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"Nursing home staff's reasoning about providing palliative care following an educational intervention - a qualitative
Camilla Ekeblom1, Carina Lundh Hagelin2, Jane Österlind2
1Department of Health Care Sciences, Marie Cederschiöld University, Box 11189, Stockholm, 100 61, Sweden. camilla.ekeblom@mchs.se.
Background:
Palliative care (PC) is increasingly recognised as an essential component of healthcare, yet access remains unequal, particularly for older people. Nursing homes accommodate older people with complex needs and account for a large proportion of deaths, making PC a central component of care in these settings and underscoring the importance of integrating a PC approach into everyday care. However, staff often lack sufficient training and may perceive PC as limited to end-of-life care rather than as an ongoing approach. Education has been proposed to strengthen PC competence, but little is known about how staff reason about PC following such initiatives. This study aimed to explore nursing home staff's reasoning about providing PC after participating in an interprofessional educational intervention (IPEI).
Methods:
A descriptive qualitative design was used. Eighteen staff members from five nursing homes in Sweden, including registered nurses, assistant nurses, a physician, first-line managers, and PC champions, participated. Data were collected through semi-structured individual interviews conducted between March and April 2024 and analysed using inductive qualitative content analysis.
Results:
Three main categories were identified: (1) managing one's own emotions, thoughts, and attitudes; (2) the significance of relationships, communication, and interactions in care; and (3) navigating norms, assumptions, and organisational structures in everyday PC. These categories reflect how staff reasoned about providing PC at individual, relational, and organisational dimensions.
Conclusions:
The findings suggest that staff perceived the IPEI as providing opportunities for personal and professional development. Staff's reasoning further suggested that alignment across individual, relational, and organisational dimensions is important in supporting the provision of PC. Providing PC was not solely a matter of enhancing staff knowledge; rather, staff's reasoning suggested that knowledge and conditions for care are shaped through the interplay between staff attitudes, their reasoning about care, relational dynamics, and organisational conditions. When these dimensions align and mutually reinforce one another, favourable conditions for providing PC may be supported. Such conditions may also be supported through interprofessional educational initiatives that combine theoretical knowledge with opportunities for reflection and practical application.
Clinical Trial Number:
Not applicable.