Ferrell Betty R, Borneman Tami
City of Hope National Medical Center, Dept. of Nursing Research & Education, Duarte, California 91010, USA.
Cancer Pract. 2002 Jan-Feb;10(1):20-7. doi: 10.1046/j.1523-5394.2002.101003.x.
The purpose of this National Cancer Institute-funded training project was to improve end-of-life care agencies through implementation of a palliative care curriculum. The Home Care Outreach for Palliative Care Education (HOPE) program was designed to improve the knowledge and skills of home healthcare professionals who provide care to the terminally ill and their families at home.
A five-module palliative care education curriculum was designed and implemented in five home care agencies in the Los Angeles area. One hundred twenty-five nurses and 28 home health aides participated. The methods of data collection included two written surveys conducted before and after intervention, chart audit tool and a case study analysis form.
The precourse data revealed deficiencies in home-care agency staff knowledge in and clinical aspects of end-of-life care. Regarding agency nurses' knowledge on end-of-life issues, the overall percentage scores from preeducation to posteducation rose from 84.6% to 89.0% (P =.0001). Participants rated the education program as extremely valuable for the home care agency staff.
As home care will likely continue to be a primary setting for end-of-life healthcare, improvement of palliative care education in home health agencies is needed. The HOPE project provided insight and experience in the education of nonhospice home care staff in end-of-life care. Participant responses and evaluations indicated that end-of-life care education can improve the quality of care provided by home health agencies. Finally, this education program may result in a heightened awareness of hospice care and, although not objectively quantified, perhaps an increase in referrals to hospice.
本项由美国国立癌症研究所资助的培训项目旨在通过实施姑息治疗课程来改善临终关怀机构。姑息治疗教育家庭护理外展（HOPE）项目旨在提高为绝症患者及其家人提供居家护理的家庭医疗保健专业人员的知识和技能。
设计了一个包含五个模块的姑息治疗教育课程，并在洛杉矶地区的五个家庭护理机构实施。125名护士和28名家庭健康助理参与其中。数据收集方法包括干预前后进行的两次书面调查、图表审核工具和一份案例分析表。
课前数据显示家庭护理机构工作人员在临终关怀的知识和临床方面存在不足。关于机构护士对临终问题的知识，从教育前到教育后的总体百分比得分从84.6%升至89.0%（P = 0.0001）。参与者认为该教育项目对家庭护理机构工作人员非常有价值。
由于家庭护理可能会继续成为临终医疗保健的主要场所，因此需要改善家庭健康机构中的姑息治疗教育。HOPE项目为非临终关怀家庭护理人员的临终关怀教育提供了见解和经验。参与者的反馈和评估表明，临终关怀教育可以提高家庭健康机构提供的护理质量。最后，这个教育项目可能会提高对临终关怀的认识，并且尽管没有客观量化，但也许会增加转介到临终关怀机构的人数。
