The Impact of Qualification and Hospice Education on Staff Attitudes during Palliative Care in Pediatric Oncology Wards—A National Survey
Abstract
:1. Introduction
2. Materials and Methods
2.1. Sampling Considerations and Recruitment
2.2. Ethical Approval
2.3. Data Collection Tools
- (1)
- Introduction to palliative therapy, first communication;
- (2)
- System of palliative care, advantages and disadvantages of palliative therapy at home and in the hospital;
- (3)
- The communication of the terminal state;
- (4)
- Most important aspects of palliative therapy from the perspective of the child, parents, and caregivers;
- (5)
- What makes palliative care appropriate and successful.
2.4. Coding and Analysis
2.5. Statistical Analysis
3. Results
3.1. Sample Characteristics
3.2. Results of NarrCat Analysis
3.3. Results of the Thematic Analysis
4. Discussion
5. Limitations
6. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
Appendix A.1. Agency Psycho-Thematic Module
Appendix A.2. Evaluation Psycho-Thematic Module
Appendix A.3. Emotion Psycho-Thematic Module
Appendix A.4. Spatio-Temporal Perspective Hypermodule
Appendix A.5. Social Reference Module
Appendix A.6. Negation Module
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Total Interviews (73) | ||||
---|---|---|---|---|
Groups | Sub-Groups | Total Numbers | Subcategories | Percentages |
Qualification | Doctors | 30 | 4 hospice providers—26 non-providers | 41% (13.3–86.7%) |
Nurses | 43 | 8 hospice providers—35 non-providers | 59% (18.6–81.4%) | |
Hospice | Providers | 12 | 4 doctors—8 nurses | 16.5% |
Non-providers | 61 | 26 doctors—35 nurses | 83.5% | |
Gender | Male | 9 | 8 doctors—1 nurse | 12.3% (88.2–11.1%) |
Female | 64 | 22 doctors—42 nurses | 87.7% (34.4–65.6%) |
Grouping | Categories—Median (IQR) | p Value |
---|---|---|
Whole cohort | Active verbs 2.32 (0.94) > passive verbs 0.53 (0.29) | p < 0.001 |
Constraint 0.58 (0.32) > intention 0.37 80.27) | p < 0.001 | |
Total emotion 1.04 (0.37) > total evaluation 0.93 (80.35) | p = 0.025 | |
Evaluation: positive 0.69 (0.31) > negative 0.21 (0.14) | p < 0.003 | |
Emotion: negative 0.58 (0.32) > positive 0.45 (0.26) | p = 0.005 | |
Positive evaluation 0.69 (0.31) > positive emotion 0.45 (0.26) | p < 0.001 | |
Negative emotion 0.58 (0.32) > negative evaluation 0.21 (0.14) | p < 0.001 | |
Experiential form 16.17 (2.82) > metanarrative and retrospective form 3.43 (2.04) | p < 0.001 | |
Dependent on qualification | Self-reference: nurses 3.32 (2.07)> doctors 2.89 (1.76) | p = 0.019 |
Negation: nurses 4.44 (1.63) > doctors 3.69 (1.29) | p < 0.001 | |
Metanarrative form: nurses 3.64 (2.42) > doctors 3.14 (1.71) | p = 0.041 | |
Dependent on hospice education | Passive verb: providers 0.68 (0.56) > non-providers 0.50 (0.27) | p = 0.022 |
Self-reference: providers 2.05 (3.01) < non-providers 3.23 (1.67) | p = 0.033 | |
Correlations | Constraint and Self-reference, Weak negative correlation R = −0.247 | p = 0.035 |
Positive emotion and We-reference,
Weak positive correlation R = 0.255 | p = 0.029 |
Question | Responses | Doctors | Nurses | p-Value |
---|---|---|---|---|
“A question about your experience of losing a child, or more specifically, the journey leading up to it: Have there been times when it was a success, have there been times when it was a failure?” | It can be a success | 73.3% | 58.1% | |
It cannot be a success | 16.7% | 16.3% | p = 0.238 | |
Undecided | 10% | 25.6% | ||
“Are the symptoms of the terminal condition discussed with the family?” | Yes | 93.3% | 58.1% | p = 0.003 * |
No | 6.6% | 25.6% | ||
Undecided | 0 | 16.3% | ||
“Could the discussion about the terminal state be late with adverse consequences for the patient, the environment or care?” | Yes | 86.6% | 86% | p = 1.0 |
No | 6.7% | 7% | ||
Undecided | 6.7% | 7% |
Question | Responses | Provider | Non-Provider | p-Value |
---|---|---|---|---|
“A question about your experience of losing a child, or more specifically, the journey leading up to it: Have there been times when it was a success, have there been times when it was a failure?” | It can be a success | 92% | 59% | |
It cannot be a success | 8% | 18% | p = 0.081 | |
Undecided | 0 | 23% | ||
“Are the symptoms of the terminal condition discussed with the family?” | Yes | 91.7% | 68.9% | p = 0.379 |
No | 8.3% | 19.6% | ||
Undecided | 0 | 11.5% | ||
“Could the discussion about the terminal state be late with adverse consequences for the patient, the environment or care?” | Yes | 75% | 88.5% | p = 0.207 |
No | 8.3% | 6.6% | ||
Undecided | 16.7% | 4.9% |
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Salamon, E.; Fodor, É.; Földesi, E.; Hauser, P.; Kriván, G.; Csanádi, K.; Garami, M.; Kovacs, G.; Csóka, M.; Tiszlavicz, L.G.; et al. The Impact of Qualification and Hospice Education on Staff Attitudes during Palliative Care in Pediatric Oncology Wards—A National Survey. Children 2024, 11, 178. https://doi.org/10.3390/children11020178
Salamon E, Fodor É, Földesi E, Hauser P, Kriván G, Csanádi K, Garami M, Kovacs G, Csóka M, Tiszlavicz LG, et al. The Impact of Qualification and Hospice Education on Staff Attitudes during Palliative Care in Pediatric Oncology Wards—A National Survey. Children. 2024; 11(2):178. https://doi.org/10.3390/children11020178
Chicago/Turabian StyleSalamon, Eszter, Éva Fodor, Enikő Földesi, Peter Hauser, Gergely Kriván, Krisztina Csanádi, Miklós Garami, Gabor Kovacs, Monika Csóka, Lilla Györgyi Tiszlavicz, and et al. 2024. "The Impact of Qualification and Hospice Education on Staff Attitudes during Palliative Care in Pediatric Oncology Wards—A National Survey" Children 11, no. 2: 178. https://doi.org/10.3390/children11020178
APA StyleSalamon, E., Fodor, É., Földesi, E., Hauser, P., Kriván, G., Csanádi, K., Garami, M., Kovacs, G., Csóka, M., Tiszlavicz, L. G., Kiss, C., Dergez, T., & Ottóffy, G. (2024). The Impact of Qualification and Hospice Education on Staff Attitudes during Palliative Care in Pediatric Oncology Wards—A National Survey. Children, 11(2), 178. https://doi.org/10.3390/children11020178