Healthcare professionals and volunteers education in palliative care to promote the best practice–an integrative review

Abstract

Background Family caregivers’ empowerment can assume strategic importance in palliative care. Healthcare professionals and volunteers have been showing significant gaps in this field. Hence, education has been advocated as an effective strategy to fill this gap. While several educational initiatives exist, a comprehensive evidence synthesis on the effectiveness of educational training on healthcare professionals and volunteers is lacking. Aims An integrative review was conducted to explore worldwide initiatives, aiming to improve healthcare professionals and volunteers’ competence in a palliative care setting especially in relation to the family caregiver. Method A scoping literature review was conducted with systematic searches in multiple databases – REDALYC, CINAHL, SCIELO, EBSCO, ERIC and MEDLINE since January 2012. Studies were selected based on programmes content and its impact evaluation. Four researchers assessed the studies regarding their eligibility with reference to the inclusion and exclusion criteria. Findings Twenty‐two studies met the eligibility criteria. Multi‐professional learning was reported, emphasising nurses and physician's enrolment. Only few studies showed participants’ learning outcomes. Inconsistencies in delivery mode and duration were identified. Impact evaluations were heterogeneous and relied on no validated instruments. Family caregiver's content was addressed only in three initiatives. Conclusions Further research is needed using a more reliable design, mode of delivery and impact measurement of educational training. In addition, more initiatives associated with cost‐effectiveness, shorter‐ and longer‐term clinical impact are needed. Despite the strides already made towards the establishment of an evidence base for healthcare professionals in the field of palliative care, either greater consideration is required for family care providers in the education of healthcare professionals and respect for the cultural diversity.

Nurses’ required end‐of‐life care competence in health centres inpatient ward – a qualitative descriptive study

“…Spirituality was the only context where nurses stated the need for competence in addressing different cultures. However, cultural care is defined as one of the core competence areas of palliative and EOL care (12,17) and is important when assessing the competence level and educational needs of nurses (18,19). This increases the challenge for quality care in organisations, as nurses have little experience and knowledge of how to consider different cultures.…”

“…In addition, competence requires skills relating to cooperation and multiprofessionalism, in addition to continuous professional development. Same competence areas have been recognised to be essential when assessing nurses' knowledge, skills and educational needs (18,19).…”

“…Nurses also need the competence to provide mental and emotional support for the patient and family (23,26,29), addressing their practical needs and allowing the patient's family to participate in the patient's care, and being present for the patient and listening (26,29). In addition, nurses need the competence to cooperate and organise care by disseminating information and coordinating patient care, arranging meetings and consulting with other professionals (18,19). Nurses' competence to support the communication and continuity of care between the patient, their family and the physician is important (25,26).…”

Effect of an end‐of‐life gerontological nursing education programme on the attitudes and knowledge of clinical nurses: A non‐randomised controlled trial

“…Specialised education can improve nurses’ advanced assessment and care skills; poor education hinders appropriate EOL nursing care (Anstey, Powell, Coles, Hale, & Gould, ; Teixeira et al, ). Palliative care is lacking in nursing curricula (Paice et al, ); 75% of nurses working in Japanese EOL facilities for older adults reported never receiving EOL care education (Okumura‐Hiroshige et al, ).…”

“…Previous studies evaluated students' satisfaction before and after their education and attitudes towards patient care, knowledge, and behavioural changes (Anstey et al, ; Morita et al, ; Smith et al, ). However, the ELNEC‐JG's effectiveness has not been measured using reliable and valid scales (Kubota et al, ; Teixeira et al, ), and few studies have examined long‐term changes in outcomes (Anstey et al, ; Kunte, Johansen, & Isenberg‐Cohen, ). Many evaluations focused on students' satisfaction or intervention usefulness.…”