Joni Gilissen1,2,3, Lara Pivodic1,2, Annelien Wendrich-van Dael1,2, Wilfried Cools3, Robert Vander Stichele4, Lieve Van den Block1,2, Luc Deliens1,5, Chris Gastmans6. 1. End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium. 2. Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), Brussels, Belgium. 3. Interfaculty Center for Data Processing and Statistics (ICDS), Vrije Universiteit Brussel (VUB), Brussels, Belgium. 4. Department of Pharmacology, Ghent University, Ghent, Belgium. 5. Department of Public Health and Primary Care, Ghent University, Ghent, Belgium. 6. Centre for Biomedical Ethics and Law, KU Leuven, Leuven, Belgium.
Abstract
BACKGROUND: Considering social cognitive theory and current literature about successful advance care planning in nursing homes, sufficient knowledge and self-efficacy are important preconditions for staff to be able to carry out advance care planning in practice. AIM: Exploring to what extent nurses' knowledge about and self-efficacy is associated with their engagement in advance care planning in nursing homes. DESIGN: Survey study as part of a baseline measurement of a randomised controlled cluster trial (NCT03521206). SETTING/PARTICIPANTS: Nurses in a purposive sample of 14 nursing homes in Belgium. METHODS: A survey was distributed among nurses, evaluating knowledge (11 true/false items), self-efficacy (12 roles and tasks on 10-point Likert-type scale) and six advance care planning practices (yes/no), ranging from performing advance care planning conversations to completing advance directives. RESULTS: A total of 196 nurses participated (66% response rate). While knowledge was not significantly associated with advance care planning practices, self-efficacy was. One unit's increase in self-efficacy was statistically associated with an estimated 32% increase in the number of practices having carried out. CONCLUSIONS: Nurses' engagement in advance care planning practices is mainly associated with their self-efficacy rather than their knowledge. Further research is necessary to improve the evidence regarding the causal relationship between constructs. However, these results suggest that educational programmes that focus solely on knowledge might not lead to increasing uptake of advance care planning in nurses.
BACKGROUND: Considering social cognitive theory and current literature about successful advance care planning in nursing homes, sufficient knowledge and self-efficacy are important preconditions for staff to be able to carry out advance care planning in practice. AIM: Exploring to what extent nurses' knowledge about and self-efficacy is associated with their engagement in advance care planning in nursing homes. DESIGN: Survey study as part of a baseline measurement of a randomised controlled cluster trial (NCT03521206). SETTING/PARTICIPANTS: Nurses in a purposive sample of 14 nursing homes in Belgium. METHODS: A survey was distributed among nurses, evaluating knowledge (11 true/false items), self-efficacy (12 roles and tasks on 10-point Likert-type scale) and six advance care planning practices (yes/no), ranging from performing advance care planning conversations to completing advance directives. RESULTS: A total of 196 nurses participated (66% response rate). While knowledge was not significantly associated with advance care planning practices, self-efficacy was. One unit's increase in self-efficacy was statistically associated with an estimated 32% increase in the number of practices having carried out. CONCLUSIONS: Nurses' engagement in advance care planning practices is mainly associated with their self-efficacy rather than their knowledge. Further research is necessary to improve the evidence regarding the causal relationship between constructs. However, these results suggest that educational programmes that focus solely on knowledge might not lead to increasing uptake of advance care planning in nurses.
Entities:
Keywords:
Advance care planning; education; knowledge; nurses; nursing homes
Authors: Aileen S Garcia; Christin L Carotta; Robin Brown; Patricia Da Rosa; Brandi Pravecek; Paula Carson Journal: Int J Nurs Pract Date: 2021-08-17 Impact factor: 2.226
Authors: Hsueh-Hsing Pan; Li-Fen Wu; Li-Fang Chang; Yu-Chun Hung; Chin Lin; Ching-Liang Ho Journal: Int J Environ Res Public Health Date: 2021-01-30 Impact factor: 3.390
Authors: Guilherme Gryschek; Dario Cecilio-Fernandes; Guilherme Antonio Moreira de Barros; Stephen Mason; Marco Antonio de Carvalho-Filho Journal: BMJ Open Date: 2020-11-18 Impact factor: 2.692