Department of Palliative Care, Policy & Rehabilitation, King's College London, Cicely Saunders Institute, London, UK.
Guy's and St Thomas' NHS Foundation Trust, London, UK.
BMJ Support Palliat Care. 2016 Jun;6(2):231-6. doi: 10.1136/bmjspcare-2015-000879. Epub 2015 Nov 22.
UK policymakers, clinicians and public wish to see improvements in end-of-life care (EoLC). However, healthcare professionals' skills and knowledge to deliver high-quality care are often lacking. Since May 2012, palliative care staff in an inner-city tertiary hospital have run a 2-day Transforming End of Life Care (TEoLC) course to improve EoLC confidence, and competence among hospital and community staff.
To evaluate course participants' self-rated confidence, competence and knowledge of EoLC topics.
A before-and-after design using self-completion questionnaires, precourse and postcourse. 14 self-assessment questions examined confidence, understanding and knowledge of EoLC topics. Mean change scores and paired t tests were calculated and free-text responses analysed thematically.
236 staff members completed the course between May 2012 and April 2014. 42% worked in hospitals and 55% in the community; the most frequent staff roles were qualified nurses (49%), senior nurses (16%) and general practitioners (15%).
All 14 self-assessment topics improved significantly (p<0.001); most improved was 'understanding and implementing Fast Track discharge'. Qualitative data showed increased knowledge and confidence in EoLC, particularly in communication, commitment to team work and holistic care. Overall, 217 (92%) participants would recommend the course and 215 (98%) indicated it would influence their practice.
The TEoLC course improved participants' self-rated confidence, competence and knowledge in EoLC. Findings have utility beyond the UK in light of the international policy recommendations to improve the palliative care skills of generalist healthcare providers.
英国政策制定者、临床医生和公众希望看到临终关怀（EoLC）的改善。然而，医疗保健专业人员提供高质量护理的技能和知识往往不足。自 2012 年 5 月以来，一家市中心三级医院的姑息治疗工作人员开设了为期两天的转化临终关怀（TEoLC）课程，以提高医院和社区工作人员的临终关怀信心和能力。
评估课程参与者对临终关怀主题的自我评估信心、能力和知识。
使用自我完成的问卷，在课程前和课程后进行前后设计。14 个自我评估问题检查了临终关怀主题的信心、理解和知识。计算了平均变化分数和配对 t 检验，并对自由文本回复进行了主题分析。
2012 年 5 月至 2014 年 4 月期间，共有 236 名员工完成了该课程。42%的人在医院工作，55%的人在社区工作；最常见的员工角色是合格护士（49%）、高级护士（16%）和全科医生（15%）。
所有 14 个自我评估主题均显著改善（p<0.001）；改善最明显的是“理解和实施快速通道出院”。定性数据显示，对临终关怀的知识和信心有所增加，特别是在沟通、对团队合作的承诺和整体护理方面。总体而言，217 名（92%）参与者会推荐该课程，215 名（98%）表示该课程将影响他们的实践。
TEoLC 课程提高了参与者对临终关怀的自我评估信心、能力和知识。鉴于国际政策建议提高普通医疗保健提供者的姑息治疗技能，这些发现不仅在英国具有实用性。
