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Supporting in an existential crisis: A mixed-methods evaluation of a training model in palliative care

Published online by Cambridge University Press:  20 June 2017

Lisa Sand ,
Mariann Olsson  and
Peter Strang
Lisa Sand*
Affiliation:
Department of Oncology-Pathology, Karolinska Institutet and Stockholms Sjukhems foundation R&D, Stockholm, Sweden
Mariann Olsson
Affiliation:
Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholms Sjukhems Foundation R&D, Stockholm, Sweden
Peter Strang
Affiliation:
Department of Oncology-Pathology, Karolinska Institutet and Stockholms Sjukhems foundation R&D, Stockholm, Sweden
*
Address correspondence and reprint requests to: Lisa Sand, ASIH Långbro Park, Bergtallsvägen 12, 125 59 Älvsjö, Stockholms Sjukhems, Mariebergsgatan 22, 112 19 Stockholm, Sweden. E-mail: [email protected].
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Abstract

Background:

Palliative care staff often report that they lack the skills and confidence to provide support during an existential crisis. Consequently, there is a definite need for a training program in this area.

Objective:

Our aim was to investigate whether a training model could give palliative care staff increased knowledge, awareness, and preparedness—all useful tools for providing support.

Methods:

A mixed-methods research design was used. Data were collected in four hospital-based palliative homecare teams in the Stockholm area. In total, 34 staff participated, representing different palliative care team professions. Before and after the intervention, a questionnaire with a 9-point Likert-type scale was completed (n = 34). Qualitative focus group discussions were conducted a month after the intervention (25 participants). These were recorded, transcribed, and analyzed using qualitative content analysis with a manifest focus.

Results:

In the quantitative part of our study, the participants showed significantly increased perceived knowledge, awareness, and preparedness in every aspect (p < 0.001 for all items). The focus group discussions revealed a process that made it possible to apply new knowledge and insight. The process began with theoretical knowledge and, through care-related reflection and self-reflection, the knowledge base gradually developed and provided useful skills and increased job satisfaction.

Significance of results:

The team-based “TrainingModel Sand/TER” can be performed without excessive effort and contribute to improved competence in providing support during an existential crisis. It is particularly useful for staff working in clinical palliative care.

Keywords

Palliative careExistential crisisEducational modelSOLO taxonomyMixed-methods research
Type
Original Article
Information
Palliative & Supportive Care , Volume 16 , Special Issue 4: Topics in Bereavement , August 2018 , pp. 470 - 478
Copyright
Copyright © Cambridge University Press 2017 

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References

REFERENCES

Beck, I., Tornquist, A., Brostrom, L., et al. (2012). Having to focus on doing rather than being: Nurse assistants' experience of palliative care in municipal residential care settings. International Journal of Nursing Studies, 49(4), 455–464.Google Scholar
Benzein, E.G. & Saveman, B.I. (2008). Health-promoting conversations about hope and suffering with couples in palliative care. International Journal of Palliative Nursing, 14(9), 439–445.Google Scholar
Biggs, J. & Tang, C. (eds.) (2011). Teaching for Quality Learning at University, 3rd ed. New York: McGraw-Hill.Google Scholar
Brajtman, S., Higuchi, K. & Murray, M.A. (2009). Developing meaningful learning experiences in palliative care nursing education. International Journal of Palliative Nursing, 15(7), 327–331.Google Scholar
Browall, M., Melin-Johansson, C., Strang, S., et al. (2010). Health care staff's opinions about existential issues among patients with cancer. Palliative & Supportive Care, 8(1), 59–68.Google Scholar
Coyle, N. (2006). The hard work of living in the face of death. Journal of Pain and Symptom Management, 32(3), 266–274.Google Scholar
Frankl, V. (2004/1946). Man's Search for Meaning. London: Random House.Google Scholar
Friedrichsen, M., Heedman, P.A., Åstradsson, E., et al. (2013). Does a half-day course about palliative care matter? A quantitative and qualitative evaluation among health care practitioners. Journal of Palliative Medicine, 16(5), 496–501.Google Scholar
Henoch, I. & Danielson, E. (2009). Existential concerns among patients with cancer and interventions to meet them: An integrative literature review. Psycho-Oncology, 18(3), 225–236.Google Scholar
Henoch, I., Strang, S., Browall, M., et al. (2015). Development of an existential support training program for healthcare professionals. Palliative & Supportive Care, 13(6), 1701–1709.Google Scholar
Krippendorff, K. (2004). Content Analysis, 2nd ed. London: Sage Publications.Google Scholar
Kristjanson, L.J., Sloan, J.A., Dudgeon, D., et al. (1996). Family members' perceptions of palliative cancer care: Predictors of family functioning and family members' health. Journal of Palliative Care, 12(4), 10–20.Google Scholar
Lee, V. (2008). The existential plight of cancer: Meaning making as a concrete approach to the intangible search for meaning. Supportive Care in Cancer, 16(7), 779–785.Google Scholar
Mann, K., Gordon, J. & MacLeod, A. (2009). Reflection and reflective practice in health professions education: A systematic review. Advances in Health Sciences Education: Theory and Practice, 14(4), 595–621.Google Scholar
Mann, K.V. (2008). Reflection: Understanding its influence on practice. Medical Education, 42(5), 449–451.Google Scholar
May, R. (1994/1984). The Discovery of Being. New York: W.W. Norton & Company.Google Scholar
Milberg, A., Strang, P. & Jakobsson, M. (2004). Next of kin's experience of powerlessness and helplessness in palliative home care. Supportive Care in Cancer, 12(2), 120–128.Google Scholar
Moulton, C.A., Regehr, G., Mylopoulos, M., et al. (2007). Slowing down when you should: A new model of expert judgment. Academic Medicine, 82(Suppl. 10), 109–116.Google Scholar
Östlund, U., Kidd, L., Wengstrom, Y., et al. (2011). Combining qualitative and quantitative research within mixed-method research designs: A methodological review. International Journal of Nursing Studies, 48(3), 369–383.Google Scholar
Palmer, R. (1969). Hermeneutics: Interpretation Theory in Schleirmacher, Dilthey, Heidegger and Gadamer. Chicago: Northwestern University Press.Google Scholar
Patton, M.Q. (2002). Qualitative Research and Evaluation Methods. London: Sage Publications.Google Scholar
Peterson, J., Johnson, M.A., Halvorsen, B., et al. (2010). What is it so stressful about caring for a dying patient? A qualitative study of nurses' experiences. International Journal of Palliative Nursing, 16(4), 181–187.Google Scholar
Sand, L. (2008). Existential Challenges and Coping in Palliative Cancer Care: Experiences of Patients and Family Members. Ph.D. dissertation. Stockholm: Karolinska Institutet.Google Scholar
Sand, L., Olsson, M. & Strang, P. (2009). Coping strategies in the presence of one's own impending death from cancer. Journal of Pain and Symptom Management, 37(1), 13–22.Google Scholar
Sandars, J. (2009). The use of reflection in medical education: AMEE Guide No. 44. Medical Teacher, 31(8), 685–695.Google Scholar
Sargeant, J.M., Mann, K.V., van der Vleuten, C.P., et al. (2009). Reflection: A link between receiving and using assessment feedback. Advances in Health Sciences Education: Theory and Practice, 14(3), 399–410.Google Scholar
Strang, S., Henoch, I., Danielson, E., et al. (2014). Communication about existential issues with patients close to death: Nurses' reflections on content, process and meaning. Psycho-Oncology, 23(5), 562–568.Google Scholar
Syren, S.M., Savemann, B.I. & Benzein, E.G. (2006). Being a family in the midst of living and dying. Journal of Palliative Care, 22(1), 26–32.Google Scholar
Tillich, P. (2014/1952). The Courage To Be. New Haven, CT: Yale University Press.Google Scholar
Weber, R. (1990). Basic Content Analysis, 2nd ed. London: Sage Publications.Google Scholar
Yalom, I. (1980). Existential Psychotherapy. New York: Basic Books.Google Scholar
Zambrano, S.C., Chur-Hansen, A. & Crawford, G.B. (2012). On the emotional connection of medical specialists dealing with death and dying: A qualitative study of oncologists, surgeons, intensive care specialists and palliative medicine specialists. BMJ Supportive & Palliative Care, 2(3), 270–275.Google Scholar
Zambrano, S.C., Chur-Hansen, A. & Crawford, G.B. (2014). The experiences, coping mechanisms, and impact of death and dying on palliative medicine specialists. Palliative & Support Care, 12(4), 309–316.Google Scholar
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