Health care professionals are crucial in providing palliative care for patients with Chronic Obstructive Pulmonary Disease. These patients are referred less often to palliative care services than...Show moreHealth care professionals are crucial in providing palliative care for patients with Chronic Obstructive Pulmonary Disease. These patients are referred less often to palliative care services than patients with other terminal diseases. Health care professionals are often reluctant to initiate palliative care as they are unsure whether they can implement it adequately. Few studies have looked at the effect of a palliative care training on the level of self-efficacy of the health care professionals. This study investigated whether an intervention with the use of simulations can increase the level of self-efficacy regarding the palliative care they provide. Additionally, the effect of self-efficacy on palliative care measures, such as the amount and duration of advanced care planning conversations with patients, and the amount of collaboration and consultation with other health care professionals was investigated. This study was a randomised cluster-controlled trial that applied a hybrid design type 2 which took part in eight hospital regions around The Netherlands. Four of the hospital regions were in the control group and four were in the intervention group. In total, 93 doctors, nurses, and palliative care consultants participated. The intervention consisted of two evening courses with information about palliative care and simulations with actors so that conversations with patients could be practiced. Additionally, a tool for recognising when palliative care needs to be initiated was offered, and extra meetings with their project managers to see if palliative care was implemented as intended. Self-efficacy was measured with the End-of-Life Professional Caregiver Survey at three time points, before intervention, five months after the interventions, and fifteen months after the intervention. An unstructured multilevel mixed model showed an increase of self-efficacy over Time for both the intervention and control group (p < .001) and an interaction between Group and Time (p < .001) indicating that the intervention group had a greater increase of self-efficacy over time compared to the control group. A Spearman Rho test showed that self-efficacy is correlated with the amount of advanced care planning conversations that are held with the patient (ρ(80) = .31, p = .004). Additionally, a Pearson correlation showed that self-efficacy is correlated with the amount of collaboration with other health care professionals (r(81) = .32, p = .003). No significant correlation was found between the level of self-efficacy and the duration of the advanced care planning conversations and the number of consultations with other health care professionals. Thus, this intervention was successful in increasing self-efficacy of health care professionals over time and that self-efficacy is correlated with some of the identified palliative care measures. A palliative care intervention can help health care professionals to feel more confident about their skills and offer better care to patients with COPD.Show less
