Palliative Care Education Program and Cognitive Competencies Among Nurses in a Selected Government Hospital in Pampanga, Philippines

Abstract

Background: Palliative Care is a specialized care given or provided to patients and their families at any time or any stage from the diagnosis of a serious illness. Palliative care provides for basic needs which comes along with curative interventions with the goal of providing the best possible quality of life for patients and their families. Nurses specialized in palliative care assists patients with their common symptoms to gain strength to carry on with their daily activities.

The study aims to determine the cognitive competencies of nurses on five (5) domains which are knowledge of symptom management, use of assessment systems, team skills, interpersonal skills, and life closure skills. Watsons (2008) theoretical propositions on transpersonal caring served as background concept. This is within the context of a caring relationship, coaching, mentoring relationship towards development of cognitive competencies to improve decision-making skills and provide quality safe care.

Objectives: The objectives of the research are to determine the cognitive competencies before and after the Palliative Care Education Program on five domains: knowledge of symptom management, use of assessment system, team skills, interpersonal skills and life closure skills, to determine the differences in cognitive competencies before and after Palliative Care Education Program, to determine the relationship between nurses’ characteristics (experience in Palliative Care, Education and Training in Palliative Care, Spirituality, and Personal experience on death and dying); and cognitive competencies on Palliative Care and to describe how Palliative Care Education Program change nurses perception on Palliative Care. This study contributes to nursing literature in the Philippines on Palliative Care Education and Cognitive Competencies within the context of transpersonal caring.

Methods: A pretest- posttest one-group design was used.

Purposive sampling was used consisting of nurses from the Palliaitve Services and related units of a training hospital. The intervention titled; “Palliative Care Education Program” was developed for this study with experts consultation. The training program of two days (16hours) included varied teaching-learning activities. The research tools are the Nurses’ Core Competency in Palliative Care (NCCPC, 2007) and the Palliative Care Quiz for Nurses (PCQN, 2017). Permission was granted for the use of the tools. Research ethics approval from the University of the Philippines Open University as well as from the training institution.

28 nurses (n=28) participated in the study, 43% of the age range 31 to 40 years greater percentage were males and 1 has doctoral degree. Most participants (61%) had no work experience in Palliative Care and most (93%) had no training in Palliative Care. Of the five (5) domains, better mean score change was reported in Knowledge of Symptom Management and Team Skills. The results further showed improvement in post mean scores of the Palliative Care Quiz on the areas of Philosophy and Principles of Palliative Care, Pain and Symptom Management and Psychosocial and Spiritual Care. On the variables, sex and family experience with death and dying, these were associated with cognitive competencies of nurses. The nurses described their experiences of increased awareness of the scientific bases of intervention in palliative care interventions and had gained better understanding of the patient situation.

Nurses’ cognitive competencies improved after palliative care education. It was recommended that palliative care education should be included as part of a continuous education program for nurses.