An intervention to improve respiratory therapists' comfort with end-of-life care.
BACKGROUND
Respiratory therapists (RTs) are often involved in treating seriously ill and dying patients, but receive little instruction in end-of-life care. Prompted by several difficult cases, we developed an interdisciplinary program to introduce practicing RTs to ethical and end-of-life issues, and evaluated the program with a dedicated survey instrument.


METHODS
A convenience sample of RTs from a university hospital and nearby community hospitals participated in a one-day interactive program, in 2005 (n = 49) and in 2008 (n = 36), that included role-play and didactic components. The questionnaire completed before and after the program included scales on comfort with end-of-life care and role in end-of-life care, and knowledge indices.


RESULTS
Nearly all the RTs had recently encountered end-of-life situations, yet most had not received dedicated training and felt ill-prepared to deal with these situations; one third reported distress related to withdrawal of treatment. The 78 participants who completed both the before and after surveys had increased comfort with end-of-life care (P < .001) and their perception of their role in end-of-life care (P < .001). Knowledge about end-of-life care also increased (P < .001).


CONCLUSIONS
A one-day interactive educational intervention can improve short-term RT comfort and role perception concerning end-of-life care. Evaluation of longer-term clinical outcomes and implementation in other venues is needed.
Brown-Saltzman
Katherine
K
UCLA Healthcare System Ethics Center, Los Angeles CA 90095, USA.
Upadhya
Devesh
D
Larner
Lyle
L
Wenger
Neil S
NS
D000328:Adult; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007318:Inservice Training; D008297:Male; D011787:Quality of Health Care; D012138:Respiratory Therapy / Q000193:education / Q000941:ethics / Q000592:standards*; D013727:Terminal Care / Q000941:ethics / Q000592:standards*