Comparative Analysis in Palliative Care Competencies

Resumen

ccording to the WHO cancer is one of the leading causes of morbidity and mortality in the world. In 2012 there was 14 million of new cases worldwide. A number of new cases is expected to rise in future. An increasing number of cases demanding a new approach from health care systems regarding the staff education, hospital equipment and interprofessional cooperation in order to give full service to the customers (patients). For several years palliative care education is a top priority in the education of nurses due to the fact that there are serious deficiencies in that area (Komaromy et al. 2000, Miller et al. 2004, Goodridge et al. 2005, Hasson et al. 2008). Nurses are the forefront of caring for terminally ill patients and their families approaching the end of life, which does not minimize role of other healthcare professionals, but nurses have main role in this process. Definition and competencies of nurses involved in this process must be precisely identified and measured from time to time in order to improve the process of end of life care and palliative care nursing. Continuous development of guidelines and protocols for palliative care nursing is particularly relevant (Watts, 2013; Gambles et al 2009, Hockey et al 2005, Jack et all 2003). Development of competencies is one of key issues in contemporary education it and can be achieved with development of proper curriculum and education schedule, especially development of a proper instrument for measurement of competencies. This research has identified most important 10 competencies in accordance with WHITE paper for EAPC and WHO. General objective. This research has one general objective and it is creation and validation of new questionnaire about competencies in field of palliative care nursing with aspect of realization of core competences in developed and under developing systems. This questionnaire is a new instrument in field of competence measurement in palliative care nursing. Specific objectives of the research are based on evaluation and comparison of competences among nurses from Bosnia and Herzegovina and Spain (Valencia area). Methodology. Methodology comprises research, cross – section, analytical method of research. Actions taken in this process were literature review, analysis of data available curricula of nursing schools, literature research, development of new instruments for measurement of competences in palliative care nursing, interviews with nurses in Bosnia and Herzegovina, development of online platform for nurses in Spain, translation of instruments to Spain language, data processing, Comparison of results from both group were done by every single item of instrument and by every competences. Results. Results are presented in two different parts: Part I (one) of results is about development of instrument PALCOM and part II (two) is about the data collected from Bosnia and Herzegovina and Spain. All results are shown in proper table and graphs that are reflecting research process. Results show the significant statistical difference between groups in Bosnia and Herzegovina and Spain (Valencia area) in some aspects, while in several aspect there is no difference. Working experience and level of education are in directly linked with self-competence measurement. There is a high statistical difference between groups with different level of education, and working experience, which has a direct impact on development of competence of nurses. Conclusion. Need for measurement of competencies is expressed in the daily development of palliative care, community palliative care, hospice care and subspecialty palliative care. Questionnaire that can measure all competencies does not exist but using general competencies in PALCOM questionnaire can cover this entire field with measurement of various domains and competencies specific to that domains. PALCOM as an instrument for evaluation of competencies in the field of palliative care, is, for the time being, a reliable instrument. With the development of palliative care, improvement can be done in the area of competencies in palliative care nursing. PALCOM is applicable in various health care systems and educational systems and it does not depended on external factors. PALCOM as instrument measures the competence level of nurses and preparedness for work in palliative care settings. First scale measure knowledge, while second scale is self-measurement of competences in accordance with the level of education and work experience. Need for the appropriate instrument for measuring competences in palliative care nursing leads us to this instrument following most economical and reasonable way of developing.