M Ten Koppel1, B D Onwuteaka-Philipsen2, J T van der Steen3, M Kylänen4, L Van den Block5, T Smets6, L Deliens7, G Gambassi8, D Collingridge Moore9, K Szczerbińska10, H R W Pasman11. 1. Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Expertise center for Palliative Care, Van der Boechorststraat 7, Amsterdam, the Netherlands. Electronic address: m.tenkoppel@vumc.nl. 2. Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Expertise center for Palliative Care, Van der Boechorststraat 7, Amsterdam, the Netherlands. Electronic address: b.philipsen@vumc.nl. 3. Leiden University Medical Center, Department of Public Health and Primary Care, Albinusdreef 2, Leiden, the Netherlands; Radboud University Medical Center, Department of Primary and Community Care, Geert Grooteplein Zuid 10, Nijmegen, the Netherlands. Electronic address: J.vanderSteen@vumc.nl. 4. National Institute for Health and Welfare, Mannerheimintie 166, Helsinki, Finland. Electronic address: marika.kylanen@thl.fi. 5. End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Laarbeeklaan 103, Brussels, Belgium. Electronic address: Lieve.Van.den.Block@vub.be. 6. End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Laarbeeklaan 103, Brussels, Belgium. Electronic address: Tinne.Smets@vub.be. 7. End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Laarbeeklaan 103, Brussels, Belgium. Electronic address: Luc.Deliens@vub.be. 8. Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, Rome, Italy. Electronic address: Giovanni.Gambassi@unicatt.it. 9. International Observatory on End-of-Life Care, Lancaster University, LA1 4YG, Lancaster, United Kingdom. Electronic address: d.collingridgemoore@lancaster.ac.uk. 10. Unit for Research on Aging Society, Department of Sociology of Medicine, Epidemiology and Preventive Medicine Chair, Faculty of Medicine, Jagiellonian University Medical College, ul. Kopernika 7a, Krakow, Poland. Electronic address: katarzyna.szczerbinska@uj.edu.pl. 11. Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Expertise center for Palliative Care, Van der Boechorststraat 7, Amsterdam, the Netherlands. Electronic address: hrw.pasman@vumc.nl.
Abstract
BACKGROUND: An important part of palliative care is discussing preferences at end of life, however such conversations may not often occur. Care staff with greater self-efficacy towards end-of-life communication are probably more likely to have such discussions, however, there is a lack of research on self-efficacy towards end-of-life discussions among long-term care staff in Europe and related factors. OBJECTIVES: Firstly, to describe and compare the self-efficacy level of long-term care staff regarding end-of-life communication across six countries; secondly, to analyse characteristics of staff and facilities which are associated to self-efficacy towards end-of-life communication. DESIGN: Cross-sectional survey. SETTINGS: Long-term care facilities in Belgium, England, Finland, Italy, the Netherlands and Poland (n = 290). PARTICIPANTS: Nurses and care assistants (n = 1680) completed a self-efficacy scale and were included in the analyses. METHODS: Care staff rated their self-efficacy (confidence in their own ability) on a scale of 0 (cannot do at all) to 7 -(certain can do) of the 8-item communication subscale of the Self-efficacy in End-of-Life Care survey. Staff characteristics included age, gender, professional role, education level, training in palliative care and years working in direct care. Facility characteristics included facility type and availability of palliative care guidelines, palliative care team and palliative care advice. Analyses were conducted using Generalized Estimating Equations, to account for clustering of data at facility level. RESULTS: Thde proportion of staff with a mean self-efficacy score >5 was highest in the Netherlands (76.4%), ranged between 55.9% and 60.0% in Belgium, Poland, England and Finland and was lowest in Italy (29.6%). Higher levels of self-efficacy (>5) were associated with: staff over 50 years of age (OR 1.86 95% CI[1.30-2.65]); nurses (compared to care assistants) (1.75 [1.20-2.54]); completion of higher secondary or tertiary education (respectively 2.22 [1.53-3.21] and 3.11 [2.05-4.71]; formal palliative care training (1.71 [1.32-2.21]); working in direct care for over 10 years (1.53 [1.14-2.05]); working in a facility with care provided by onsite nurses and care assistants and offsite physicians (1.86 [1.30-2.65]); and working in a facility where guidelines for palliative care were available (1.39 [1.03-1.88]). CONCLUSION: Self-efficacy towards end-of-life communication was most often low in Italy and most often high in the Netherlands. In all countries, low self-efficacy was found relatively often for discussion of prognosis. Palliative care education and guidelines for palliative care could improve the self-efficacy of care staff.
BACKGROUND: An important part of palliative care is discussing preferences at end of life, however such conversations may not often occur. Care staff with greater self-efficacy towards end-of-life communication are probably more likely to have such discussions, however, there is a lack of research on self-efficacy towards end-of-life discussions among long-term care staff in Europe and related factors. OBJECTIVES: Firstly, to describe and compare the self-efficacy level of long-term care staff regarding end-of-life communication across six countries; secondly, to analyse characteristics of staff and facilities which are associated to self-efficacy towards end-of-life communication. DESIGN: Cross-sectional survey. SETTINGS: Long-term care facilities in Belgium, England, Finland, Italy, the Netherlands and Poland (n = 290). PARTICIPANTS: Nurses and care assistants (n = 1680) completed a self-efficacy scale and were included in the analyses. METHODS: Care staff rated their self-efficacy (confidence in their own ability) on a scale of 0 (cannot do at all) to 7 -(certain can do) of the 8-item communication subscale of the Self-efficacy in End-of-Life Care survey. Staff characteristics included age, gender, professional role, education level, training in palliative care and years working in direct care. Facility characteristics included facility type and availability of palliative care guidelines, palliative care team and palliative care advice. Analyses were conducted using Generalized Estimating Equations, to account for clustering of data at facility level. RESULTS: Thde proportion of staff with a mean self-efficacy score >5 was highest in the Netherlands (76.4%), ranged between 55.9% and 60.0% in Belgium, Poland, England and Finland and was lowest in Italy (29.6%). Higher levels of self-efficacy (>5) were associated with: staff over 50 years of age (OR 1.86 95% CI[1.30-2.65]); nurses (compared to care assistants) (1.75 [1.20-2.54]); completion of higher secondary or tertiary education (respectively 2.22 [1.53-3.21] and 3.11 [2.05-4.71]; formal palliative care training (1.71 [1.32-2.21]); working in direct care for over 10 years (1.53 [1.14-2.05]); working in a facility with care provided by onsite nurses and care assistants and offsite physicians (1.86 [1.30-2.65]); and working in a facility where guidelines for palliative care were available (1.39 [1.03-1.88]). CONCLUSION: Self-efficacy towards end-of-life communication was most often low in Italy and most often high in the Netherlands. In all countries, low self-efficacy was found relatively often for discussion of prognosis. Palliative care education and guidelines for palliative care could improve the self-efficacy of care staff.
Authors: Mary Ersek; Kathleen T Unroe; Joan G Carpenter; John G Cagle; Caroline E Stephens; David G Stevenson Journal: J Am Med Dir Assoc Date: 2021-12-23 Impact factor: 4.669
Authors: Danni Collingridge Moore; Sheila Payne; Lieve Van den Block; Maud Ten Koppel; Katarzyna Szczerbińska; Katherine Froggatt Journal: BMC Res Notes Date: 2019-08-14
Authors: Raquel Herrero-Hahn; Rafael Montoya-Juárez; César Hueso-Montoro; Celia Martí-García; Diego Alejandro Salazar-Blandón; María Paz García-Caro Journal: Int J Environ Res Public Health Date: 2019-12-02 Impact factor: 3.390
Authors: Maartje S Klapwijk; Natashe Lemos Dekker; Monique A A Caljouw; Wilco P Achterberg; Jenny T van der Steen Journal: BMC Palliat Care Date: 2020-11-30 Impact factor: 3.234
Authors: Lisa Granat; Sofia Andersson; Emina Hadziabdic; Margareta Brännström; Anna Sandgren Journal: BMC Palliat Care Date: 2022-04-11 Impact factor: 3.234