of nurses and general practitioners with the supervision showed an extremely positive assessment of both nurses and general practitioners regarding supervision. Conclusions: Supervision affects positively the process of palliative home care. It seems important to adjust the number of supervision meetings according to the needs of the individual team in order to achieve an optimized team performance.