Palliative-care nurses' and physicians' descriptions of the competencies needed in their working units.

BACKGROUND: Specialists were asked to describe the most essential palliative and end-of-life care competencies needed in their working units, in order to deepen the understanding of the phenomenon. AIM: To describe the most essential competencies of palliative-care nurses and physicians. METHODS: The data was collected using an open-ended question in a survey sent to registered nurses (n=129) working within palliative care and to physicians (n=64) with a special competency in palliative care. The data was analysed using content analysis. RESULTS: The description of the most essential competencies included 16 main categories and 63 subcategories in total. The three strongest main categories were 'clinical competence', 'competence in social interactions' and 'competence in giving support'. Eleven main categories were based on both nurses' and physicians' data, while five main categories were created from nurses' data only. CONCLUSION: Interprofessional palliative-care education is recommended for the undergraduate and postgraduate education of nurses and physicians.

Palliative Nursing Competencies Required for Different Levels of Palliative Care Provision: A Qualitative Analysis of Health Care Professionals' Perspectives.

Background: Nurses must possess adequate competencies to provide high-quality palliative care. Earlier statements have described certain competencies that are relevant for palliative care, yet only limited empirical research has focused on the perspective of health care professionals to clarify which competencies are required for different levels of palliative care provision. Objective: The aim was to describe the required palliative nursing competencies of registered nurses aligned to different levels of palliative care provision, from the perspectives of multiprofessional groups. Design: A qualitative study design. Setting/Subjects: A purposive sample of professionals, working in different levels of palliative care across various settings in Finland, was used to gain information about the aim of the study (n = 222). Measurements: Content analysis was applied to describe the competencies of registered nurses. Results: Competencies relevant to basic palliative care were categorized under 17 main categories, which included a total of 75 subcategories. "Competence in managing the most common symptoms" was the main category that contained the largest number of reduced expressions (f = 75). An analysis of specialist palliative care data yielded 10 main categories, including 49 subcategories, with "Competence in maintaining expertise and taking care of own well-being at work" containing the most reduced expressions. Conclusion: The study provided new knowledge; more specifically, competencies related to encounters and maintaining hope were described as palliative care nursing competences. The results can be used to ensure that palliative nursing education focuses on the competences that are necessary in practice.

The required competencies of physicians within palliative care from the perspectives of multi-professional expert groups: a qualitative study.

BACKGROUND: Although statements on the competencies required from physicians working within palliative care exist, these requirements have not been described within different levels of palliative care provision by multi-professional workshops, comprising representatives from working life. Therefore, the aim of this study was to describe the competencies required from physicians working within palliative care from the perspectives of multi-professional groups of representatives from working life. METHODS: A qualitative approach, using a workshop method, was conducted, wherein the participating professionals and representatives of patient organizations discussed the competencies that are required in palliative care, before reaching and documenting a consensus. The data (n = 222) was collected at workshops held in different parts of Finland and it was analyzed using a qualitative content analysis method. RESULTS: The description of the competencies required of every physician working within palliative care at the general level included 13 main categories and 50 subcategories in total. 'Competence in advanced care planning and decision-making' was the main category which was obtained from the highest number of reduced expressions from the original data (f = 125). Competence in social interactions was another strong main category (f = 107). In specialist level data, six main categories with 22 subcategories in total were found. 'Competence in complex symptom management' was the main category which was obtained from the biggest number of reduced expressions (f = 46). A notable association between general level and specialist level data was related to networking, since one of the general level categories was 'Competence in consultations and networking' (f = 34) and one of the specialist level categories was 'Competence to offer consultative and educational support to other professionals' (f = 30). Moreover, part of the specialist level results were subcategories which belonged to the main categories produced from the general level data. CONCLUSIONS: The competencies described in this study emphasize decision-making, social interactions and networking. It is important to listen to the voices of the working-life representatives when planning curricula. Moreover, the views of the working-life representatives inform how the competencies gained during their education meet the challenges of the ordinary work.