Eran Ben-Arye1,2, Yael Keshet3, Maria Livas4,5, Thomas Breitkreuz4,6. 1. Integrative Oncology Program, Lin and Carmel Medical Centers, Clalit Health Services; Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel. eranben@netvision.net.il. 2. The Oncology Service, Lin Medical Center, 35 Rothschild St, Haifa, Israel. eranben@netvision.net.il. 3. Department of Sociology and Anthropology, Western Galilee Academic College, Galilee, Israel. 4. Paracelsus-Krankenhaus Unterlengenhardt, Bad Liebenzell, Germany. 5. Projekt Integrative Onkologie, Medizinische Klinik III, Städtisches Klinikum Karlsruhe, Karlsruhe, Germany. 6. Die Filderklinik, Stuttgart, Germany.
Abstract
OBJECTIVE: Complementary and integrative medicine (CIM) is acknowledged in more and more oncology-care centers as part of supportive and palliative cancer care. However, only limited research is available on medical training of CIM practitioners regarding end-of-life (EOL) care. In this study, we assess the impact of multi-disciplinary EOL training on cultural-diverse groups of CIM-trained healthcare practitioners (HCPs) working in integrative oncology care settings in Germany and Israel. METHODS: The authors co-designed an evidence-based patient-centered EOL-training curriculum incorporating palliative and CIM concepts of care. Afterwards, a 3-day course was designed for 25 HCPs working in three anthroposophic-medicine-oriented medical centers in Germany and 14 CIM-trained HCPs from one oncology center in Israel. Qualitative assessment of the EOL-training impact on trainees was assessed 4-month post-intervention. Narratives were analyzed using ATLAS.ti software for systematic coding. RESULTS: Post-training narrative assessment was reported by 18 German and 14 Israeli HCPs comprising 10 physicians, 12 nurses and paramedical practitioners, and 10 CIM therapists and spiritual care-providers. Content analysis of post-training outcomes suggested participants' attitude-change regarding their professional role in EOL care as individuals and as members of a team. Participants acquired practical clinical tools to enhance EOL care and to better communicate with patients about death, implementing a patient-centered, cultural-sensitive approach. CONCLUSIONS: EOL training of CIM-trained HCPs enhances communication and palliative clinical skills. Multidisciplinary and international training settings emphasize a cross-cultural perspective and enrich the bio-psycho-social-spiritual model of palliative care.
OBJECTIVE: Complementary and integrative medicine (CIM) is acknowledged in more and more oncology-care centers as part of supportive and palliative cancer care. However, only limited research is available on medical training of CIM practitioners regarding end-of-life (EOL) care. In this study, we assess the impact of multi-disciplinary EOL training on cultural-diverse groups of CIM-trained healthcare practitioners (HCPs) working in integrative oncology care settings in Germany and Israel. METHODS: The authors co-designed an evidence-based patient-centered EOL-training curriculum incorporating palliative and CIM concepts of care. Afterwards, a 3-day course was designed for 25 HCPs working in three anthroposophic-medicine-oriented medical centers in Germany and 14 CIM-trained HCPs from one oncology center in Israel. Qualitative assessment of the EOL-training impact on trainees was assessed 4-month post-intervention. Narratives were analyzed using ATLAS.ti software for systematic coding. RESULTS: Post-training narrative assessment was reported by 18 German and 14 Israeli HCPs comprising 10 physicians, 12 nurses and paramedical practitioners, and 10 CIM therapists and spiritual care-providers. Content analysis of post-training outcomes suggested participants' attitude-change regarding their professional role in EOL care as individuals and as members of a team. Participants acquired practical clinical tools to enhance EOL care and to better communicate with patients about death, implementing a patient-centered, cultural-sensitive approach. CONCLUSIONS: EOL training of CIM-trained HCPs enhances communication and palliative clinical skills. Multidisciplinary and international training settings emphasize a cross-cultural perspective and enrich the bio-psycho-social-spiritual model of palliative care.
Entities:
Keywords:
Anthroposophic medicine; Doctor-patient communication; End of life; Integrative oncology; Palliative care; Psycho-oncology
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Authors: G S Kienle; E Ben-Arye; B Berger; C Cuadrado Nahum; T Falkenberg; G Kapócs; H Kiene; D Martin; U Wolf; H Szöke Journal: Evid Based Complement Alternat Med Date: 2019-11-12 Impact factor: 2.629