title: Culturally Competent Palliative and Hospice Care Training for Ethnically Diverse Staff in Long-Term Care Facilities.
abstract: Between 2013 and 2030, older adults 65 years and older of racial/ethnic populations in the U.S. is projected to increase by 123% in comparison to the Whites (Non-Hispanics). To meet this demand, training of ethnically diverse health staff in long-term care facilities in palliative and hospice care is imperative. The purpose of this study was to evaluate a palliative and hospice care training of staff in two nursing homes in Hawaii - (a) to evaluate knowledge and confidence over three time periods, and (b) to compare staff and family caregiver satisfaction at end of program. The educational frameworks were based on cultural and communication theories. Fifty-two ethnically diverse staff, a majority being Asian (89%), participated in a 10-week module training and one 4 hour communication skills workshop. Staff evaluation included knowledge and confidence surveys, pre- and post-test knowledge tests, and FAMCARE-2 satisfaction instrument. There were nine Asian (89%) and Pacific Islander (11%) family caregivers who completed the FAMCARE-2 satisfaction instrument. The overall staff knowledge and confidence results were promising. The staff rated overall satisfaction of palliative care services lower than the family caregivers. Implications for future research, practice, and education with palliative and hospice care training of ethnically diverse nursing home staff is to include patient and family caregiver satisfaction of palliative and hospice care services, evaluation of effectiveness of cross-cultural communication theories in palliative and hospice care staff training, and support from administration for mentorship and development of these services in long term care facilities.
authors.affiliation: 1 Department of Nursing, School of Nursing and Dental Hygiene, University of Hawai'i at Manoa, Honolulu, HI, USA.
authors.forename: Merle R
authors.initials: MR
authors.lastname: Kataoka-Yahiro
authors.affiliation: 2 Corporate Human Resources, Hawaii Health Systems Corporation, Honolulu, HI, USA.
authors.forename: Sandra
authors.initials: S
authors.lastname: McFarlane
authors.affiliation: 3 Kokua Mau-Hawaii Hospice and Palliative Care Organization, Honolulu, HI, USA.
authors.forename: Jeannette
authors.initials: J
authors.lastname: Koijane
authors.affiliation: 4 University of Rochester, School of Medicine and Dentistry, Clinical and Translational Science Institute, Rochester, NY, USA.
authors.forename: Dongmei
authors.initials: D
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D017028:Caregivers; D003142:Communication; D054521:Cultural Competency / Q000193:education*; D005006:Ethnicity; D005260:Female; D006254:Hawaii; D006282:Health Personnel / Q000193:education; D006707:Homes for the Aged / Q000458:organization & administration; D017051:Hospice Care / Q000458:organization & administration*; D006801:Humans; D007318:Inservice Training / Q000458:organization & administration*; D019359:Knowledge; D008297:Male; D008875:Middle Aged; D044468:Native Hawaiian or Pacific Islander; D009735:Nursing Homes / Q000458:organization & administration; D010166:Palliative Care / Q000458:organization & administration*; D017060:Patient Satisfaction; D020377:Self Efficacy
keywords: end-of-life care; family caregiver satisfaction; long-term care facilities; nursing homes; palliative and hospice care training; palliative care; staff satisfaction