职业群体之间在姑息治疗特定教育需求和长期护理院跨专业合作强度方面有哪些差异？
What are the differences among occupational groups related to their palliative care-specific educational needs and intensity of interprofessional collaboration in long-term care homes?
机构信息
Faculty of Health Sciences, 3N25F, McMaster University, 1280 Main Street West, Hamilton, ON, L8N 3Z5, Canada.
Queen's University Belfast, Belfast, UK.
出版信息
BMC Palliat Care. 2017 May 18;16(1):33. doi: 10.1186/s12904-017-0207-y.
BACKGROUND
The purpose of this study was to compare the differences across occupational groups related to their end-of-life care-specific educational needs and reported intensity of interprofessional collaboration in long-term care (LTC) homes.
METHODS
A cross-sectional survey, based on two questionnaires, was administered at four LTC homes in Ontario, Canada using a modified Dilman's approach. The first questionnaire, End of Life Professional Caregiver Survey, included three domains: patients and family-centered communication, cultural and ethical values, effective care delivery. The Intensity of Interprofessional Collaboration Scale included two subscales: care sharing activities, and interprofessional coordination. In total, 697 LTC staff were given surveys, including personal support workers, support staff (housekeeping, kitchen, recreation, laundry, dietician aids, office staff), and registered staff (licensed nurses, physiotherapists, social workers, pharmacists, physicians).
RESULTS
A total of 317 participants completed the survey (126 personal support workers, 109 support staff, 82 registered staff) for a response rate of 45%. Significant differences emerged among occupational groups across all scales and subscales. Specifically, support staff rated their comfort of working with dying patients significantly lower than both nurses and PSWs. Support staff also reported significantly lower ratings of care sharing activities and interprofessional coordination compared to both registered staff and personal support workers.
CONCLUSIONS
These study findings suggest there are differing educational needs and sense of interprofessional collaboration among LTC staff, specific to discipline group. Both the personal support workers and support staff groups appeared to have higher needs for education; support staff also reported higher needs related to integration on the interdisciplinary team. Efforts to build capacity within support staff related to working with dying residents and their families are needed. Optimal palliative care may require resources to increase the availability of support for all staff involved in the care of patients.
背景
本研究旨在比较不同职业群体在长期护理（LTC）院临终关怀特定教育需求和报告的跨专业合作强度方面的差异。
方法
在加拿大安大略省的四家 LTC 院，采用经过修改的 Dilman 方法，基于两份问卷进行了横断面调查。第一份问卷是《临终关怀专业护理人员调查》，包括三个领域：以患者和家庭为中心的沟通、文化和伦理价值观、有效护理提供。《跨专业合作强度量表》包括两个分量表：护理共享活动和跨专业协调。共有 697 名 LTC 员工接受了调查，包括个人支持工作者、支持人员（家政、厨房、娱乐、洗衣、营养师助手、办公室工作人员）和注册人员（持牌护士、物理治疗师、社会工作者、药剂师、医生）。
结果
共有 317 名参与者完成了调查（126 名个人支持工作者、109 名支持人员、82 名注册人员），应答率为 45%。所有量表和分量表在职业群体之间都出现了显著差异。具体而言，支持人员在与临终患者一起工作的舒适度方面的评分明显低于护士和个人支持工作者。支持人员在护理共享活动和跨专业协调方面的评分也明显低于注册人员和个人支持工作者。
结论
这些研究结果表明，LTC 员工之间存在不同的教育需求和跨专业合作意识，具体取决于学科群体。个人支持工作者和支持人员群体似乎都有更高的教育需求；支持人员还报告说，在跨学科团队中整合方面的需求更高。需要努力在支持人员中建立与临终患者及其家属合作的能力。为了提供最佳的姑息治疗，可能需要资源来增加所有参与患者护理的员工的支持。
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