Development and Implementation of a Survey to Assess Health-Care Provider’s Competency, Attitudes, and Knowledge About Perinatal Palliative Care

Abstract

Perinatal palliative care is an emerging area of health care. To date, no published tools assess health-care provider's knowledge and level of comfort in providing such care. A 2-phase study was undertaken to develop and implement a survey to evaluate the self-assessed competency, attitudes, and knowledge of health-care providers working in perinatal palliative care. Phase 1 included a review of the literature and appraisal of palliative and death-related instruments to inform the initial draft of the Perinatal Palliative Care Survey (PPCS). Twenty-four Canadian pediatric palliative care specialists critiqued the PPCS, establishing its face and content validity. Phase 2 involved administering the PPCS at 4 sites across Canada, resulting in 167 responses from nurses, physicians, and midwives. The majority of participants responded that they possessed a degree of comfort in providing perinatal palliative care, particularly with assessing pain (76%), managing pain (69%), assessing other symptoms (85%), and managing other symptoms (78%). Two areas where participants level of confidence or extreme confidence was diminished included having conversations with families about the possibility of their infant dying (55%) and knowing and accessing community palliative care resources (32%). Responses in the knowledge section identified gaps related to opioid use, pharmacological interventions for breathlessness, pain behaviors, and tolerance developed to opioids and sedatives. Eighty-six percent of respondents stated that if education about palliative care was made available, they would participate with priority topics identified as communication with families (75%), managing symptoms (69%), pain management (69%), and ethical issues (66%). The PPCS provides a useful assessment to determine the educational needs of health-care providers delivering perinatal palliative care.

Continuing a pregnancy after diagnosis of a lethal fetal abnormality: Views and perspectives of Australian health professionals and parents

“…Despite resource constraints, HP willingness to provide comprehensive and sensitive care to parents was evident. These findings, consistent with the literature, demonstrate that holistic patient‐centred care, with unconditional respect for parents’ choices, provides a more positive experience for both HPs and parents 6,30‐33 …”

Assessment of Healthcare Professionals' Self-Perceived Competence in Perinatal/Neonatal Palliative Care After a 3-Day Training Course

“…The 32 items addressing competence were derived using a two-pronged approach. First, the literature was reviewed and a validated questionnaire by Stekenes and colleagues (15) was modified with permission to create the 32 outcome variables in the survey. The items were examined by two neonatologists and a researcher, reworded where needed, and agreement was reached regarding the inclusion of the final items.…”

Compassion and Community in Perinatal Palliative Care: Understanding the Necessity of the Patient Perspective Through Narrative Illustration

“…Perinatal palliative care is a nascent area of specialization in the field of palliative care. 1 As is often the case with emerging fields, the data and education available may be limited, so opportunities are rare for examining evidence or gaining knowledge about treatment protocol.…”

“…In a recent 2-phase survey study of Canadian physicians and nurses, the providers were asked to self-assess their comfort level and knowledge of perinatal palliative care. 1 Providers felt most competent in assessing and managing both pain and other symptoms, but they were significantly much less comfortable in communication with families about the dying child and knowing and assessing community palliative care resources. 1 The gap is wide-nearly 75% of respondents were comfortable in pain/symptom assessment and management, while only about 44% were comfortable in the more intimate aspects of care concerning communication and community resources.…”

“…1 The gap is wide-nearly 75% of respondents were comfortable in pain/symptom assessment and management, while only about 44% were comfortable in the more intimate aspects of care concerning communication and community resources. 1 This survey study not only supports the need for more education and knowledge in perinatal palliative care, it elucidates the specific type of competency necessary for it, echoing other research available.…”