Frey Rosemary, Boyd Michal, Foster Sue, Robinson Jackie, Gott Merryn
Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
Waitemata District Health Board, Auckland, New Zealand.
BMJ Support Palliat Care. 2016 Dec;6(4):465-473. doi: 10.1136/bmjspcare-2015-000943. Epub 2016 Jun 10.
Previous research has indicated that staff in aged residential care (ARC) may be unprepared for their role in palliative care provision. The need for palliative care knowledge among ARC staff has been characterised as 'pervasive'. Determining the palliative care education, communication and support needs of ARC clinical care staff is, therefore, of critical importance to the delivery of quality healthcare in this setting.
A survey of clinical staff (n=431) in 52 ARC facilities in 1 urban district health board was conducted, using a paper-based questionnaire. Instruments included the 3-item Experiences with End of Life scale, developed measures of communication and support (13 items), support accessibility (12 items), and palliative care education (19 items).
Only 199 (46.2%) of staff participants reported undertaking palliative care education. Nurses were more likely to have engaged in palliative care education in comparison with healthcare assistants (HCAs) (χ(1, N=387)=18.10, p=0.00). Participants (n=347) who wanted further education preferred an interactive, hands-on applied education (13.9%) in comparison to short topic-specific sessions/seminars (6.5%) or lecture-based courses (7.7%).
The study reveals an ongoing need for staff palliative care education. Results suggest the development of an integrated model of care which draws on both hospice and ARC staff expertise.
先前的研究表明，老年护理机构（ARC）的工作人员可能对其在提供姑息治疗方面的角色准备不足。ARC工作人员对姑息治疗知识的需求被描述为“普遍存在”。因此，确定ARC临床护理人员的姑息治疗教育、沟通和支持需求，对于在这种环境中提供高质量医疗保健至关重要。
对1个市区卫生委员会的52个ARC机构的临床工作人员（n = 431）进行了一项调查，使用纸质问卷。调查工具包括3项临终体验量表、沟通和支持（13项）、支持可及性（12项）以及姑息治疗教育（19项）的自编测量工具。
只有199名（46.2%）工作人员参与者报告接受过姑息治疗教育。与医疗助理（HCA）相比，护士更有可能参与过姑息治疗教育（χ(1, N = 387) = 18.10，p = 0.00）。希望接受进一步教育的参与者（n = 347）中，与短期特定主题会议/研讨会（6.5%）或讲座式课程（7.7%）相比，更喜欢互动式、实践应用教育（13.9%）。
该研究揭示了对工作人员进行姑息治疗教育的持续需求。结果表明需要开发一种综合护理模式，借鉴临终关怀机构和ARC工作人员的专业知识。
