Early palliative home care: Evaluation of an interprofessional educational intervention for district nurses and general practitioners about nutritional care

Abstract

Background:Teamwork is important in early palliative home care, and interprofessional education is required to achieve teamwork. It is thus crucial to ensure that interprofessional education works well for the members of all participating professions because levels of knowledge and educational needs may vary.Aim:To evaluate, by profession, the effectiveness of an interprofessional educational intervention for district nurses and general practitioners on three areas of nutritional care for patients in a palliative phase.Design:A quasi-experimental study that used a computer-based, study-specific questionnaire to evaluate the effectiveness of the intervention. The continuing education in primary health care (ConPrim®) model was used to create the intervention. ConPrim includes a web-based program, a practical exercise and a case seminar, all with interprofessional training.Setting:Primary health care centers in Stockholm County, Sweden. Intervention group (n = 87; 48 district nurses, 39 general practitioners); control group (n = 53; 36 district nurses, 17 general practitioners).Results:The total intervention effect was significant in all three areas, p = 0.000–0.004. The intervention effects were similar and significant for both professions in areas 1 and 2. In area 3, the intervention effects were significant for general practitioners but not for district nurses.Conclusions:The intervention seems promising, as it may create better prerequisites for teamwork and caring for patients living at home. However, it needs to be optimized to better increase district nurses’ level of knowledge (area 3).

“A palliative end-stage COPD patient does not exist”: a qualitative study of barriers to and facilitators for early integration of palliative home care for end-stage COPD

“…Previous interventions in early PC and PHC for end-stage COPD mainly focused on caring for one symptom, for example managing breathlessness 44 or provided training about one care aspect, such as nutrition. 23 Instead, we suggest using several components to provide a holistic PHC approach, in order to fully tackle the lack of early integrated PHC for people with end-stage COPD.…”

“… 21 Reasons for not referring end-stage COPD patients were according to the physicians due to a lack of time, because PC was not meaningful, or that PC needs were addressed in standard care. 21 As research on implementing early integration of PHC for end-stage COPD is thin on the ground, with studies only exploring patients’ acceptance of integrated PHC, 19 investigating PC and end-of-life discussions for COPD in general 22 or not specifically focusing on end-stage COPD, 16 , 23 a more detailed examination of challenges and possibilities for early integration of PHC for end-stage COPD is needed to gain insight into reasons why early integration of PHC for end-stage COPD is currently lacking and how to tackle this.…”

Effectiveness of traditional lectures and case methods in Swedish general practitioners’ continuing medical education about COPD: a cluster randomised controlled trial

“…26 A previous study in a similar setting found that primary healthcare professionals appreciate CME outreach visits. 35 The CME outreach visits in the current study were thus another strength, as they enabled the GPs to attend the CME sessions despite their busy schedules. Another strength was the choice to conduct the follow-up measurement 12 months after the intervention, which enabled us to describe the sustained effects of the interventions.…”

Symptom Burden in Patients With Home Care Who Are at Risk for Malnutrition: A Cross-Sectional Study

“…9 Such results, which show that health-care professionals did not pay sufficient attention to patients' symptom burden, confirm that there is a gap between recommendations 25,26 and practice. 9,27 Other reasons why malnutrition often goes unrecognized may be unclear professional responsibility for nutritional care, 15 poor knowledge and communication, and low awareness of patients' risk for malnutrition. 9 This study adds detail about the symptom burden of older patients who are in early palliative stages and are at risk for malnutrition.…”

“…8 Primary healthcare professionals should therefore prioritize the use of recommended nutritional screening tools, 9 although they do not always do so. [10][11][12] As part of an educational intervention for primary healthcare professionals that was developed and evaluated by the authors of the current study, [13][14][15] a number of screening tools were used to gather information on the nutritional situation of older patients in early palliative stages of illness. These data gave us the opportunity to investigate nutrition-related topics on which information is scarce, 16 including how self-reported symptom burden is related to risk for malnutrition.…”