College of Nursing and Department of Neurology of the Second Affiliated Hospital of Guangzhou Medical University, 250 Changgang Dong RD, Guangzhou, 510260, People's Republic of China.
Nursing Department of the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, People's Republic of China.
BMC Palliat Care. 2021 Mar 25;20(1):50. doi: 10.1186/s12904-021-00738-x.
In many countries, nurses are ill-prepared to provide care to patients with terminal illnesses. Limited education and training affect their ability to deliver proper palliative care. Only a few studies have explored appropriate and effective training methods of palliative care in China. Therefore, we aimed to provide evidence for a palliative care training system by appraising the effects of a mixed-method intervention on participants' knowledge of palliative care and attitudes towards dying patients and death.
An e-learning intervention approach was adopted for 97 nurses from oncology departments across five hospitals, using a mobile terminal combined with a virtual forum and face-to-face interactions. We conducted a pre- and post-training evaluation through the Palliative Care Quiz of Nursing (PCQN), Frommelt Attitude Toward Care of the Dying Scale Form B (FATCOD-B), and Death Attitude Profile-Revised (DAP-R).
After a three-week intervention, there was a significant increase in the PCQN and FATCOD-B scores as compared to the baseline. For PCQN, the total score increased from 10.3 ± 1.9 to 11.1 ± 2.2 (p = .011) and the score for management of pain and other symptoms increased from 7.7 ± 1.7 to 8.4 ± 1.7 (p = .003). FATCOD-B scores increased noticeably from 100.6 ± 7.9 to 102.9 ± 8.9 (p = .019). The DAP-R scores showed no obvious difference between pre- and post-intervention results.
The mixed-method intervention was effective in improving participants' knowledge and attitudes about palliative care. The implementation of training for nurses at appropriate intervals during both education and professional life is required, especially regarding the improvement in participants' attitudes towards death. Therefore, palliative care training in China should receive more attention.
在许多国家，护士在为绝症患者提供护理方面准备不足。有限的教育和培训影响了他们提供适当姑息治疗的能力。在中国，只有少数研究探讨了姑息治疗的适当和有效培训方法。因此，我们旨在通过评估混合方法干预对参与者姑息治疗知识和对临终患者及死亡态度的影响，为姑息治疗培训系统提供证据。
采用电子学习干预方法，对来自五家医院肿瘤科的 97 名护士进行培训，使用移动终端结合虚拟论坛和面对面互动。我们通过姑息护理知识测验（PCQN）、Frommelt 临终关怀态度量表 B 版（FATCOD-B）和死亡态度量表修订版（DAP-R）进行了培训前后的评估。
经过三周的干预，PCQN 和 FATCOD-B 评分与基线相比均显著提高。PCQN 总分从 10.3±1.9 增加到 11.1±2.2（p=0.011），疼痛和其他症状管理评分从 7.7±1.7 增加到 8.4±1.7（p=0.003）。FATCOD-B 评分从 100.6±7.9 明显增加到 102.9±8.9（p=0.019）。DAP-R 评分在干预前后无明显差异。
混合方法干预有效地提高了参与者对姑息治疗的知识和态度。需要在教育和职业生涯中适当的间隔时间为护士提供培训，特别是要提高参与者对死亡的态度。因此，中国应更加重视姑息治疗培训。
