Machira Gladys W, Mageto Irene G, Mwaura James
Director, Nursing Council of Kenya, P. O. Box 14683 - 00400, Nairobi - Kenya, Email:
Senior lecturer, Aga Khan School of Nursing & Midwifery, 3 Parklands Avenue, Nairobi - Kenya, Email:
Can Oncol Nurs J. 2025 Mar 1;35(2):337-360. doi: 10.5737/23688076352337. eCollection 2025 Spring.
The number of patients requiring end-of-life care in acute care hospitals in Kenya continues to increase due to increases in non-communicable diseases. Despite advances in the field of palliative care (PC), its utilization is deficient in our setting, particularly at the end of life. Many patients and family members have unmet needs during the end-of-life phase. The aim of this study was to identify and validate end-of-life nursing competencies required by non-specialized nurses in Kenya. Validation of competencies for end-of-life care would help to develop relevant professional development programs in palliative care for these nurses.
A two-round modified Delphi study was conducted. A 20-member panel of specialists in end-of-life care was involved in the identification and validation of the end-of-life nursing care competencies.
The results highlighted a total of eight core competencies namely: palliative nursing care; pain management; symptom management; ethical-legal issues; psychosocial, cultural and spiritual considerations; communication; loss, grief and bereavement; and death and dying. Additionally, 92 sub-competencies were identified that general nurses should possess within three domains of learning: knowledge (43 competencies), attitude (17 competencies), and practice/skills (32 competencies).
The study forms a basis from which the identified end-of-life competencies can be utilized for continuous professional development programs for general nurses in acute care hospitals. Such programs could enhance the capacities of the general nurses and promote the integration of end-of-life care in acute care hospitals, thus improving the outcomes in quality of life for patients and families.
由于非传染性疾病的增加，肯尼亚急性护理医院中需要临终关怀的患者数量持续上升。尽管姑息治疗领域取得了进展，但在我们的环境中其利用率仍然不足，尤其是在临终阶段。许多患者和家庭成员在临终阶段有未得到满足的需求。本研究的目的是确定并验证肯尼亚非专科护士所需的临终护理能力。验证临终护理能力将有助于为这些护士制定相关的姑息治疗专业发展计划。
进行了两轮改良的德尔菲研究。一个由20名临终关怀专家组成的小组参与了临终护理能力的识别和验证。
结果突出了总共八项核心能力，即：姑息护理；疼痛管理；症状管理；伦理法律问题；心理社会、文化和精神方面的考虑；沟通；丧失、悲伤和丧亲之痛；以及死亡和临终。此外，还确定了92项子能力，普通护士应在三个学习领域具备这些能力：知识（43项能力）、态度（17项能力）和实践/技能（32项能力）。
该研究形成了一个基础，据此可以将确定的临终能力用于急性护理医院普通护士的持续专业发展计划。此类计划可以提高普通护士的能力，并促进急性护理医院中临终关怀的整合，从而改善患者及其家庭的生活质量结果。
