Exploring palliative care practice and learning needs of allied health professionals in the Loddon Mallee region of Victoria: a cross-sectional survey
Lucy Rodda
A and Stephen Barrett B C *
A
B
C
Abstract
The objectives of this study were to examine the roles and needs of allied health professionals (AHPs) working in public healthcare settings in rural and regional Victoria, Australia in providing components of palliative care in their routine practice.
A cross-sectional study was conducted between March and May 2023. Surveys were collected from AHPs working in public healthcare settings in the Loddon Mallee region of Victoria, Australia. Clinicians reported on the frequency of provision of care to patients with terminal illness, and their self-reported skill and confidence in providing interventions to patients with palliative care needs.
In total, 121 clinicians completed the survey. Almost every respondent reported they had provided care to patients with a terminal illness, with 41% of clinicians providing this care daily or weekly. The respondents were confident carrying out generalist interventions such as maintaining physical function but reported lower confidence in managing common symptoms of terminal illness such as loss of appetite, swallowing difficulties and changing communication needs. Two-thirds of respondents had not undertaken any training specific to palliative care, with many unaware of how to access palliative care-specific training.
AHPs in rural and remote areas regularly provide care to patients with terminal illness. As the number of patients seen in non-specialist palliative care settings is likely to increase in rural and regional areas, the low self-reported confidence in providing common components of care, and the low uptake of palliative care-specific training must be addressed to ensure AHPs can provide high-quality care to people with terminal illness.
Keywords: allied health, Australia, end-of-life, education, hospital, palliative care, rural health, survey, training.
References
1 Radbruch L, De Lima L, Knaul F, Wenk R, Ali Z, Bhatnaghar S, et al. Redefining palliative care—a new consensus-based definition. J Pain Symptom Manag 2020; 60: 754-64.
| Crossref | Google Scholar | PubMed |
2 Australian Institute of Health and Welfare. Palliative care services in Australia. 2023. Available at https://www.aihw.gov.au/reports/palliative-care-services/palliative-care-services-in-australia/contents/summary
3 Etkind SN, Bone AE, Gomes B, Lovell N, Evans CJ, Higginson IJ, et al. How many people will need palliative care in 2040? Past trends, future projections and implications for services. BMC Med 2017; 15: 102.
| Crossref | Google Scholar |
4 Graham F, Clark D. The changing model of palliative care. Medicine 2008; 36: 64-6.
| Crossref | Google Scholar |
6 Pieters J, Dolmans DH, Verstegen DM, Warmenhoven FC, Courtens AM, van den Beuken-van Everdingen M. Palliative care education in the undergraduate medical curricula: students’ views on the importance of, their confidence in, and knowledge of palliative care. BMC Palliat Care 2019; 18: 72.
| Crossref | Google Scholar | PubMed |
7 Rabow M, Kvale E, Barbour L, Cassel JB, Cohen S, Jackson V, et al. Moving upstream: a review of the evidence of the impact of outpatient palliative care. J Palliat Med 2013; 16: 1540-9.
| Crossref | Google Scholar | PubMed |
8 Morgan DD, Rawlings D, Moores CJ, Button L, Tieman JJ. The changing nature of palliative care: implications for allied health professionals’ educational and training needs. Healthcare 2019; 7: 112.
| Crossref | Google Scholar | PubMed |
10 Buhagiar MA, Downes J, Shaik A. Providing quality allied health placements in palliative care. Focus Health Prof Educ 2017; 18: 36-46.
| Google Scholar |
11 Eva G, Morgan D. Mapping the scope of occupational therapy practice in palliative care: A European Association for Palliative Care cross-sectional survey. Palliat Med 2018; 32: 960-8.
| Crossref | Google Scholar | PubMed |
12 Tieman J, Morgan D, Jones K, Gordon S, Chakraborty A. Allied health professionals’ contribution to care at end of life in aged care settings. Aust J Prim Health 2023; 29: 341-8.
| Crossref | Google Scholar | PubMed |
13 The Loddon Mallee Region Palliative Care Consortium. Annual Report 2020–2021. 2021. Available at https://www.lmrpcc.org.au/wp-content/uploads/2021/12/LMRPCC-Annual-Report-2021.pdf
14 Bakitas M, Watts KA, Malone E, Dionne-Odom JN, McCammon S, Taylor R, et al. Forging a new frontier: providing palliative care to people with cancer in rural and remote areas. J Clin Oncol 2020; 38: 963.
| Crossref | Google Scholar | PubMed |
15 Bogaardt H, Veerbeek L, Kelly K, van der Heide A, van Zuylen L, Speyer R. Swallowing problems at the end of the palliative phase: incidence and severity in 164 unsedated patients. Dysphagia 2015; 30: 145-51.
| Crossref | Google Scholar | PubMed |
16 Van Lancker A, Velghe A, Van Hecke A, Verbrugghe M, Van Den Noortgate N, Grypdonck M, Verhaeghe S, Bekkering G, Beeckman D. Prevalence of symptoms in older cancer patients receiving palliative care: a systematic review and meta-analysis. J Pain Symptom Manage 2014; 47(1): 90-104.
| Crossref | Google Scholar | PubMed |
18 van Gaans D, Erny-Albrecht K, Tieman J. Palliative Care Within the Primary Health Care Setting in Australia: A Scoping Review. Public Health Rev 2022; 43: 1604856.
| Crossref | Google Scholar | PubMed |
19 White N, Oostendorp LJ, Minton O, Yardley S, Stone P. Palliative care training in undergraduate medical, nursing and allied health: a survey. BMJ Support Palliat Care 2022; 12: e489-92.
| Crossref | Google Scholar | PubMed |
20 Morgan DD, Litster C, Winsall M, Devery K, Rawlings D. “It’s given me confidence”: a pragmatic qualitative evaluation exploring the perceived benefits of online end‐of‐life education on clinical care. BMC Palliat Care 2021; 20: 57.
| Crossref | Google Scholar | PubMed |
21 Palliative Care Australia. Palliative Care Service Development Guidelines. 2018. Available at https://palliativecare.org.au/wp-content/uploads/dlm_uploads/2018/02/PalliativeCare-Service-Delivery-2018_web2.pdf
22 Australian Government Deptartment of Health and Aged Care. Palliative care education and training. 2023. Available at https://www.health.gov.au/topics/palliative-care/education-and-training
23 Aldridge MD, Hasselaar J, Garralda E, van der Eerden M, Stevenson D, McKendrick K, et al. Education, implementation, and policy barriers to greater integration of palliative care: a literature review. Palliat Med 2016; 30: 224-39.
| Crossref | Google Scholar | PubMed |
24 Callinan J. Barriers and facilitators to e-learning in palliative care. Int J Palliat Nurs 2020; 26: 394-402.
| Crossref | Google Scholar | PubMed |
25 Bethlehem J. Selection bias in web surveys. Int Stat Rev 2010; 78: 161-88.
| Crossref | Google Scholar |
26 Markaki A, Malhotra S, Billings R, Theus L. Training needs assessment: tool utilization and global impact. BMC Med Educ 2021; 21: 310.
| Crossref | Google Scholar | PubMed |
27 Foreman KJ, Marquez N, Dolgert A, Fukutaki K, Fullman N, McGaughey M, et al. Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: reference and alternative scenarios for 2016–40 for 195 countries and territories. Lancet 2018; 392: 2052-90.
| Crossref | Google Scholar | PubMed |
28 Paguio JT, Yu DSF, Su JJ. Systematic review of interventions to improve nurses’ work environments. J Adv Nurs 2020; 76: 2471-93.
| Crossref | Google Scholar | PubMed |
