The Changing Nature of Palliative Care: Implications for Allied Health Professionals’ Educational and Training Needs

Morgan, Deidre; Rawlings, Deb; Moores, Carly; Button, Lizzie; Tieman, Jennifer

doi:10.3390/healthcare7040112

Cited by 19 publications

(24 citation statements)

References 15 publications

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“…[ 37 – 39 ]. Although communication skills training is included in most health professional education, minimal time is spent on how to broach end-of-life conversations [ 7 , 21 , 40 ]. The modules provided a framework by which health professionals could proactively respond to patient and carer needs.…”

Section: Discussionmentioning

confidence: 99%

“…Some indicated it gave them the courage to initiate end-of-life discussions. Health professionals also recognise this but report needing additional training [ 14 , 21 , 33 ]. Importantly, our findings build on existing studies that report additional training, including use of suites of responses such as question prompt lists, improves end-of-life discussions for health professionals, patients and families [ 45 , 46 ].…”

Section: Discussionmentioning

confidence: 99%

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“It’s given me confidence”: a pragmatic qualitative evaluation exploring the perceived benefits of online end‐of‐life education on clinical care

et al. 2021

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Background Hospital admissions for end-of-life care are increasing exponentially across the world. Significant numbers of health professionals are now required to provide end-of-life care with minimal training. Many health professionals report they lack confidence to provide this care, particularly those in acute hospital settings. This study explored the perceived benefits of online education on health professionals’ capacity to provide end-of-life care. Methods This qualitative study adopted a pragmatic approach. Thirty semi-structured interviews were conducted with allied health professionals, nurses and doctors who had completed a minimum of three End-of-Life Essentials online education modules. Interviews were held on line and face-to-face, audio-recorded and transcribed verbatim. Demographic data were also collected. Three major themes and one minor theme were constructed from the data using inductive thematic analysis. Results Themes were (1). Perceptions of preparedness to provide end-of-life care, (2). Shifts in approaching end-of-life discussions and (3). Motivation for engagement with online modules. Participants reported validation of knowledge and improved confidence to have end-of-life discussions with patients, carers and team members. They also noted improved ability to recognise the dying process and improved conversations with team members about patient and carer needs. Videos portraying a novice and then more able end-of-life discussions were particularly valued by participants. Modules provided practical guidance on how to engage in discussions about the end of life and care needs. Participants were self-motivated to improve their knowledge and skills to enhance end-of-life care provision. Continuing professional development requirements were also a motivator for module completion. Conclusions This study explored health professionals’ perspectives about the perceived benefits of online education modules on their clinical practice. Module completion enhanced participant confidence and self-reported improved competence in end-of-life care provision. Findings build on existing research that supports the valuable role online education plays in supporting confidence and ability to actively engage with patients, carers and colleagues about provision of end-of-life care; however, self-report cannot be used as a proxy for improved clinical competence.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“It’s given me confidence”: a pragmatic qualitative evaluation exploring the perceived benefits of online end‐of‐life education on clinical care

et al. 2021

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“…Future research could examine factors influencing adjustment to AE in compressed end-of-life time frames. AE in this study was provided by allied health professionals experienced in working with people with advanced disease; however, not all allied health professionals feel confident working with this cohort [ 59 ]. Future research could examine factors associated with AE prescription by allied health professionals with limited experience in palliative care.…”

Section: Discussionmentioning

confidence: 99%

The Complexities of Prescribing Assistive Equipment at the End of Life—Patient and Caregivers’ Perspectives

Morgan

Willis

Sweet³

et al. 2022

Healthcare

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Ongoing participation in valued and essential everyday activities remains a priority for people with advanced disease. This study sought to understand factors influencing patients with advanced disease and caregivers’ utilisation of assistive equipment that enable this participation. Employing a pragmatic approach, purposive sampling identified participants who were interviewed in their homes. A semi-structured interview guide was employed to elicit community dwelling patients’ and caregivers’ perspectives about assistive equipment utilisation. Recorded interviews were analysed inductively and themes were constructed from the data. Fourteen interviews were conducted with patients and caregivers. Patients had a range of cancers and COPD. Three empirically developed themes demonstrate the complexities associated with the use of assistive equipment at the end of life: 1. Enabling engagement in everyday activities; 2. Dependency—a two-way street; 3. The pragmatics of choosing, using or declining assistive equipment. Participants were motivated to use assistive equipment when it optimised their function, enabled participation and supported their values, roles and interests. Conversely, use of assistive equipment could be met with ambivalence as it represented deterioration or could cause conflict within relationships. Caregivers found assistive equipment made it easier for them to provide physical care. Skilled proactive assistive equipment prescription and training by allied health professionals enhanced patient and caregiver confidence and capacity to engage in everyday activities.

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“…Speech and language therapists provide support to patients with life-limiting illnesses across numerous clinical settings, including acute hospitals, community and residential care. 11 However, they are not considered core members of the palliative multidisciplinary team internationally. 6–8,12 There is evidence that this is beginning to change, for example in Ireland speech and language therapists have recently been recognised as essential members of the palliative care team.…”

Section: Introductionmentioning

confidence: 99%

‘There’s this big fear around palliative care because it’s connected to death and dying’: A qualitative exploration of the perspectives of undergraduate students on the role of the speech and language therapist in palliative care

Collins

2022

Palliat Med

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Background: Speech and language therapy in palliative care is a developing discipline of clinical practice. Research literature has highlighted that undergraduate palliative care education in speech and language therapy is inconsistent and inadequate. However, limited research has been carried out to date in relation to student speech and language therapists and palliative care. Aim: To explore the role of speech and language therapists in palliative care from the perspective of speech and language therapy students in Ireland. Design: A qualitative descriptive research study was conducted, involving focus group interviews. Setting/participants: Purposive sampling was used to recruit 12 student speech and language therapists from one university site for this study. Undergraduate second, third and fourth year students were eligible for inclusion. Results: This study revealed that undergraduate student speech and language therapists collectively agree that there is a role for speech and language therapy in palliative care. Although students acknowledged that speech and language therapists can make a positive difference to patients’ lives, and academic lectures were positively received, insufficient exposure to palliative care has resulted in fear, uncertainty and a lack of confidence amongst student speech and language therapists. Conclusions: A greater emphasis on palliative care is needed in undergraduate speech and language therapy education to ensure confidence and competency development. An exploration of student speech and language therapists’ experiences in a specialist palliative care unit would be advantageous to determine the appropriateness of this setting for clinical placements.

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The Changing Nature of Palliative Care: Implications for Allied Health Professionals’ Educational and Training Needs

Cited by 19 publications

References 15 publications

“It’s given me confidence”: a pragmatic qualitative evaluation exploring the perceived benefits of online end‐of‐life education on clinical care

“It’s given me confidence”: a pragmatic qualitative evaluation exploring the perceived benefits of online end‐of‐life education on clinical care

The Complexities of Prescribing Assistive Equipment at the End of Life—Patient and Caregivers’ Perspectives

‘There’s this big fear around palliative care because it’s connected to death and dying’: A qualitative exploration of the perspectives of undergraduate students on the role of the speech and language therapist in palliative care

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