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Utilization of palliative care principles in nursing home care: Educational interventions

Published online by Cambridge University Press:  15 June 2015

Berit Seiger Cronfalk ,
Britt-Marie Ternestedt ,
Lise-Lotte Franklin Larsson ,
Eva Henriksen ,
Astrid Norberg  and
Jane Österlind
Berit Seiger Cronfalk*
Affiliation:
Ersta Sköndal University College, Palliative Research Centre, Stockholm, Sweden Karolinska Institutet, Department of Oncology–Pathology, Stockholm, Sweden Stord Haugesund University College, Department of Nursing Science, Haugesund, Norway
Britt-Marie Ternestedt
Affiliation:
Ersta Sköndal University College, Palliative Research Centre, Stockholm, Sweden Karolinska Institutet, Department of Neurobiology, Care Science and Society, Stockholm, Sweden
Lise-Lotte Franklin Larsson
Affiliation:
Ersta Sköndal University College, Palliative Research Centre, Stockholm, Sweden Sophiahemmet University College, Department of Nursing Science, Stockholm, Sweden
Eva Henriksen
Affiliation:
Stockholm County Council, Research and Development FOUnu, Stockholm, Sweden
Astrid Norberg
Affiliation:
Ersta Sköndal University College, Palliative Research Centre, Stockholm, Sweden Umeå University, Department of Nursing, Umeå, Sweden
Jane Österlind
Affiliation:
Ersta Sköndal University College, Palliative Research Centre, Stockholm, Sweden
*
Address correspondence and reprint requests to: Berit Seiger Cronfalk, Ersta Sköndal högskola, P.O. Box 11189, SE-10061 Stockholm, Sweden. E-mail: [email protected] and [email protected]
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Abstract

Objective:

This study is part of the overarching PVIS (Palliative Care in Nursing Homes) project aimed at building competence in palliative care for nursing home staff. Our objective was to describe nursing home staff's attitudes to competence-building programs in palliative care.

Method:

Three different programs were developed by specialist staff from three local palliative care teams. In all, 852 staff at 37 nursing homes in the greater Stockholm area participated. Staff from 7 nursing homes participated in 11 focus-group discussions. Variation in size between the seven nursing homes initiated purposeful selection of staff to take part in the discussions, and descriptive content analysis was used.

Results:

The results suggest that staff reported positive experiences as they gained new knowledge and insight into palliative care. The experiences seemed to be similar independent of the educational program design. Our results also show that staff experienced difficulties in talking about death. Enrolled nurses and care assistants felt that they carried out advanced care without the necessary theoretical and practical knowledge. Further, the results also suggest that lack of support from ward managers and insufficient collaboration and of a common language between different professions caused tension in situations involved in caring for dying people.

Significance of results:

Nursing home staff experienced competence-building programs in palliative care as useful. Even so, further competence is needed, as is long-term implementation strategies and development of broader communication skills among all professions working in nursing homes.

Keywords

Palliative careNursing home staffCompetence-building programs
Type
Original Articles
Information
Palliative & Supportive Care , Volume 13 , Issue 6 , December 2015 , pp. 1745 - 1753
Copyright
Copyright © Cambridge University Press 2015 

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References

REFERENCES

Ahmedzai, S.H., Costa, A., Blengini, C., et al. (2004). On behalf of the international working group convened by the European School of Oncology: A new international framework for palliative care. European Journal of Cancer, 40, 2192–2200.Google Scholar
Augustsson, H., Tornquist, A. & Hasson, H. (2013). Challenges in transferring individual learning to organizational learning in the residential care of older people. Journal of Health Organization and Management, 27(3), 390–408.CrossRefGoogle ScholarPubMed
Beck, I., Jakobsson, U. & Edberg, A.K. (2014 a). Applying a palliative care approach in residential care: Effects on nurse assistants' work situation. Palliative & Support Care, 21, 1–11.Google Scholar
Beck, I., Tornquist, A. & Edberg, A.K. (2014 b). Nurse assistants' experiences of an intervention focused on a palliative care approach for older people in residential care. International Journal of Older People Nursing, 9(2), 140–150.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
Cullen, L. & Adams, S.L. (2012). Planning for implementation of evidence-based practice. The Journal of Nursing Administration, 42(4), 222–230.Google Scholar
Cullen, L., Smelser, J., Wagner, M., et al. (2012). Evidence into practice: Using research findings to create practice recommendations. Journal of Perianesthia Nursing, 27(5), 343–351.Google Scholar
Davies, E.H. & Higginson, I.J. (2004). Better palliative care for old people. Copenhagen: WHO Regional Office for Europe.Google Scholar
Davies, S.L., Goodman, C., Bunn, F., et al. (2011). A systematic review of integrated working between care homes and health care services. BMC Health Services Research, 11, 320.CrossRefGoogle ScholarPubMed
Dwyer, L.L., Hansebo, G., Andershed, B., et al. (2011). Nursing home residents' views on dying and death: Nursing home employee's perspective. International Journal of Older People Nursing, 6(4), 251–260.CrossRefGoogle ScholarPubMed
Ellershaw, J. (2002). Clinical pathways for care of the dying: An innovation to disseminate clinical excellence. Journal of Palliative Medicine, 5(4), 617–621.CrossRefGoogle ScholarPubMed
Hall, S., Petkova, H., Agis, D., et al. (eds.) (2011). Palliative care for older people: Better practices. WHO. Available from http://www.euro.who.int/en/publications/abstracts/palliative-care-for-older-people-better-practices.Google Scholar
James, I., Andershed, B., Gustavsson, B., et al. (2010 a). Emotional knowing in nursing practice: In the encounter between life and death. International Journal of Qualitative Studies on Health and Well-Being, 5(2). Available from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2904589/.Google Scholar
James, I., Andershed, B., Gustavsson, B., et al. (2010 b). Knowledge constructions in nursing practice: Understanding and integrating different forms of knowledge. Qualitative Health Research, 20(11), 1500–1518.Google Scholar
Kuhn, D.R. & Forrest, J.M. (2012). Palliative care for advanced dementia: A pilot project in two nursing homes. American Journal of Alzheimer's Disease and Other Dementias, 27(1), 33–40.Google Scholar
McLafferty, I. (2004). Focus group interviews as a data collecting strategy. Journal of Advanced Nursing, 48(2), 187–194.Google Scholar
Mellström, M. (2006). Dokumentation och rättssäkerhet inom äldreomsorgen [Documentation and juristic law in care of older people]. Lund, Sweden: Studentlitteratur.Google Scholar
Morgan, D.L. (2010). Reconsidering the role of interaction in analyzing and reporting focus groups. Qualitative Health Research, 20(5), 718–722.CrossRefGoogle ScholarPubMed
Morgan, D.L. & Bottorff, J.L. (2010). Advancing our craft: Focus group methods and practice. Qualitative Health Research, 20(5), 579–581.Google Scholar
Neergaard, M.A., Olesen, F., Jensen, A.B., et al. (2010 a). Shared care in basic level palliative home care: Organizational and interpersonal challenges. Journal of Palliative Medicine, 13(9), 1071–1077.Google Scholar
Neergaard, M.A., Vedsted, P., Olesen, F., et al. (2010 b). Associations between successful palliative trajectories, place of death and GP involvement. Scandinavian Journal of Primary Health Care, 28(3), 138–145.CrossRefGoogle ScholarPubMed
Österlind, J., Hansebo, G., Lindqvist, R., et al. (2009). Moving on a roundabout at the end of life: What counts? Waiting times for transfer to sheltered accommodation for older people in Sweden. Health Policy, 91(2), 183–188.Google Scholar
Österlind, J., Hansebo, G., Andersson, J., et al. (2011). A discourse of silence; professional carers reasoning of death and dying in nursing homes. Ageing and Society 31(4), 529–544.Google Scholar
Patton, M.Q. (2002). Qualitative research and evaluation methods, 3rd ed. Thousand Oaks, CA: Sage.Google Scholar
Raunkiaer, M. & Timm, H. (2010). Development of palliative care in nursing homes: evaluation of a Danish project. International Journal of Palliative Nursing, 16(12), 613–620.Google Scholar
Raunkiaer, M. & Timm, H. (2012). Organizational interventions concerning palliation in community palliative care services: A literature study. International Scholarly Research Notes. Available from http://www.hindawi.com/journals/isrn/2012/769262/.Google Scholar
Raunkiaer, M. & Timm, H. (2013). Interventions concerning competence building in community palliative care services: A literature review. Scandinavian Journal of Caring Sciences, 27(4), 804–819.Google Scholar
Scott-Cawiezell, J., Schenkman, M., Moore, L., et al. (2004). Exploring nursing home staff's perceptions of communication and leadership to facilitate quality improvement. Journal of Nursing Care Quality, 19(3), 242–252.Google Scholar
Seymour, J., Almack, K. & Kennedy, S. (2010). Implementing advance care planning: A qualitative study of community nurses' views and experiences. BMC Palliative Care, 9, 4.Google Scholar
Socialstyrelsen (2006). Vård i livets slutskede: Socialstyrelsens bedömning av utvecklingen i landsting och kommuner (2006-103-8).Google Scholar
Socialstyrelsen (2011). Nationell tillsyn av vård och omsorg om äldre, Delrapport (2011-5-28).Google Scholar
Socialstyrelsen (2012). Att ta fram ett vård- och omsorgsprogram för de mest sjuka alder: Stöd för vård- och omsorgsgivare, kommuner, landsting och regioner (2012-10-2).Google Scholar
Statistics Sweden (2015). Available from www.scb.se.Google Scholar
Swedish Palliative Register (2015). Available from www.svenskpalliativregister.se.Google Scholar
Swedish Social Policy Acts (2001). SFS nr. 2001-06-07, and Socialtjänstlag, 2001:453.Google Scholar
Ternestedt, BM. (2009). A dignified death and identity: Promoting care. In Dignity in care for older people. Nordenfelt, L. (ed.), pp. 146–167. Oxford: Blackwell Publishing.CrossRefGoogle Scholar