Generic placeholder image

Current Alzheimer Research

Editor-in-Chief

ISSN (Print): 1567-2050
ISSN (Online): 1875-5828

Research Article

Level of Knowledge and Attitudes Towards Palliative Care for People with Advanced Dementia in Spain: Role of Professional and Academic Factors

Author(s): Pilar Pérez-Ros, Omar Cauli*, Iván Julián-Rochina, Carol O. Long and Elena Chover-Sierra

Volume 19, Issue 11, 2022

Published on: 28 December, 2022

Page: [785 - 794] Pages: 10

DOI: 10.2174/1567205020666221221145259

Price: $65

Abstract

Background: Providing quality end-of-life care to individuals with advanced dementia is crucial. To date, little attention has been paid to palliative care knowledge and attitudes toward palliative care for people with advanced dementia in Spain.

Objectives: To investigate the knowledge of and attitudes toward palliative care for advanced dementia among registered nurses and physicians in Spain.

Methods: A descriptive, cross-sectional survey design was used. This study included a convenience sample of 402 nurses (n = 290) and physicians (n = 112). Two instruments were administered: demographic characteristics and Spanish version of the Questionnaire of Palliative Care for Advanced Dementia (qPAD-SV). Descriptive statistics and multiple regression were used for data analysis.

Results: Overall, the nurses and physicians had moderate mean scores for both knowledge of and attitudes regarding palliative care for advanced dementia. Physicians had a higher level of knowledge (p < 0.05) compared to nurses. Additionally, physicians and nursing staff who had professional experience/ education in geriatrics and those who had received palliative care and hospice training had greater (p < 0.01) knowledge of palliative care. In addition, healthcare professionals who had received dementia care training and who had worked in nursing homes had higher levels (p < 0.05) of knowledge and attitudes toward palliative care.

Conclusion: This study indicates the need to provide nurses and physicians with more education for select groups of professionals who have had limited education and experience in caring for older adults with advanced dementia.

Keywords: Palliative care, specialist nurse, training, attitudes, education, advanced dementia.

« Previous
[1]
Moga DC, Roberts M, Jicha G. Dementia for the primary care provider. Prim Care 2017; 44(3): 439-56.
[http://dx.doi.org/10.1016/j.pop.2017.04.005] [PMID: 28797371]
[2]
Sidani MA, Reed BC, Steinbauer J. Geriatric care issues. Prim Care 2017; 44(1): e15-36.
[http://dx.doi.org/10.1016/j.pop.2016.09.018] [PMID: 28164825]
[3]
Niu H, Álvarez-Álvarez I, Guillén-Grima F, Aguinaga-Ontoso I. Prevalence and incidence of Alzheimer’s disease in Europe: A meta-analysis. Neurologia 2017; 32(8): 523-32.
[http://dx.doi.org/10.1016/j.nrl.2016.02.016] [PMID: 27130306]
[4]
Lozano R, Naghavi M, Foreman K, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380(9859): 2095-128.
[http://dx.doi.org/10.1016/S0140-6736(12)61728-0] [PMID: 23245604]
[5]
Gaugler J, James B, Johnson T, Scholz K, Weuve J. 2016 Alzheimer’s disease facts and figures. Alzheimers Dement 2016; 12(4): 459-509.
[http://dx.doi.org/10.1016/j.jalz.2016.03.001] [PMID: 27570871]
[6]
Sampson EL. Palliative care for people with dementia. Br Med Bull 2010; 96(1): 159-74.
[http://dx.doi.org/10.1093/bmb/ldq024] [PMID: 20675657]
[7]
Caron CD, Griffith J, Arcand M. End-of-life decision making in dementia: The perspective of family caregivers. 2016; 4: 113-36.
[http://dx.doi.org/10.1177/1471301205049193]
[8]
Oishi A, Murtagh FEM. The challenges of uncertainty and interprofessional collaboration in palliative care for non-cancer patients in the community: A systematic review of views from patients, carers and health-care professionals. Palliat Med 2014; 28(9): 1081-98.
[http://dx.doi.org/10.1177/0269216314531999] [PMID: 24821710]
[9]
Chen IH, Lin KY, Hu SH, et al. Palliative care for advanced dementia: Knowledge and attitudes of long-term care staff. 2018; 27: 848-58.
[10]
Albers G, Froggatt K, Van den Block L, et al. A qualitative exploration of the collaborative working between palliative care and geriatric medicine: Barriers and facilitators from a European perspective. BMC Palliat Care 2016; 15(1): 47.
[http://dx.doi.org/10.1186/s12904-016-0118-3] [PMID: 27169558]
[11]
Pautex S, Roller-Wirnsberger R, Singler K, Van den Noortgate N. Palliative care competencies for geriatricians across Europe: a Delphi consensus study. Eur Geriatr Med 2021; 12(4): 817-24.
[http://dx.doi.org/10.1007/s41999-020-00445-5] [PMID: 33523375]
[12]
Visser R, Borgstrom E, Holti R. The overlap between geriatric medicine and palliative care: a scoping literature review. J Appl Gerontol 2021; 40(4): 355-64.
[http://dx.doi.org/10.1177/0733464820902303] [PMID: 32008412]
[13]
Goldsmith J, Wittenberg-Lyles E, Rodriguez D, Sanchez-Reilly S. Interdisciplinary geriatric and palliative care team narratives: collaboration practices and barriers. Qual Health Res 2010; 20(1): 93-104.
[http://dx.doi.org/10.1177/1049732309355287] [PMID: 20019350]
[14]
Quinn KL, Stukel T, Stall NM, et al. Association between palliative care and healthcare outcomes among adults with terminal non-cancer illness: population based matched cohort study. BMJ 2020; 370: m2257.
[http://dx.doi.org/10.1136/bmj.m2257] [PMID: 32631907]
[15]
Houttekier D, Vandervoort A, Van den Block L, van der Steen JT, Vander Stichele R, Deliens L. Hospitalizations of nursing home residents with dementia in the last month of life: Results from a nationwide survey. Palliat Med 2014; 28(9): 1110-7.
[http://dx.doi.org/10.1177/0269216314535962] [PMID: 24866759]
[16]
Bayer A. Death with dementia-the need for better care. Age Ageing 2006; 35(2): 101-2.
[http://dx.doi.org/10.1093/ageing/afj033] [PMID: 16414963]
[17]
Harasym P, Brisbin S, Afzaal M, et al. Barriers and facilitators to optimal supportive end-of-life palliative care in long-term care facilities: a qualitative descriptive study of community-based and specialist palliative care physicians’ experiences, perceptions and perspectives. BMJ Open 2020; 10(8): e037466.
[http://dx.doi.org/10.1136/bmjopen-2020-037466] [PMID: 32759247]
[18]
Ersek M, Carpenter JG. Geriatric palliative care in long-term care settings with a focus on nursing homes. J Palliat Med 2013; 16(10): 1180-7.
[http://dx.doi.org/10.1089/jpm.2013.9474] [PMID: 23984636]
[19]
Jones C, Moyle W, Stockwell-Smith G. Caring for older people with dementia: An exploratory study of staff knowledge and perception of training in three Australian dementia care facilities. Australas J Ageing 2013; 32(1): 52-5.
[http://dx.doi.org/10.1111/j.1741-6612.2012.00640.x] [PMID: 23521737]
[20]
Chang E, Daly J, Johnson A, et al. Challenges for professional care of advanced dementia 2009; 15: 41-7.
[http://dx.doi.org/10.1111/j.1440-172X.2008.01723.x]
[21]
Kada S, Nygaard HA, Mukesh BN, Geitung JT. Staff attitudes towards institutionalised dementia residents. J Clin Nurs 2009; 18(16): 2383-92.
[http://dx.doi.org/10.1111/j.1365-2702.2009.02791.x] [PMID: 19583668]
[22]
Powers BA, Watson NM. Meaning and practice of palliative care for nursing home residents with dementia at end of life. Am J Alzheimers Dis Other Demen 2008; 23(4): 319-25.
[http://dx.doi.org/10.1177/1533317508316682] [PMID: 18453644]
[23]
Stevenson DG, Bramson JS. Hospice care in the nursing home setting: A review of the literature. J Pain Symptom Manage 2009; 38(3): 440-51.
[http://dx.doi.org/10.1016/j.jpainsymman.2009.05.006] [PMID: 19735904]
[24]
Chover-Sierra E, Pérez-Ros P, Julián-Rochina I, Long CO, Cauli O. Knowledge and attitudes towards palliative care: validation of the spanish version of questionnaire on palliative care for advanced dementia. Healthc 2022; 10: 656.
[http://dx.doi.org/10.3390/healthcare10040656]
[25]
Long CO, Sowell EJ, Hess RK, Alonzo TR. Development of the questionnaire on palliative care for advanced dementia (qPAD). Am J Alzheimers Dis Other Demen 2012; 27(7): 537-43.
[http://dx.doi.org/10.1177/1533317512459793] [PMID: 23002199]
[26]
Cohen J. Statistical power analysis for the behavioral sciences. Stat Power Anal Behav Sci 2013.
[http://dx.doi.org/10.4324/9780203771587]
[27]
Lasmarías C, Subirana-Casacuberta M, Mancho N, Aradilla-Herrero A. Spanish cross-cultural adaptation and psychometric properties of the advance care planning self-efficacy: a cross-sectional study. J Palliat Med 2021; 24(12): 1807-15.
[http://dx.doi.org/10.1089/jpm.2020.0653] [PMID: 34143670]
[28]
Jones A, Maclagan LC, Watt JA, et al. Reasons for repeated emergency department visits among community‐dwelling older adults with dementia in Ontario, Canada. J Am Geriatr Soc 2022; 70(6): 1745-53.
[http://dx.doi.org/10.1111/jgs.17726] [PMID: 35238398]
[29]
Hvalič-Touzery S, Skela-Savič B, Macrae R, et al. The provision of accredited higher education on dementia in six European countries: An exploratory study. Nurse Educ Today 2018; 60: 161-9.
[http://dx.doi.org/10.1016/j.nedt.2017.10.010] [PMID: 29132018]
[30]
Damián J, Valderrama-Gama E, Rodríguez-Artalejo F, Martín-Moreno JM. Health and functional status among elderly individuals living in nursing homes in Madrid. Gac Sanit 2004; 18(4): 268-74.
[http://dx.doi.org/10.1016/S0213-9111(04)72013-0] [PMID: 15324637]
[31]
Iliffe S, Davies N, Manthorpe J, et al. Improving palliative care in selected settings in England using quality indicators: a realist evaluation. BMC Palliat Care 2016; 15(1): 69.
[http://dx.doi.org/10.1186/s12904-016-0144-1] [PMID: 27484414]
[32]
Mitchell SL, Black BS, Ersek M, et al. Advanced dementia: state of the art and priorities for the next decade. Ann Intern Med 2012; 156(1_Part_1): 45-51.
[http://dx.doi.org/10.7326/0003-4819-156-1-201201030-00008] [PMID: 22213494]
[33]
Sachs GA, Shega JW, Cox-Hayley D. Barriers to excellent end-of-life care for patients with dementia. J Gen Intern Med 2004; 19(10): 1057-63.
[http://dx.doi.org/10.1111/j.1525-1497.2004.30329.x] [PMID: 15482560]
[34]
Bausewein C, Daveson BA, Currow DC, et al. EAPC White Paper on outcome measurement in palliative care: Improving practice, attaining outcomes and delivering quality services - Recommendations from the European Association for Palliative Care (EAPC) Task Force on Outcome Measurement. Palliat Med 2016; 30(1): 6-22.
[http://dx.doi.org/10.1177/0269216315589898] [PMID: 26068193]
[35]
Long C. Palliative care for advanced dementia: nursing home staff knowledge and attitudes (S714). J Pain Symptom Manage 2017; 53(2): 417.
[http://dx.doi.org/10.1016/j.jpainsymman.2016.12.224]
[36]
Martín-Martín J, López-García M, Medina-Abellán MD, et al. Physicians’ and nurses’ knowledge in palliative care: Multidimensional regression models. Int J Environ Res Public Health 2021; 18(9): 5031.
[http://dx.doi.org/10.3390/ijerph18095031] [PMID: 34068622]
[37]
Leber W, McMullen H, Anderson J, et al. Promotion of rapid testing for HIV in primary care (RHIVA2): a cluster-randomised controlled trial. Lancet HIV 2015; 2(6): e229-35.
[http://dx.doi.org/10.1016/S2352-3018(15)00059-4] [PMID: 26423195]
[38]
Hagan TL, Xu J, Lopez RP, Bressler T. Nursing’s role in leading palliative care: A call to action. Nurse Educ Today 2018; 61: 216-9.
[http://dx.doi.org/10.1016/j.nedt.2017.11.037] [PMID: 29245101]
[39]
Sekse RJT, Hunskår I, Ellingsen S. The nurse’s role in palliative care: A qualitative meta-synthesis. J Clin Nurs 2018; 27(1-2): e21-38.
[http://dx.doi.org/10.1111/jocn.13912] [PMID: 28695651]
[40]
Suikkala A, Tohmola A, Rahko EK, Hökkä M. Future palliative competence needs - a qualitative study of physicians’ and registered nurses’ views. BMC Med Educ 2021; 21(1): 585.
[http://dx.doi.org/10.1186/s12909-021-02949-5] [PMID: 34789216]
[41]
Martínez-Sabater A, Chover-Sierra P, Chover-Sierra E. Spanish nurses’ knowledge about palliative care. a national online survey. Int J Environ Res Public Health 2021; 18(21): 11227.
[http://dx.doi.org/10.3390/ijerph182111227] [PMID: 34769747]
[42]
Bolt SR, Meijers JMM, Steen JT, Schols JMGA, Zwakhalen SMG. Nursing staff needs in providing palliative care for persons with dementia at home or in nursing homes: a survey. J Nurs Scholarsh 2020; 52(2): 164-73.
[http://dx.doi.org/10.1111/jnu.12542] [PMID: 32039556]
[43]
Kim S, Lee K, Kim S. Knowledge, attitude, confidence, and educational needs of palliative care in nurses caring for non-cancer patients: a cross-sectional, descriptive study. BMC Palliat Care 2020; 19(1): 105.
[http://dx.doi.org/10.1186/s12904-020-00581-6] [PMID: 32652984]
[44]
Hodiamont F, Hock H, Ellis-Smith C, et al. Culture in the spotlight-cultural adaptation and content validity of the integrated palliative care outcome scale for dementia: A cognitive interview study. Palliat Med 2021; 35(5): 962-71.
[http://dx.doi.org/10.1177/02692163211004403] [PMID: 33863246]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy