Basic knowledge and understanding of palliative care among nurses working in a group of tertiary care hospitals.

Abstract

Background: Continuous education and training is needed for nurses to overcome barriers of accessing palliative care in India.

Methods: An evaluation of baseline knowledge about the basics of palliative care was conducted using a validated questionnaire, Palliative Care Knowledge Questionnaire-Basic (PCKQ-B), as a pretest. A comprehensive 1 day Continuing Nursing Education (CNE) and workshop was conducted for nurses from hospitals across Delhi-NCR. The effectiveness was evaluated using a pre and posttest method with PCKQ-B. PCKQ-B is a 25-question test developed in India and rigorously validated for nurses working in tertiary care hospitals in India. Descriptive analysis was performed for demographics and to summarise the data and paired t-test to compare pre and post data.

Results: A total of 102 nurses participated in the CNE and took pre and post tests. Nurses came from six tertiary care private hospitals across Delhi-NCR. A total of 79% of the participants were females with a mean age of 25.61 years. The mean score of the participants increased from 14.5 in the pre CNE to 18 in the post CNE which was statistically significant (p=0.000). Nurses scoring >60% (16 out of 25) questions correctly increased from 27% in pre-test to 70% in post-test. The question that was correctly answered by the minimum number of participants (13%) in pre-test was 'use of placebos is appropriate in some types of pain' highlighting the common myth and poor clinical practice, which only improved to 35% even in post test. While it was encouraging to find out that more than 88% participants were aware that the 'severity of pain determines the method of pain treatment' and 'prognosis should always be clearly communicated' even in pre-test while the percentage increased to 99% in post test.

Conclusion: Baseline knowledge about palliative care remains dismal, but engaging learning interventions like CNE and workshops can bring significant improvement to palliative care understanding of the nursing staff. However, this must be followed up with regular refresher classes and courses to build a strong framework with a learned workforce.