Palliative Care Nurses' Core Competence Status And Construction Of Training Program

ObjectiveTo develop an instrument measuring Chinese Palliative care nurses' core competence and to test its reliability and validity.Using the tool to investigate status quo of core competence of palliative care nurses.Based on above,a palliative care nurse training program was constructed to provide reference for training palliative care nurses in China.MethodThis study can be divided into three parts.1.Development and test of the instrument measuring Chinese palliative care nurses' core competence.Based on literature review and results of semi-structured interview,draft of the instrument was prepared.Then the instrument was estimate through two rounds of Delphi expert consultation(including 16 experts).After that,the tool was tested by small sample and large sample survey,the later was divided into three stages: At first stage,we collected 246 valid questionnaires,using IBM SPSS21.0 software for exploratory factor analysis;At second stage,we collected 30 questionnaires,which were using to test retest reliability;At third stage,we collected302 questionnaires,using AMOS software to do confirmatory factor analysis.2.Investigation of core competence level of palliative care nurses in China.We collected 436 questionnaires to investigate palliative care nurses' core competence level using the instrument.We used IBM SPSS21.0 to describe and analysis data.3.Construction of palliative care nurse' training program.According to COPAtheory and Fink's meaningful learning objectives,we constructed training objectives,training contents,training methods and assessment methods of the training program for palliative care nurses.Results1.Palliative care nurses' core competence instrument consisted of 28 items,including 4 dimensions: ethical care competence,physical and mental care competence,spiritual care competence and self-psychological adjustment competence.Four common factors were extracted by exploratory factor analysis and the contribution rate of cumulative variance was 74.10%.The overall Cronbach's ?coefficient of the questionnaire was 0.970,all dimensions were more than 0.9,the split-half reliability was 0.889,the retest reliability was 0.976.The fitting index of confirmatory factor analysis including chi-square index / degrees of freedom=1.650,GFI=0.909,AGFI=0.884,CFI=0.809,IFI=0.819,RMSEA=0.04.The results of reliability and validity meet requirements of psychological measurement thus can be used to evaluate palliative care nurses' core competence.2.The standardized score of core competence of palliative care nurses was(38.60± 1.22)and the lowest two dimensions were physical and mental care competence and spiritual care competence.The results of one-way ANOVA or t test showed that the core competence level of palliative care nurses with different age,title,department,teaching and training experience was significantly different.The results of multiple linear regression analysis showed that the above five variables could explain 37.3% of total variation(P<0.05).3.Training is provided to registered nurses working in hospice wards(institutions).The items of the instrument developed in the early stage were transformed as the training objectives of the palliative care nurses' training program,and the training objectives were divided into six categories according to Fink's meaningful learning objectives.According to different objectives,training contents,training methods,assessment and evaluation methods were constructed.After that,seven experts specialist in palliative care related fields were invited to give some suggestions.Finally,a training program for palliative care nurses was preliminarily formed.ConclusionPalliative care nurses' core competence instrument consisted of 28 items.The survey of palliative care nurses showed that their core competence scores were relatively low.Based on these,we constructed a preliminary draft of palliative care nurses' training program,including targeted participants,objectives,contents,assessment and evaluation methods.In the future,experimental research is needed totest practicability and effectiveness of the training program.