To meet the growing palliative care (PC) needs of China’s aging population, we culturally adapted and pilot tested an evidence-based basic PC training program for practicing clinicians.
Design:
Barrera’s framework guided a multistage, surface, and deep structural adaptation of an existing course. We pilot tested the final curricula with 51 participants in September 2022. Participant demographics and postcourse satisfaction survey were descriptively analyzed.
Results:
A total of 20 nurses and 29 physicians completed the course and instruments. Majority of participants were between 31 and 50 years old (n = 39, 79.6%), female (n = 41, 83.7%), internal medicine trained (n = 30, 61.2%), and worked in tertiary hospitals (n = 47, 95.9). Most participants considered the course quality to be “high” or “very high” (n = 47, 95.9%).
Conclusions:
Practicing physicians and nurses in mainland China consider this culturally adapted basic PC training to be feasible and acceptable. Future studies should evaluate the effectiveness of PC training and develop strategies to overcome implementation challenges.
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References
1.
XieY, XuY, YangS, et al.Investigation of the awareness of and demand for hospice care and attitudes towards life-sustaining treatment at the end of life among community residents in Hangzhou. BMC Palliative Care, 2020; 19(1):128.
2.
YanY, ZhangH, GaoW, et al.Current awareness of palliative care in China. Lancet Glob Health, 2020; 8(3):e333–e335.
NiK, GongY, LiF, et al.Knowledge and attitudes regarding hospice care among outpatients and family members in two hospitals in China. Medicine (Baltimore), 2019; 98(16):e15230.
5.
LengA, JingJ, NicholasS, et al.Geographical disparities in treatment and health care costs for end-of-life cancer patients in China: a retrospective study. BMC Cancer, 2019; 19(1):39.
6.
LengA, JingJ, NicholasS, et al.Catastrophic health expenditure of cancer patients at the end-of-life: a retrospective observational study in China. BMC Palliat Care, 2019; 18(1):43.
7.
TangY. Death attitudes and truth disclosure: A survey of family caregivers of elders with terminal cancer in China. Nurs Ethics, 2019; 26(7–8):1968–1975.
8.
YiTW, DengYT, ChenHP, et al.The discordance of information needs between cancer patients and their families in China. Patient Educ Couns, 2016; 99(5):863–869.
9.
SharkeyL, LoringB, CowanM, et al.National palliative care capacities around the world: Results from the World Health Organization Noncommunicable Disease Country Capacity Survey. Palliat Med, 2018; 32(1):106–113.
10.
WangT, MolassiotisA, ChungBPM, et al.Current research status of palliative care in Mainland China. J Palliat Care, 2018; 33(4):215–241.
11.
WillemsenAM, MasonS, ZhangS, et al.Status of palliative care education in Mainland China: A systematic review. Palliat Support Care, 2020:1–11.
12.
BarreraMJr., CastroFG, StryckerLA, et al.Cultural adaptations of behavioral health interventions: a progress report. J Consult Clin Psychol, 2013; 81(2):196–205.
13.
TsaoL, SlaterSE, DoyleKP, et al.Palliative care-related knowledge, attitudes, and self-assessment among physicians in Vietnam. J Pain Symptom Manage, 2019; 58(6):1015–1022.e1010.
14.
TsaoL, KweteXJ, SlaterSE, et al.Effect of training on physicians' palliative care-related knowledge and attitudes in Vietnam. J Pain Symptom Manage, 2023.
15.
HallGC, IbarakiAY, HuangER, et al.A meta-analysis of cultural adaptations of psychological interventions. Behav Ther, 2016; 47(6):993–1014.
16.
BekelmanDB, FinkRM, SannesT, et al.Puente para cuidar (bridge to caring): A palliative care patient navigator and counseling intervention to improve distress in Latino/as with advanced cancer. Psychooncology, 2020; 29(4):688–695.
17.
LengJ, LuiF, ChenA, et al.Adapting meaning-centered psychotherapy in advanced cancer for the Chinese immigrant population. J Immigr Minor Health, 2018; 20(3):680–686.
18.
KwokHHY, LowJ, DevakumarD, et al.Experience and perspectives on palliative or end-of-life care of Chinese people and their families as immigrants to high-income countries: a systematic review and thematic synthesis. BMJ Glob Health, 2020; 5(12).
19.
DaubmanB-R, StoltenbergM, KaneK, et al.Analyzing the unique needs of international palliative care learners attending a united states-based palliative care education and practice course. Journal of Palliative Medicine, 2021; 24(11):1721–1724.
20.
DaubmanBR, Pérez-CruzPE, LeivaO, et al.Furthering palliative care training in Latin America: development and assessment of an advanced diploma course in palliative care in Chile. J Pain Symptom Manage, 2022; 64(2):128–136.
21.
BhatC, LaDonnaKA, DewhirstS, et al.Unobserved observers: Nurses' perspectives about sharing feedback on the performance of resident physicians. Acad Med, 2022; 97(2):271–277.
22.
HokkaM, RajalaM, KaakinenP, et al.The effect of teaching methods in palliative care education for undergraduate nursing and medical students: a systematic review. Int J Palliat Nurs, 2022; 28(6):245–253.
23.
KwokIB, VembuK, BrownK, et al.Project ECHO in the Caribbean: building a virtual community for palliative care education needs. J Pain Symptom Manage, 2022; 64(2):e77–e81.
24.
LiWW, ChhabraJ, SinghS. Palliative care education and its effectiveness: a systematic review. Public Health, 2021; 194:96–108.
25.
NakazawaY, MiyashitaM, MoritaT, et al.The palliative care knowledge test: reliability and validity of an instrument to measure palliative care knowledge among health professionals. Palliat Med, 2009; 23(8):754–766.
26.
YamamotoR, KizawaY, NakazawaY, et al.The palliative care knowledge questionnaire for PEACE: reliability and validity of an instrument to measure palliative care knowledge among physicians. J Palliat Med, 2013; 16(11):1423–1428.
27.
Lopez-GarciaM, RubioL, Gomez-GarciaR, et al.Palliative care knowledge test for nurses and physicians: validation and cross-cultural adaptation. BMJ Support Palliat Care, 2020; 12(3):324–331.
28.
López-GarcíaM, RubioL, Martin-de-Las-HerasS, et al.Instruments to measure skills and knowledge of physicians and medical students in palliative care: A systematic review of psychometric properties. Med Teach, 2022; 44(10):1–13.
29.
MoreauKA. Has the new Kirkpatrick generation built a better hammer for our evaluation toolbox? Med Teach, 2017; 39(9):999–1001.
30.
HsiehH-F, ShannonSE. Three approaches to qualitative content analysis. Qualitative Health Research, 2005; 15(9):1277–1288.
31.
LynchT, ConnorS, ClarkD. Mapping levels of palliative care development: a global update. J Pain Symptom Manage, 2013; 45(6):1094–1106.
32.
LaabarTD, SaundersC, AuretK, et al.Socially, culturally and spiritually sensitive public health palliative care models in the lower-income countries: An integrative literature review. Indian J Palliat Care, 2023; 29(1):15–27.
33.
StoltenbergM, SpenceD, DaubmanBR, et al.The central role of provider training in implementing resource-stratified guidelines for palliative care in low-income and middle-income countries: Lessons from the Jamaica Cancer Care and Research Institute in the Caribbean and Universidad Catolica in Latin America. Cancer. 2020; 126(Suppl 10):2448–2457.
34.
DaubmanBR, StoltenbergM, SpenceD, et al.Implementing palliative care training in the Caribbean: development and assessment of a basic palliative care training course in Jamaica. J Pain Symptom Manage, 2021; 62(6):1145–1153.
35.
JiaZ, StokesSC, PanSY, et al.Heart to heart cards: a novel, culturally tailored, community-based advance care planning tool for Chinese Americans. Am J Hosp Palliat Care, 2021; 38(6):650–657.
36.
LioJ, NingX, WuL, et al.Exploring palliative care competency standards for medical education in China: a survey of national hospice service program providers. Journal of Palliative Medicine, 2017; 21(1):6–8.
37.
FaulknerL. Beyond the five-user assumption: benefits of increased sample sizes in usability testing. Behavior Research Methods, Instruments, & Computers, 2003; 35(3):379–383.
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