title: Multi-faceted palliative care intervention: aged care nurses' and care assistants' perceptions and experiences.
abstract: OBJECTIVE
  This paper is a report of a study to describe residential aged care nurses' and care assistants' perceptions of a multi-faceted palliative care intervention to identify potential areas to be addressed during subsequent action research phases.
  
  
  BACKGROUND
  Action research was used to enhance the delivery of a palliative approach in residential aged care. The chronic care model guided the development of a multi-faceted intervention. This involved the: (1) establishment of a 'link nurse' role; (2) learning and development strategies for nurses, care assistants and general practitioners; (3) use of multi-disciplinary team meetings; and (4) access to specialist consultation.
  
  
  METHODS
  A purposive sample (n = 28) of aged care nurses and care assistants participated in a series of four focus groups conducted in July 2005. Thematic content analysis of the transcripts was performed.
  
  
  RESULTS
  Four themes emerged: (1) targeted education can make a difference; (2) a team approach is valued; (3) clinical assessment tools are helpful; and (4) using the right language is essential. Participants described increased understanding of palliative care concepts, enhanced competencies, greater confidence to deliver palliative care and a desire to adopt a multi-disciplinary approach to care planning.
  
  
  CONCLUSIONS
  Sustaining a culture that is committed to ongoing learning and development interventions and creating multi-disciplinary teams in the aged care setting is critical to embedding a palliative approach. The chronic care model is a useful framework to guide the development of interventions leading to better palliative care outcomes for residents and their families.
authors.affiliation: School of Nursing, Family and Community Health, University of Western Sydney, New South Wales, Australia. jane.phillips@canceraustralia.gov.au
authors.forename: Jane L
authors.initials: JL
authors.lastname: Phillips
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Davidson
authors.forename: Debra
authors.initials: D
authors.lastname: Jackson
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Kristjanson
mesh_terms: D000368:Aged; D001291:Attitude of Health Personnel; D001315:Australia; D017144:Focus Groups; D005851:Geriatric Nursing / Q000193:education*; D006707:Homes for the Aged; D006801:Humans; D007400:Interprofessional Relations; D009740:Nursing Staff / Q000193:education* / Q000523:psychology; D010166:Palliative Care / Q000458:organization & administration / Q000523:psychology* / Q000592:standards; D010348:Patient Care Team