Palliative care professionals' perceptions of their skills and the implementability of evidence-based bereavement care guidance: A cross-sectional survey study.
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Abstract
Objective: Bereavement support is recommended in specialised palliative care, but it is often underdeveloped. This study assessed palliative care professionals' (PCPs') skills in family care, their attitudes towards evidence-based practices, and their perceptions of a new, evidence-based bereavement care guidance before its implementation.
Methods: A cross-sectional study was conducted between September and December 2023 in specialised palliative care services in two Swiss hospitals. Seven validated instruments were used to assess PCPs' skills in family care (FNPS, EPCS, and ICS-Nurse), attitudes towards evidence-based practices (EBP-B), and perception of a newly developed, evidence-based bereavement care guidance (acceptability AIM, appropriateness IAM, feasibility FIM). The data were analysed using descriptive and nonparametric methods.
Results: The 39 participants (response 63%; 28 nurses, 6 physicians, 5 others) rated their skills in family care as high (median ⩾75% of scale range) and had an open attitude towards evidence-based practices (median 64%). They perceived the bereavement care guidance as highly acceptable and appropriate (median 75%) and rather feasible (median 68%). A more favourable attitude towards evidence-based practices was associated with higher perceived acceptability (Spearman's rho, p = 0.038), appropriateness (Spearman's rho, p = 0.029), and feasibility (Spearman's rho, p = 0.0019) of the guidance. Acceptability, appropriateness, and self-assessed skills (FNPS) depended on the local context (Mann-Whitney U test, p ⩽ 0.022).
Conclusion: This study shows that PCPs rate their skills in working with families at the end of life as high and perceive evidence-based bereavement care as implementable. An open attitude towards evidence-based practices supports more favourable perceptions of new bereavement care guidance before its implementation.
目的：在专业姑息治疗中推荐丧亲支持，但它往往不发达。本研究评估了姑息治疗专业人员（pcp）在家庭护理方面的技能，他们对循证实践的态度，以及他们在实施新的循证丧亲护理指导之前对其的看法。方法：在2023年9月至12月期间对瑞士两家医院的专业姑息治疗服务进行了横断面研究。采用7种经过验证的工具来评估pcp在家庭护理方面的技能（FNPS， EPCS和ICS-Nurse），对循证实践的态度（EBP-B），以及对新开发的循证丧亲护理指南的看法（可接受性AIM，适当性IAM，可行性FIM）。使用描述性和非参数方法对数据进行分析。结果：39名参与者（回应63%；28名护士，6名医生，5名其他人）将他们在家庭护理方面的技能评为高（量表范围的中位数大于或等于75%），并对循证实践持开放态度（中位数为64%）。他们认为丧亲护理指导是高度可接受和适当的（中位数为75%）和相当可行的（中位数为68%）。对循证实践更有利的态度与更高的可接受性（Spearman’s rho, p = 0.038）、适当性（Spearman’s rho, p = 0.029）和可行性（Spearman’s rho, p = 0.0019）相关。可接受性、适当性和自我评估技能（FNPS）依赖于当地环境（Mann-Whitney U检验，p≤0.022）。结论：本研究表明，pcp对他们在生命末期与家庭合作的技能评价很高，并且认为基于证据的丧亲护理是可实施的。对循证实践的开放态度支持在实施新的丧亲护理指导之前对其有更有利的看法。
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