Influencing factors of knowledge, attitude and behavior in children's palliative care among pediatric healthcare workers: a cross-sectional survey in China.

BACKGROUND: Palliative care has become a key medical field worldwide. Although research relating to adult palliative care is well-established, less is known about children's palliative care (CPC). Therefore, this study investigated the knowledge, attitude and behavior of pediatric healthcare workers (PHWs) regarding CPC and analyzed the influencing factors for the implementation and development of CPC. METHODS: A cross-sectional survey of 407 PHWs was carried out in a Chinese province from November 2021 to April 2022. The questionnaire consisted of two parts: a general information form and questions on the knowledge, attitude and behavior of PHWs about CPC. Data were analyzed using t-test, ANOVA and multiple regression analysis. RESULTS: The total score of the PHWs' knowledge, attitude and behavior about CPC was 69.98, which was at a moderate level. PHWs' CPC knowledge, attitude, and behavior are positively correlated.The most important influencing factors were working years, highest education, professional title, job position, marital status, religion, grade of hospital (I, II or III), type of medical institution, experience of caring for a terminally ill child/kinsfolk and total hours of CPC education and training received. CONCLUSIONS: In this study, PHWs in a Chinese province had the lowest scores on the knowledge dimension of CPC, with moderate attitude and behavior and various influencing factors. In addition to professional title, highest education and working years, it is also worth noting that the type of medical institution and marital status also affected the score. Continuing education and training of PHWs in CPC should be emphasized by the administrators of relevant colleges and medical institutions. Future research should start with the above-mentioned influencing factors and focus on setting up targeted training courses and evaluating the post-training effects.

The effectiveness of emergency knowledge training of pediatric medical workers based on the knowledge, skills, simulation model: a quasi-experimental study.

BACKGROUND: Basic life support and advanced life support are essential emergency management skills for medical workers, and pediatricians' first aid skills can be improved through emergency knowledge training. METHODS: A controlled pre-post-intervention quasi-experimental study design was used. The study setting was a tertiary children's hospital in China. In November 2019, a KSS model of emergency knowledge learning was developed and tested, and pediatric medical workers (N = 1448) were trained with it. The outcome measures were based on an emergency knowledge questionnaire devised by the authors that measured the effectiveness of training by comparing the pre-and post-training scores of the particpants. RESULTS: Pediatric medical workers scored significantly higher in total emergency knowledge after the training course than before [75.00 (62.50, 85.00) versus 100.00 (95.00, 100.00); P = 0.00]. Basic life support and advanced life support knowledge score significantly improved after training. Teamwork scores were significantly higher after the training than before [5.00 (5.00, 10.00) versus 10.00 (10.00, 10.00); P = 0.00]. Scores were significantly higher after the training (P < 0.001), especially for case analysis questions (P = 0.00). The attitudes of the medical workers towards the training were all positive and affirmative. CONCLUSION: The KSS model was shown to be effective in improving the emergency knowledge of pediatric medical workers. Future research will be to explore the effectiveness of the model with different participants and at other hospitals or other institutions such as schools, encouraging more people to participate in and evaluate the model to promote its optimization. TRIAL REGISTRATION: Hunan Children's Hospital, HCHLL-2018-03.

Evaluation of a Neonatal Resuscitation Training Programme for Healthcare Professionals in Zanzibar, Tanzania: A Pre-post Intervention Study.

Background: Neonatal mortality rates remain high in Sub-Saharan African countries. Improving the newborn resuscitation skills of healthcare professionals is important in addressing this challenge. The aim of this study was to evaluate a neonatal resuscitation training programme delivered over a two-year period for healthcare professionals in Zanzibar, Tanzania. Methods: A pre- and post-intervention study was designed. We delivered neonatal resuscitation training over a 2-day period in 2017 and 2 days of refresher training in 2018. Knowledge was evaluated by a self-designed survey (11 items with a total score of 22) before and after the two training periods, and skills were evaluated by a skills checklist (six domains with 25 items with a total score of 50) completed by the trainers based on their observations. Statistical analysis included differences in the knowledge and skills scores before and after the training sessions and between the two periods. Results: A total of 23 healthcare professionals participated and completed both neonatal resuscitation training sessions. The knowledge mean scores before and after the training in 2017 increased from 9.60 to 13.60 (95% CI: -5.900; -2.099, p < 0.001), and in 2018, the scores increased from 10.80 to 15.44 (95% CI: -6.062; -3.217, p < 0.001). The mean knowledge scores post-training over time were 13.60 in 2017 and 15.44 in 2018 (95% CI: -3.489; 0.190, p = 0.030). The resuscitation skills performance between the two time periods increased from a mean of 32.26 (SD = 2.35) to a mean of 42.43 (SD = 1.73) (95% CI: -11.402; -8.945, p < 0.001). Conclusion: The neonatal resuscitation training programme increased the theoretical knowledge and resuscitation skills before and after the two training sessions and over time after a 9-month period. Continuous neonatal resuscitation training based on the local needs in resource-limited countries is essential to provide confidence in healthcare professionals to initiate resuscitation and to improve newborn outcomes.