National impact of the EPEC-pediatrics enhanced train-the-trainer model for delivering education on pediatric palliative care

Article indépendant

WIDGER, Kimberley | WOLFE, Joanne | FRIEDRICHSDORF, Stefan | POLE, Jason D. | BRENNENSTUHL, Sarah | LIBEN, Stephen | GREENBERG, Mark | BOUFFET, Eric | SIDEN, Harold | HUSAIN, Amna | WHITLOCK, James A. | LEYDEN, Myra | RAPOPORT, Adam

BACKGROUND: Lack of pediatric palliative care (PPC) training impedes successful integration of PPC principles into pediatric oncology. OBJECTIVES: We examined the impact of an enhanced implementation of the Education in Palliative and End-of-Life Care for Pediatrics (EPEC®-Pediatrics) curriculum on the following: (1) knowledge dissemination; (2) health professionals' knowledge; (3) practice change; and (4) quality of PPC. DESIGN: An integrated knowledge translation approach was used with pre-/posttest evaluation of care quality. Setting/Subjects/Measurements: Regional Teams of 3-6 health professionals based at 15 pediatric oncology programs in Canada became EPEC-Pediatrics Trainers who taught the curriculum to health professionals (learners) and implemented quality improvement (QI) projects. Trainers recorded the number of learners at each education session and progress on QI goals. Learners completed knowledge surveys. Care quality was assessed through surveys with a cross-sectional sample of children with cancer and their parents about symptoms, quality of life, and care quality plus reviews of deceased patients' health records. RESULTS: Seventy-two Trainers taught 3475 learners; the majority (96.7%) agreed that their PPC knowledge improved. In addition, 10/15 sites achieved practice change QI goals. The only improvements in care quality were an increased number of days from referral to PPC teams until death by a factor of 1.54 (95% confidence interval [CI] = 1.17–2.03) and from first documentation of advance care planning until death by a factor of 1.50 (95% CI = 1.06–2.11), after adjusting for background variables. CONCLUSION: While improvements in care quality were only seen in two areas, our approach was highly effective in achieving knowledge dissemination, knowledge improvement, and practice change goals.

http://dx.doi.org/10.1089/jpm.2017.0532

Voir la revue «JOURNAL OF PALLIATIVE MEDICINE, 21»

Autres numéros de la revue «JOURNAL OF PALLIATIVE MEDICINE»

Consulter en ligne

Suggestions

Du même auteur

National impact of the EPEC-pediatrics enhanc...

Article indépendant | WIDGER, Kimberley | JOURNAL OF PALLIATIVE MEDICINE | n°9 | vol.21

BACKGROUND: Lack of pediatric palliative care (PPC) training impedes successful integration of PPC principles into pediatric oncology. OBJECTIVES: We examined the impact of an enhanced implementation of the Education in Palliative...

Location of death among children with life-th...

Article indépendant | WIDGER, Kimberley | CMAJ open | n°2 | vol.11

BACKGROUND: Patterns in location of death among children with life-threatening conditions (e.g., cancer, genetic disorders, neurologic conditions) may reveal important inequities in access to hospital and community support service...

Location of death among children with life-th...

Article indépendant | WIDGER, Kimberley | CMAJ open | n°2 | vol.11

BACKGROUND: Patterns in location of death among children with life-threatening conditions (e.g., cancer, genetic disorders, neurologic conditions) may reveal important inequities in access to hospital and community support service...

De la même série

Feasibility of a palliative care intervention...

Article indépendant | VERMA, Manisha | JOURNAL OF PALLIATIVE MEDICINE | n°3 | vol.36

Background: Patients with hepatocellular cancer (HCC) are at risk for poor quality of life (QoL) and high symptom burden, coupled with limited treatment options. Palliative care (PC) can play an important role in reducing the suff...

"You suffer from being interested" : a tribut...

Article indépendant | MILLER, Pringl | JOURNAL OF PALLIATIVE MEDICINE | n°12 | vol.31

I met Hank during my palliative medicine fellowship after his nurse Cynthia paged me to request a consult for existential suffering. When reviewing Hank's electronic medical record, it became evident he was dying and averse to spe...

Top ten tips palliative care clinicians shoul...

Article indépendant | CHUNG, Jenny E. | JOURNAL OF PALLIATIVE MEDICINE | n°1 | vol.27

As of 2019, there are 4.2 million Filipino Americans (FAs) and 1.9 million Korean Americans (KAs) in the United States, largely concentrated in New York, California, Texas, Illinois, and Washington. In both populations, similar to...

Interventions for family caregivers of patien...

Article indépendant | ALSHAKHS, Sulaiman | JOURNAL OF PALLIATIVE MEDICINE | n°1 | vol.27

There is a need for understanding the breadth of interventions for caregivers of individuals receiving hospice care at home, given the important role caregivers play in caring and the negative outcomes (e.g., depression) associate...

Associations between measures of disability a...

Article indépendant | CHANG, Victoria A. | JOURNAL OF PALLIATIVE MEDICINE | n°1 | vol.27

Background: The modified Rankin Scale (mRS), which measures degree of disability in daily activities, is the most common outcome measure in stroke research. Quality of life (QoL), however, is impacted by factors other than disabil...

Chargement des enrichissements...