ALPHA-Rheinland, University of Bonn, Bonn, Germany.
J Palliat Med. 2013 Jul;16(7):794-8. doi: 10.1089/jpm.2012.0586. Epub 2013 May 23.
In Germany, more and more terminally ill patients spend their last days of life in nursing homes, and this presents a challenge for these institutions. Even though palliative care is a growing domain in health care, no quantitative in-depth evaluations of the status quo in nursing homes has been conducted so far in Germany, partly because of lacking measuring tools.
This study used a new questionnaire to assess German health care professionals' theoretical knowledge of palliative care and their perceived self-efficacy. Both variables have been proven to be indicators for the quality of the implementation of palliative care in nursing homes.
We used the Bonn Palliative Care Knowledge Test (Bonner Palliativwissenstest, BPW) questionnaire to measure knowledge of palliative care in the domains of medicine, care, and psychosocial care and to measure self-efficacy relating to palliative care.
Care workers (N=130) in five nursing homes in the region of Aachen in western Germany answered the questionnaires. The results show low knowledge (on average 52.8% correct answers) and self-efficacy relating to palliative care, although work with dying people is their daily challenge. While general knowledge correlated with work experience, a negative correlation of specific self-efficacy with age and working experience was observed.
Lower self-efficacy of care workers experienced in palliative care probably implies that the difficulty of palliative care skills is underestimated by inexperienced care workers. Palliative care training is urgently needed to improve knowledge and self-efficacy. Guidance to assist care professionals involved in palliative care in nursing homes needs to be developed and provided.
在德国,越来越多的绝症患者在养老院度过生命的最后时光,这给这些机构带来了挑战。尽管姑息治疗是医疗保健领域日益增长的领域,但迄今为止,德国尚未对养老院的现状进行定量深入评估,部分原因是缺乏衡量工具。
本研究使用新问卷评估德国卫生保健专业人员对姑息治疗的理论知识和自我效能感。这两个变量都已被证明是衡量养老院姑息治疗实施质量的指标。
我们使用波恩姑息治疗知识测试(Bonner Palliativwissenstest,BPW)问卷来衡量医学、护理和心理社会护理领域的姑息治疗知识,并衡量与姑息治疗相关的自我效能感。
来自德国西部亚琛地区五家养老院的 130 名护理人员回答了问卷。结果表明,尽管临终关怀是他们的日常挑战,但姑息治疗知识和自我效能感较低(平均正确回答率为 52.8%)。一般知识与工作经验相关,而特定自我效能感与年龄和工作经验呈负相关。
经验丰富的姑息治疗护理人员自我效能感较低,可能意味着缺乏经验的护理人员低估了姑息治疗技能的难度。迫切需要姑息治疗培训来提高知识和自我效能感。需要制定并提供指导,以帮助参与养老院姑息治疗的护理人员。