Culturally Competent Palliative and Hospice Care Training for Ethnically Diverse Staff in Long-Term Care Facilities.

Between 2013 and 2030, older adults 65 years and older of racial/ethnic populations in the U.S. is projected to increase by 123% in comparison to the Whites (Non-Hispanics). To meet this demand, training of ethnically diverse health staff in long-term care facilities in palliative and hospice care is imperative. The purpose of this study was to evaluate a palliative and hospice care training of staff in two nursing homes in Hawaii - (a) to evaluate knowledge and confidence over three time periods, and (b) to compare staff and family caregiver satisfaction at end of program. The educational frameworks were based on cultural and communication theories. Fifty-two ethnically diverse staff, a majority being Asian (89%), participated in a 10-week module training and one 4 hour communication skills workshop. Staff evaluation included knowledge and confidence surveys, pre- and post-test knowledge tests, and FAMCARE-2 satisfaction instrument. There were nine Asian (89%) and Pacific Islander (11%) family caregivers who completed the FAMCARE-2 satisfaction instrument. The overall staff knowledge and confidence results were promising. The staff rated overall satisfaction of palliative care services lower than the family caregivers. Implications for future research, practice, and education with palliative and hospice care training of ethnically diverse nursing home staff is to include patient and family caregiver satisfaction of palliative and hospice care services, evaluation of effectiveness of cross-cultural communication theories in palliative and hospice care staff training, and support from administration for mentorship and development of these services in long term care facilities.

Asian and native Hawaiian family caregiver satisfaction with palliative care services in nursing homes.

AIM: The aim of this study was to gauge Asian and native Hawaiian family satisfaction with palliative care services in two nursing homes in Hawaii, US. METHODS: This is a mixed-method study using a convergent design. Nine nursing home family caregivers who had received palliative care services took part. They completed a Famcare-2 satisfaction survey and participated in a 1-hour interview. Descriptive analyses and directed content analysis were completed and results were compared. RESULTS: The Famcare-2 results indicated that family caregivers were satisfied with palliative care services. The interviews provided in-depth information on the major areas discussed in the survey-management of patient physical symptoms and comfort, information, family support, and patient psychological care. CONCLUSIONS: There is a need to address family caregiver and interdisciplinary nursing home staff communication based on culturally appropriate approaches for palliative as well as end of-life care services among Asians and native Hawaiians.

A survey of oncology advanced practice nurses in Ontario: profile and predictors of job satisfaction.

The purpose of this study was to examine role structures and processes and their impact on job satisfaction for oncology advanced practice nurses (APNs) in Ontario. APNs caring for adult, paediatric or palliative patients in integrated regional cancer programs, tertiary care hospitals or community hospitals and agencies were invited to complete a mailed self-report questionnaire. A total of 73 of 77 APNs participated in the study. Most APNs (55%) were acute care nurse practitioners employed by regional cancer programs or tertiary care hospitals. Adult patients with breast or haematological cancers and those receiving initial treatment or palliative care were the primary focus of APN roles. APN education needs related to specialization in oncology, leadership and research were identified. Overall, APNs were minimally satisfied with their roles. Role confidence (beta = .404, p = .001) and the number of overtime hours (beta = -.313, p = .008) were respective positive and negative predictors of APN job satisfaction. Progress in role development is described, and recommendations for improving role development and expanding the delivery of oncology APN services are provided.

Redefining the primary nurse role in oncology care: A 21st century perspective.

Oncology nursing is a rapidly evolving specialty with increasing demands upon nurses to respond to the complex needs of cancer patients and their families. Primary nursing (PN) has been the model of care delivery utilized at our cancer centre for more than two decades. The nursing department determined it was time that a review and redefining of the role be undertaken. These objectives were achieved through the implementation of the Primary Nurse Role Development Project. This article discusses: a brief background of why the existing role needed to be reviewed and revised; an overview of how primary nursing has been applied historically at the centre; and details regarding the project plan and its implementation. Results from the project provided a competency-based oncology primary nurse role description, which will be outlined along with proposals for improving nursing practice. Our goal is to achieve optimal care for our patients.