NUrsing Homes End of Life care Program (NUHELP): developing a complex intervention

Area of Science:

• Gerontology
• Palliative Care
• Health Services Research

Background:

• Nursing homes are increasingly vital for end-of-life care.
• High prevalence of end-of-life symptoms and palliative care needs in nursing home residents.
• Need for context-specific palliative care programs for Spanish nursing homes.

Purpose of the Study:

• To develop an end-of-life care program for Spanish nursing homes.
• Adapt existing models to the specific needs of Spanish nursing home staff.
• Improve the quality of palliative care in nursing home settings.

Main Methods:

• Descriptive study of a complex intervention over three phases.
• Phase 1: Assessed staff self-efficacy (SEPC scale) and attitudes (FATCOD-B scale) pre- and post-training.
• Phase 2: Delphi technique to select objectives from 42 quality standards.
• Phase 3: Focus groups to design interventions based on selected objectives.

Main Results:

• Palliative care training improved staff self-efficacy and attitudes.
• 14 standards were selected, forming 5 key objectives for end-of-life care.
• 22 interventions were designed to meet these objectives, forming the NUHELP program.

Conclusions:

• The NUHELP program offers a structured approach to improving end-of-life care in nursing homes.
• Implementation can modify clinical practice, organization, and health system integration.
• The program serves as an effective model for health intervention in long-term care facilities.