Aregay Atsede, O'Connor Margaret, Stow Jill, Ayers Nicola, Lee Susan
Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia.
Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway.
Palliat Support Care. 2023 Jun 30:1-10. doi: 10.1017/S1478951523000755.
This study aims to measure and explore the barriers to translating theoretical knowledge of palliative care into clinical practice.
A mixed-method study, combining a cross-sectional survey and key interviews was conducted. The quantitative data were obtained from 173 nurses and the key interviews were conducted with 42 health professionals drawn from multiple settings. For quantitative data analysis, Statistical Package for the Social Sciences software were conducted, and a thematic analysis supported with NVivo software were used for analyzing qualitative data.
Of the 220 nurses invited, 173 completed the survey (79%). Most (78%) had a bachelor's degree in nursing. Fewer than half, 69 (40%) scored 75% or more for the knowledge test; 173 (100%) scored 50% or greater for attitude; and only 32 (18.5%) scored 75% or greater for self-reported practice. While there was a small, positive correlation between palliative care attitudes and self-reported practice ( = 0.22, = 0.003), the qualitative findings indicated that nurses had significant challenges in translating their theoretical knowledge into clinical practice. Limited clinical practice was linked to inadequate knowledge resulting from insufficient integration of palliative care content in undergraduate curricula and a lack of follow-up training. This was further exacerbated by shortages of medicine, staff, and financial resources and was linked to limited attention accorded to palliative care by the government.
While the results showed the majority held positive views toward palliative care, improving palliative care practices requires, and enhancing nurses' knowledge of palliative care. This requires changing teaching methods and engaging policymakers.
本研究旨在衡量和探索将姑息治疗的理论知识转化为临床实践的障碍。
开展了一项混合方法研究,将横断面调查与关键访谈相结合。定量数据来自173名护士,关键访谈则针对从多个机构抽取的42名卫生专业人员进行。对于定量数据分析,使用了社会科学统计软件包,定性数据的分析则采用了NVivo软件支持的主题分析。
在受邀的220名护士中,173名完成了调查(79%)。大多数(78%)拥有护理学学士学位。不到一半,即69名(40%)在知识测试中得分达到75%或更高;173名(100%)在态度方面得分达到50%或更高;而自我报告的实践得分达到75%或更高的只有32名(18.5%)。虽然姑息治疗态度与自我报告的实践之间存在微弱的正相关(r = 0.22,p = 0.003),但定性研究结果表明,护士在将理论知识转化为临床实践方面面临重大挑战。有限的临床实践与本科课程中姑息治疗内容整合不足以及缺乏后续培训导致的知识不足有关。药品、人员和财政资源短缺进一步加剧了这一情况,并且与政府对姑息治疗的关注有限有关。
虽然结果显示大多数人对姑息治疗持积极看法,但改善姑息治疗实践需要提高护士的姑息治疗知识。这需要改变教学方法并让政策制定者参与进来。