The training effects of a continuing education program on nurses’ knowledge and attitudes to palliative care: a cross sectional study

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Abstract

Background

Most nurses in China have not been trained to take care of end-of-life patients appropriately due to lack of educational resources and insufficient training. A palliative care program was launched by the Jiangsu Nursing Association (JNA training program) and to identify gaps in palliative care training. The main aim of this study was to evaluate the training effects of the JNA training program on nurses’ knowledge and attitudes to palliative care.

Methods

A cross-sectional study was conducted with 10 048 registered nurses in all regions of Jiangsu. All participants completed an online questionnaire using the Chinese version of The Palliative Care Quiz for Nursing (PCQN-C) and the Frommelt Attitude Toward Care of the Dying scale (FATCOD-B-C). A propensity score matched analysis was performed between the nurses who had attended the JNA training program and whose who hadn’t.

Results

The average score of PCQN-C among all nurses was 8.79, while the mean score of the FATCOD-B-C was 103.62. Those participants who attended the JNA training program had significantly better scores than those who did not. Propensity score matching analysis showed that the palliative care training program failed to improve nurses’ knowledge in psychosocial and spiritual care or their attitudes towards the necessity of family support although there was positive impact on other aspects of palliative care.

Conclusions

Knowledge of palliative care among Chinese nurses remains low. Training programs may improve general knowledge and attitudes to palliative care. However, important aspects of knowledge such as communication skills, family support, and psychosocial aspects of care, are missing. These gaps should be filled in future palliative care training programs targeting nurses with oriental culture background.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12904-022-00953-0.

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Most cited references 14

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Palliative Care

Andreas Ullrich, Tokuo Yoshida, Amanda Marlin … (2002)

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A systematic review of the effects of advance care planning facilitators training programs

Carmen Chan, Nancy Hiu Yim Ng, Helen Y L Chan … (2019)

Background Advance care planning (ACP) is the process of ongoing communication among patients, family and health care professionals regarding what plans for future care are preferred in the event that patients become unable to make their own decisions. Clinicians play an important role in ACP as both initiators and decision coaches. However, lack of training for clinicians has frequently been reported as the reason for low involvement in ACP discussions - hence the present review evaluates the effectiveness of ACP training programs for healthcare professionals to guide the development of novel training programs for them in the future. Methods A literature search for intervention studies was conducted independently by two reviewers in July 2018. Participants included all healthcare professionals working with adult patients suffering from terminal illness. The primary outcomes were the professionals’ knowledge of and attitudes towards ACP, and self-perceived competence in ACP conversations. The Effective Public Health Practice Project appraisal tool was used to examine the quality of the studies included. Results A total of 4025 articles were identified, and ten eligible articles, covering 1081 participants, were included in the review. However, there is a lack of high quality randomized controlled trials of providing ACP training for nurses working in non-palliative care hospital settings. The overall quality of the intervention studies was moderate. All the studies included used instructional sessions in their interventions, while some contained group discussion, role-play and the use of advanced technology. The training programs increased the knowledge, attitudes towards shared decision-making, perceived communication skills, confidence, comfort and experiences concerned with discussing end-of-life (EOL) issues. Patient advocacy, job satisfaction and perceived level of adequate training for EOL care were improved. The use of ‘decision aids’ was rated as acceptable and clinically useful. Conclusions Training for healthcare professionals in ACP has positive effects on their knowledge, attitude and skills. The use of decision aids and advanced technology, instructional sessions with role play, training content focused on ACP communication skills and the needs and experience of patient in the ACP process, and a values-based ACP process are all those factors that made the ACP training programs effective.

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The palliative care knowledge of nursing home staff: The EU FP7 PACE cross-sectional survey in 322 nursing homes in six European countries

Tinne Smets, Lara Pivodic, Ruth Piers … (2018)

Background: The provision of high-quality palliative care in nursing homes (NHs) is a major challenge and places demands on the knowledge and skills of the staff. Aim: This study assesses the palliative care knowledge of staff in NHs in Europe. Design: Cross-sectional study using structured survey Setting/participants: Nurses and care assistants working in 322 representative samples of NHs in Belgium, the Netherlands, England, Finland, Poland and Italy. Palliative care knowledge is measured with the Palliative Care Survey. Scores on the scales range between 0 and 1; higher scores indicate more knowledge. Results: A total of 3392 NH-staff were given a questionnaire, and 2275 responded (67%). Knowledge of basic palliative care issues ranged between 0.20 in Poland (95% confidence interval (CI) 0.19; 0.24) and 0.61 in Belgium (95% CI 0.59; 0.63), knowledge of physical aspects that can contribute to pain ranged between 0.81 in Poland (95% CI 0.79; 0.84) and 0.91 in the Netherlands (95% CI 0.89; 0.93), and knowledge of psychological reasons that can contribute to pain ranged between 0.56 in England (95% CI 0.50; 0.62) and 0.87 in Finland (95% CI 0.83; 0.90). Factors associated with knowledge were country, professional role and having undertaken formal training in palliative care. Conclusions: Knowledge of nurses and care assistants concerning basic palliative care issues appears to be suboptimal in all participating countries, although there is substantial heterogeneity. Education of nursing staff needs to be improved across, but each country may require its own strategy to address the unique and specific knowledge gaps.

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Author and article information

Contributors

Jinfeng Wu: hlxhcx@sina.com

Junjie Du: junjie.du@njmu.edu.cn

Journal

Journal ID (nlm-ta): BMC Palliat Care

Journal ID (iso-abbrev): BMC Palliat Care

Title: BMC Palliative Care

Publisher: BioMed Central (London )

ISSN (Electronic): 1472-684X

Publication date (Electronic): 26 April 2022

Publication date PMC-release: 26 April 2022

Publication date Collection: 2022

Volume: 21

Electronic Location Identifier: 56

Affiliations

[1 ]Jiangsu Nursing Association, Nanjing, 210008 China

[2 ]GRID grid.412676.0, ISNI 0000 0004 1799 0784, Department of Geriatrics, , The First Affiliated Hospital of Nanjing Medical University, ; Nanjing, 210029 China

[3 ]GRID grid.5475.3, ISNI 0000 0004 0407 4824, Faculty of Health and Medical Sciences, , The University of Surrey, ; Guildford, GU2 7XH UK

[4 ]GRID grid.412676.0, ISNI 0000 0004 1799 0784, Clinical Medicine Research Institution, , The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, ; Nanjing, 210029 China

[5 ]GRID grid.412676.0, ISNI 0000 0004 1799 0784, Oncology Department, , The Affiliated Hospital of Nanjing University Medical School, ; Nanjing, 210009 China

[6 ]GRID grid.412676.0, ISNI 0000 0004 1799 0784, Interventional Radiology Department, , The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, ; Nanjing, 210029 China

[7 ]GRID grid.413389.4, ISNI 0000 0004 1758 1622, Oncology Department, , The Affiliated Hospital of Xuzhou Medical University, ; Xuzhou, 221006 China

[8 ]GRID grid.412676.0, ISNI 0000 0004 1799 0784, Department of Geriatrics, , The First Affiliated Hospital of Nanjing Medical University, ; Nanjing, 210029 China

[9 ]GRID grid.412676.0, ISNI 0000 0004 1799 0784, Department of Cardiovascular Surgery, , The First Affiliated Hospital of Nanjing Medical University, ; Nanjing, 210029 China

Article

Publisher ID: 953

DOI: 10.1186/s12904-022-00953-0

PMC ID: 9040326

PubMed ID: 35473551

SO-VID: be4f255e-b348-414f-b078-3f792d2ce1cf

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 8 February 2022

Date accepted : 20 April 2022

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100001809, National Natural Science Foundation of China;

Award ID: 71704084

Custom metadata

ScienceOpen disciplines: Anesthesiology & Pain management

Keywords: attitude,knowledge,palliative care,continuing education

Data availability:

ScienceOpen disciplines: Anesthesiology & Pain management

Keywords: attitude, knowledge, palliative care, continuing education

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The training effects of a continuing education program on nurses’ knowledge and attitudes to palliative care: a cross sectional study

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Abstract

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Indigenous Knowledge

Most cited references 14

Palliative Care

A systematic review of the effects of advance care planning facilitators training programs

The palliative care knowledge of nursing home staff: The EU FP7 PACE cross-sectional survey in 322 nursing homes in six European countries

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