Related Experiment Video
Updated: Jul 13, 2025
E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
Facing uncertainty - Pilot testing of a palliative prognostic index training with hospital aged care assessment teams
Katrin Gerber1, Melissa J Bloomer2, Barbara Hayes3
1Melbourne School of Psychological Science, The University of Melbourne, Parkville VIC, 3010 Australia; Melbourne Ageing Research Collaboration, National Ageing Research Institute, Parkville VIC, 3052 Australia; School of Media and Communication, RMIT, Melbourne VIC, 3000 Australia; The Royal Melbourne Hospital, Parkville VIC, 3052 Australia.
Background:
Prognostic avoidance can delay discussions about older hospital patients' life expectancy. This pilot study examined the effects of a prognostic training program on hospital clinicians' knowledge and confidence in identifying older patients at risk of dying.
Methods:
Fifty-seven clinicians from aged care assessment teams at two Australian hospitals were introduced to the Palliative Prognostic Index, a 5-item checklist indicating prognoses between 3 and 6 weeks. Mixed-methods training evaluation included pre-post-training surveys and semi-structured interviews, conducted three months post-training.
Results:
Clinicians used a combination of experience, knowledge, and intuition as strategies to generate prognoses. Allied health staff relied on intuition more often than medical and nursing staff. Prognostic tools were rarely used. Pre-post-training comparisons showed significant improvements in clinicians' knowledge and confidence in identifying signs of dying, particularly amongst allied health. Follow-up interviews highlighted advantages and challenges of using prognostic tools. Recommendations are made for addressing these.
