title: Utilization of palliative care principles in nursing home care: Educational interventions.
abstract: OBJECTIVE
  This study is part of the overarching PVIS (Palliative Care in Nursing Homes) project aimed at building competence in palliative care for nursing home staff. Our objective was to describe nursing home staff's attitudes to competence-building programs in palliative care.
  
  
  METHODS
  Three different programs were developed by specialist staff from three local palliative care teams. In all, 852 staff at 37 nursing homes in the greater Stockholm area participated. Staff from 7 nursing homes participated in 11 focus-group discussions. Variation in size between the seven nursing homes initiated purposeful selection of staff to take part in the discussions, and descriptive content analysis was used.
  
  
  RESULTS
  The results suggest that staff reported positive experiences as they gained new knowledge and insight into palliative care. The experiences seemed to be similar independent of the educational program design. Our results also show that staff experienced difficulties in talking about death. Enrolled nurses and care assistants felt that they carried out advanced care without the necessary theoretical and practical knowledge. Further, the results also suggest that lack of support from ward managers and insufficient collaboration and of a common language between different professions caused tension in situations involved in caring for dying people.
  
  
  CONCLUSIONS
  Nursing home staff experienced competence-building programs in palliative care as useful. Even so, further competence is needed, as is long-term implementation strategies and development of broader communication skills among all professions working in nursing homes.
authors.affiliation: Ersta Sköndal University College,Palliative Research Centre,Stockholm,Sweden.
authors.forename: Berit Seiger
authors.initials: BS
authors.lastname: Cronfalk
authors.affiliation: Ersta Sköndal University College,Palliative Research Centre,Stockholm,Sweden.
authors.forename: Britt-Marie
authors.initials: BM
authors.lastname: Ternestedt
authors.affiliation: Ersta Sköndal University College,Palliative Research Centre,Stockholm,Sweden.
authors.forename: Lise-Lotte Franklin
authors.initials: LL
authors.lastname: Larsson
authors.affiliation: Stockholm County Council,Research and Development FOUnu,Stockholm,Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Henriksen
authors.affiliation: Ersta Sköndal University College,Palliative Research Centre,Stockholm,Sweden.
authors.forename: Astrid
authors.initials: A
authors.lastname: Norberg
authors.affiliation: Ersta Sköndal University College,Palliative Research Centre,Stockholm,Sweden.
authors.forename: Jane
authors.initials: J
authors.lastname: Österlind
mesh_terms: D017144:Focus Groups; D006801:Humans; D017145:Models, Educational; D009726:Nurses; D009735:Nursing Homes; D010166:Palliative Care / Q000379:methods*; D011795:Surveys and Questionnaires
keywords: Competence-building programs; Nursing home staff; Palliative care