Development of palliative care educational programmes continues in Japan. An instrument to evaluate a wider range of palliative care knowledge among general physicians and nurses is needed. However, such an instrument does not currently exist. The aim of this study was to develop an assessment to measure the efficacy of palliative care educational programmes. The questionnaire survey was validated with a group of 940 nurses at two facilities. The response rate was 85 % (n = 797). This study used psychometric methods such as item response theory and intraclass correlation coefficients. Ultimately, 20 items in 5 domains including 'philosophy', 'pain', 'dyspnoea', 'psychiatric problems' and 'gastrointestinal problems' were selected. For these items, the intraclass correlation was 0.88 overall and 0.61-0.82 in each domain; the Kuder-Richardson formula 20 in internal consistency was 0.81. Validity and reliability of the instrument were established. This tool is designed to evaluate a wider range of palliative care knowledge than currently available assessments and can be used for general physicians and nurses. The evaluation of educational programmes and the clarification of actual knowledge acquired are possible using this instrument.

The validity and reliability of these scales were established. Therefore, the clarification of actual practices used and difficulties experienced will be possible using these scales.

Nurses' palliative care knowledge, difficulties, and self-reported practices improved over the seven-year study period, especially in terms of expert support in designated cancer hospitals and knowledge among nurses in designated cancer hospitals.

The PEACE education program improved physicians' knowledge of, practices in, and difficulties with palliative care.

We successfully validated a newly developed palliative care knowledge questionnaire to evaluate PEACE effectiveness (PEACE-Q). The PEACE-Q could be useful for evaluating both palliative care knowledge among physicians and education programs in primary palliative care.

Physicians' knowledge of and difficulties with palliative care improved on a national level. The PEACE program may have contributed to these improvements. Cancer 2018;124:626-35. © 2017 American Cancer Society.

BackgroundLead V1 on electrocardiography (ECG) can detect the dominant frequency (DF) of atrial fibrillation (AF) in the right atrium (RA). Paroxysmal AF is characterized by a frequency gradient from the left atrium (LA) to the right atrium (RA). We examined the ability of magnetocardiography (MCG) to detect regional DFs in both the atria.MethodsStudy subjects comprised 18 consecutive patients referred for catheter ablation of persistent AF. An MCG system with 64 magnetic sensors was used to perform MCG in the frontal, lateral, and back planes prior to the ablation procedure in each patient. DFMCG and organization index (OIMCG) were calculated using fast Fourier transformation. Intracardiac electrograms (ICEs) in both the atria and the coronary sinus (CS) were mapped at 17 sites. Regional DFsICE were also determined.ResultsMean LA DFICE was higher than mean RA DFICE (6.40±0.66 versus 6.16±0.80 Hz, P=0.03). DFMCG in the channel having the highest OIMCG was 6.61±0.88 Hz in the frontal plane, 6.52±0.64 Hz in the lateral plane, and 6.42±0.62 Hz in the back plane (P=0.3). In each plane, DFMCG correlated with DFICE at the RA appendage (R=0.95, P<0.0001), the LA appendage (R=0.91, P<0.0001), and the CS (R=0.93, P<0.0001). DFECG in V5 modestly correlated with DFICE at the LA appendage (R=0.82, P<0.0001).ConclusionsMCG could more precisely detect the DFs in the LA and the CS than ECG. However, the usefulness of pre-procedural detection of the AF frequency gradient for ablation therapy needs to be evaluated in future prospective studies.

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