目的:评估共同设计的培训计划,\'没有谈话太艰难\',可以帮助癌症,姑息治疗和更广泛的医疗保健专业人员支持患者在父母去世时与他们的受抚养子女进行沟通。我们检查了培训提供的学习观念,它有助于在父母去世时与家人沟通的信心,和主观经验,和反应,培训。我们还探索了实践行为的潜在变化。
方法:pre-post,convergent,平行,混合方法研究。对实践变化的动机进行了定量测量,并通过半结构化面试进行定性。对自我效能感和预期结果进行了非参数分析;描述性统计数据检查了对有用性的看法;在实践中使用学习的意图以及对培训的反应。半结构化访谈深入考察了学习的动机和看法。6周,练习日志记录了直接的练习效果和反思。
方法:1天培训3次,代表总数36人:2021年12月在线,2022年2月,2022年3月面对面。以在线或纸质格式相应交付的问卷,在线半结构化面试。
方法:pre-post:姑息治疗专业人员(n=14/12),急性癌症临床护士专家(n=16/11),其他医疗保健专业人员(n=5/5)。
结果:在自我效能感(19个维度中的17个p<0.003)和结果期望(14个信念中的3个p<0.036)方面观察到了积极的变化。在实践中使用学习的有用性和意图的感知平均得分为82-94(量表0=低到100=高)。在工作场所和更广泛的实践中分享学习和影响变化受到高度肯定。内容,风格和交付得到了积极的认可。确定了将包括在培训中的其他内容。
结论:培训计划有可能改变实践行为。一项大规模的研究将评估向英国各个专业人员和整个团队提供的培训的推出情况。它将提供长期反馈,以了解跨专业角色的实践行为和变化的中介。
OBJECTIVE: To evaluate how the codesigned training programme, \'No conversation too tough\', can help cancer, palliative and wider healthcare professionals support patients to communicate with their dependent children when a parent is dying. We examined perceptions of learning provided by the training, its contribution to confidence in communicating with families when a parent is dying, and subjective experience of, and reactions to, the training. We also explored potential changes in practice behaviours.
METHODS: Pre-post, convergent, parallel, mixed-methods study. Motivations for practice change were measured quantitatively, and qualitatively through semi-structured interviews. Non-parametric analysis was conducted for self-efficacy and outcome expectancy measures; descriptive statistics examined perceptions of usefulness; intentions to use learning in practice and reactions to the training. Semi-structured interviews examined motivations and perceptions of learning in depth. A 6-week, practice log recorded immediate practice effects and reflections.
METHODS: 1-day training delivered 3 times, total delegates 36: online December 2021, February 2022, face-to-face March 2022. Questionnaires delivered correspondingly in online or paper formats, semi-structured interviews online.
METHODS: Pre-post: palliative care professionals (n=14/12), acute cancer clinical nurse specialists (n=16/11), other healthcare professionals (n=5/5).
RESULTS: Positive changes were observed in self-efficacy (17 of 19 dimensions p<0.003) and outcome expectancies (3 of 14 beliefs p<0.036). Perceptions of usefulness and intentions to use learning in practice mean scores were 82-94 (scales 0=low to 100=high). There was high affirmation for sharing learning and influencing change in the workplace and wider practice. Content, style and delivery were positively endorsed. Further elements to be included in the training were identified.
CONCLUSIONS: The training programme has the potential to effect change in practice behaviours. A large-scale study will evaluate the roll-out of the training delivered to individual professionals and whole teams across the UK. It will provide longer-term feedback to understand practice behaviour and mediators of change across professional roles.