Correction: Perspectives, perceived self-efficacy, and preparedness of newly qualified physicians in practising palliative care—a qualitative study (original) (raw)
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BMC Palliative Care
Background Dealing with life-limiting illnesses, death, dying and grief, is uncharted territory for medical graduates. It is a field that is heavily influenced by cultural, religio-spiritual and social factors. This adds complexity to palliative and end-of-life-care, which challenges newly qualified physicians and requires the formation of appropriate knowledge, skills, and attitudes in junior doctors. This study aimed to obtain insight into the perspectives, perceived self-efficacy, and preparedness of newly qualified Nigerian physicians in practising palliative care and identify potential variables influencing them. Methods The study was a cross-sectional, multi-centre survey of newly qualified Nigerian physicians, using semi-structured, in-depth qualitative interviews. The data were analysed by applying content-structuring qualitative content analysis. Results Forty semi-structured interviews were conducted with medical house officers at two tertiary institutions in Nigeria. The ...
2022
Background Dealing with life-limiting illnesses, death, dying and grief, is uncharted territory for the fresh medical graduate. It is a eld that is heavily in uenced by cultural, religio-spiritual and social factors. These add a complexity to palliative and end-of-life-care that challenges newly quali ed physicians and requires the formation of appropriate knowledge, skills and attitudes in the junior doctor. This study aimed at obtaining insight into the perspectives and preparedness of newly quali ed physicians in Nigeria, regarding the practice of palliative care. Methods The study was a cross-sectional, multicentre survey of newly quali ed Nigerian physicians, using semistructured qualitative interviews. The data was analysed, applying content-structuring qualitative content analysis. Results Forty semi-structured interviews were held with medical House O cers at two Nigerian tertiary institutions. The qualitative content analysis resulted in a comprehensive code system. Palliative care practice as experienced by young physicians in Nigeria was highlighted by four codes: Breaking Bad News; Pronouncing a Prognosis and Diagnosing Dying; Involving the Family and Pain and Symptom Management. Other codes highlighted possible in uences on the newly quali ed physicians' palliative care practice. Main themes that were the major in uencers here were: socioeconomic considerations of a resource-limited setting and cultural-religious aspects characteristic to Nigeria. Conclusions This study offers valuable insight into potential socio-cultural and socioeconomic variables on palliative care practice in Nigeria. Evidence on social, cultural and religio-spiritual dimensions of palliative care is indispensable for culturally sensitive care. The results could aid in the development of appropriate knowledge, skills and attitudes in newly quali ed physicians through culturally and contextually appropriate palliative care training measures. The results may be applicable to other Sub-Saharan African settings and to African communities in the diaspora and may be used to improve future palliative care practice with a socio-cultural perspective. Background Socio-cultural" is a compound-term relating to a combination of social and cultural factors. Culture is de ned by Cain et al. (27) as "a dynamic framework that evolves and adapts within an ecologic and technical setting through historical, political, and social forces. The framework provides a structure that positions its subgroup members in juxtaposition. Each subgroup creates a dynamic system of beliefs, values, lifestyles, and opportunities that provide its members a sense of safety, identity, and meaning of and for life within the social, biologic, physical, and political niche. According to Cain et al. (27), social factors come into play when looking at subcultural groups and the complex power relationships and rules of social interaction among them. Subcultural groups are characterized, among others, by gender identity, sexual identity, age, occupation and educational background, and a nity groups. Cain et al. (27) argue that cultural in uences on PC preferences of patients and family members are evident but often not fully understood by physicians. However, not only cultural factors in uence PC practice. Social factors as well as knowledge and access may be just as important in the utilization and provision of PC. The term "socio-economic" signi es the interaction of social and economic factors, in the sense that economic conditions, insurance status, structural and nancial resources, and education shape care preferences and PC practice (27). In African settings, there is a noticeable dearth in research on cultural and spiritual dimensions of health, illness and meaning-making in PC (28). This study is aiming to address the pressing need for research on socio-cultural, religio-spiritual and socioeconomic in uences on the PC practice in Africa. Methods The study was a cross-sectional, multicentre survey of NQPs in Nigeria, using semi-structured qualitative interviews. Setting The participants were recruited from two tertiary institutions in Nigeria, namely,
Effect of palliative care training on perceived self-efficacy of the nurses
BMC Palliative Care
Background: Nurses are involved in providing end-of-life care for end stage individuals and their self-efficacy is one of the key factors bearing on such care. The purpose of this study was to determine the effect of palliative care on perceived self-efficacy of the nurses. Methods: This is a quasi-experimental study with pretest-posttest design. Sampling was randomized and included 40 individuals. The intervention consisted of palliative care training for four sessions, each lasting 45 min. Data were collected using demographic and perceived self-efficacy questionnaires completed before and after the intervention. Data were then analyzed by SPSS 16 software using descriptive and inferential statistics. Results: The mean age of the participants was 38.6 and their work experience was 14.25 years. The majority of the participants were female (85%) and had a bachelor level of education (92.5%). The findings showed that "perceived self-efficacy", "psychosocial support" and "symptom management" improved significantly after intervention (p < 0.05). Conclusion: Based on the results, palliative care education has the potential to increase nurses' perceived self-efficacy. Since all members of the health care team Including nurses play an important role in providing palliative care, nursing managers can take an effective step to maximize the capacity of nurses by planning and supporting training in this regard.
Journal of …, 2008
Title. Improving district nurses' confidence and knowledge in the principles and practice of palliative care. Aim. This paper is a report of part of an evaluation of the impact of a national palliative care education and support programme on the knowledge and confidence of members of district nursing teams. Background. District nursing teams are the mainstay of 'hands on' provision of care at home. In recognition of their central role, the English Department of Health commissioned a national palliative care education programme as postregistration education had been limited. Methods. The evaluation, conducted between 2002 and 2004, had a mixed methods design. In the summative component, 1280 nurses were randomly selected from eight cancer networks to receive postal questionnaires 1 year apart, before and after the educational intervention. Changes in scores were calculated and a multiple regression analysis undertaken to identify predictors of improvement in confidence in competence and knowledge. The formative component involved qualitative interviews with a sub-sample of 39 district nurses participating in the programme. Findings. Nurses who responded in both years (374/32%) were included in the analysis. There was a small statistically significant increase in confidence in palliative care competency and knowledge after participation in the educational programmes. Nurses without district nursing qualifications and who had never worked in specialist palliative care had the largest improvements in scores. Qualitative data supported these findings. Conclusion. The findings suggest that the education programme led to improvements in self-reported district nursing confidence in palliative care competencies and knowledge; it is likely that the baseline level of palliative care confidence in competency and knowledge has as a result been raised nationally.
Ceylon Medical Journal
Introduction: Though palliative care is an essential component in the continuum of cancer care, it is still at an evolving phase in Sri Lanka.Objective: To identify knowledge, attitude, self-perceived competencies in practicing palliative care and factors associated among medical officers in National Cancer Institute, Sri Lanka.Methods: A descriptive cross sectional study was conducted among doctors in National Cancer Institute in 2020/21 using self-administered questionnaire to assess knowledge, attitudes and self-perceived competencies on palliative care. Doctors worked less than 3 months and directly not involved in patient care were excluded. Scoring systems were used to assess knowledge, attitudes and self-perceived competencies. A descriptive analysis of data was done using SPSS 21 using median scores, frequencies and chi- square test. Ethical clearance was taken from the Ethical Review Committee, Faculty of Medicine, University of Colombo. Results: Out of 120 doctors includ...
Journal of palliative medicine, 2015
Interventions to improve pediatric trainee education in palliative care have been limited by a lack of reliable and valid tools for measuring effectiveness. We developed a questionnaire to measure pediatric fellows' self-efficacy (comfort), knowledge, and perceived adequacy of prior medical education. We measured the questionnaire's reliability and validity. The questionnaire contains questions regarding self-efficacy (23), knowledge (10), fellow's perceived adequacy of prior medical education (6), and demographics. The survey was developed with palliative care experts, and sent to fellows in U.S. pediatric cardiology, critical care, hematology/ oncology, and neonatal-perinatal medicine programs. Measures of reliability, internal consistency, and validity were calculated. One hundred forty-seven fellows completed the survey at test and retest. The self-efficacy and medical education questionnaires showed high internal consistency of 0.95 and 0.84. The test-retest reliabi...
Indian journal of palliative care
Patients with chronic life-limiting conditions on palliative care (PC) prefer to be treated at home. Medical care by family physicians (FPs) reduces demand on costly and busy hospital facilities. Working of PC team in collaboration with FPs is thus helpful in home-based management of patients. This study aimed at exploring the extent of knowledge of FPs about PC and the need for additional training. Semi-structured interviews were conducted with ten FPs from two suburbs of Mumbai, currently served by home care services of a tertiary cancer care center. Data were digitally recorded, transcribed, and analyzed using exploratory analysis followed by content analysis to develop thematic codes. FPs perceive PC as symptom control and psychological support helpful in managing patients with advanced life-limiting illnesses. Further training would help them in PC provision. Such training programs should preferably focus on symptom management and communication skills. There is a need for furth...