Palliative and end‐of‐life educational interventions for staff working in long‐term care facilities: An integrative review of the literature

Abstract

BackgroundGiven the increase in the number of deaths within long‐term care facilities (LTCFs), the need for palliative and end‐of‐life (EOL) care education among such facilities has been increasing. As such, a systematic synthesis of global palliative and EOL care educational approaches and evaluation can aid further educational development.ObjectiveTo synthesise the current literature on palliative and EOL care educational interventions for staff working in LTCFs and identify barriers to, and facilitators of, intervention implementation.MethodsThe study used an integrative review framework wherein indexed databases, namely, CINAHL, EMBASE, MEDLINE, PsycINFO, Web of Science, Cochrane Library and Japan Medical Abstract Society, were systematically searched for studies published in English and Japanese between 2007 and 2019. Search terms that are related to palliative care, LTCF, and education were combined to increase search sensitivity. The quality of the papers was assessed using Joanna Briggs Institute Critical Appraisal Tools and the Mixed‐Methods Appraisal Tool.ResultsA total of 52 studies were included in the review. Our results suggested that although studies in this area and setting have been evolving, suboptimal developmental research and educational practices, global variability and unstandardised approaches to education and lacking viewpoints from service users have remained. Barriers to intervention implementation were also reported due to the specific characteristics of LTCFs, which include high staff turnover and considerable variation in professional skills and experience.ConclusionsGiven the different LTCF types, systems and policies across each country or region, further research on standardised educational interventions with contextual considerations using large‐scale studies with robust methodology is needed to meet the increasing demand for palliative and EOL care among the global ageing population.Implications for practicePalliative and EOL care educational intervention for LTCF staff need to include more consideration of context, organisational culture and the user involvement throughout the process of education and research to enhance the quality of care in this complex setting.

Pragmatic Trials in Long-Term Care: Research Challenges and Potential Solutions in Relation to Key Areas of Care

“…Feasible interventions are those that are integrated into the care plan or part of ongoing care processes, 7,46 aligned with policy, or important to the setting based on relevant organizational, patientcentered, and/or regional/national goals. 47 Active participation of a champion and stakeholder team was consistently mentioned as essential to successful implementation and sustainability. 46,48,49 Care initiatives that are perceived as beneficial to staff and residents are also more likely to be sustained by staff providing the care.…”

Living, loving and letting go‐navigating the relational within palliative care of older people in long‐term care facilities: An action research study

“…This approach to care also appreciates the relationships that develop in the unit between staff, residents and their families and allows staff time to grieve.' (CIG#36,37,38) education, psychological empowerment, experience, age and leadership (Boltz et al, 2019;Collingridge Moore et al, 2020;Frey et al 2019;Lida et al, 2020). Additionally, there is a troubling disconnect between the vision, funding and organisation of LTC as homes for living and the reality that they are increasingly required to serve as hospices for older people (Connolly et al, 2014).…”

“…Consequently, little or no PC is provided at earlier stages in the disease trajectory (Cable-Williams & Wilson, 2017). There is also evidence that LTCF staff may lack critical knowledge of PC and, therefore, are unprepared for their role (Cable-Williams & Wilson, 2017;Collingridge Moore et al, 2020;Frey et al, 2016Frey et al, , 2017Lida et al, 2020;Trotta et al, 2018;Unroe et al, 2015), while there remains a lack of standardisation of such care (Lida et al, 2020;Smets et al, 2018;Trotta et al, 2018).…”

Flooding, Food Security and the Sustainable Development Goals in Nigeria: An Assemblage and Systems Thinking Approach

“…Drawing from previous studies to generate a new and concrete interpretation of problems fosters scholarship and advances theory (Post et al 2020). Integrative reviews are broad and do not exclude studies based on design or the type of research to enable a holistic understanding of the phenomena under study (Iida et al 2020) This study followed the steps outlined by Paré and Kitsiou (2017) for conducting reviews that aim to stand as an original body of work in contrast to literature reviews conducted to identify gaps in the literature to justify or act as a base to a researcher's work. Academic databases, specifically Google Scholar and ProQuest, were searched by using keywords including 'flooding', 'food security', and 'SDGs' in Nigeria.…”