Educational needs in palliative care: A survey of GPs and community nurses

Abstract

Background: Most patients with cancer want to die at home and will spend most of the final year of life there. Primary care staff will, therefore, provide the bulk of palliative care at home. Yet, palliative care training for staff is fragmented and ad hoc. Some feel inadequately trained for the tasks they are expected to perform.

Aim: The aim of this study was to carry out an educational needs assessment in palliative care of general practitioners and community nurses in Northern Ireland.

Method: A semi-structured postal questionnaire was sent to 1018 GPs and 750 community nurses with a reminder approximately one month later.

Results: 611 GPs and 497 nurses replied giving a response rate of 60% for the doctors and 66% for nurses. 52% of doctors and 94% of nurses expressed a special interest in palliative care. Though the majority of both groups felt confident in their palliative care skills, 83% of doctors and 95% of nurses said they would be likely to undertake further training in palliative care. Preferences for the topics and type of further training were similar for the two groups. The most popular topics for further training for both groups were pain and symptom control, bereavement care and research and audit methods. Preferred methods of further training included specialist lectures, discussion with specialists, hands-on experience in a hospice and multidisciplinary team meetings. Perceived barriers to further training were lack of time, lack of locally available courses, expense of providing locums or of self-funding courses and lack of recognition from management.

Conclusion: Primary care staff have expressed a keenness to provide community palliative care and provide it well. It now rests with managers and educationalists in the field to recognise and support staff in their needs.

Key Words:

• palliative care
• primary care
• educational needs