CONTINUING OUR SERIES TO CELEBRATE THE INTERNATIONAL YEAR OF THE NURSE AND MIDWIFE 2020 AND THE BENEFITS THAT NURSING AND MIDWIFERY BRING TO THE HEALTH OF THE GLOBAL POPULATION.
To mark this world first, the European Association for Palliative Care (EAPC) is publishing a special series of 12 monthly posts to honour the work of nurses who work in palliative care and draw attention to several issues that are linked to this crucial workforce. Today, we are delighted to welcome as our guest writers, Minna Hökkä (Finland), Sandra Martins Pereira (Portugal) and Pablo Hernández-Marrero (Portugal).
As the World Health Organization, the European Association for Palliative Care, and other international associations recognise, nurses have a crucial role in providing high-quality palliative care across the continuum of healthcare provision. However, many times, when discussing nursing involvement in palliative care with nurses and nursing students, they highlight the need for more competencies and education about palliative care. As palliative care nurses ourselves, this expressed need, stemming from our colleagues and students, triggered us to perform research about palliative care nursing competencies.
In Finland, for instance, the EduPal-project is developing palliative medicine and nursing education based on international guidelines and research. Similar initiatives are also being conducted in other European and non-European countries. In fact, the need to further develop palliative care nursing competencies is also a major concern of international associations, such as the EAPC. Recent efforts developed by the recently concluded EAPC Taskforce on Preparation for Practice in Palliative Care Nursing across the European Union (EU) have highlighted the need to foster synergies. This was the basis for our international cooperation when doing this research, now published in Palliative Medicine.1
When providing palliative care in a wide range of healthcare settings, at least two or three levels of provision can be identified, namely: (i) palliative care approach, (ii) generalist palliative care, and (iii) specialist palliative care.2 All nurses should have appropriate education and competencies to provide high-quality palliative care. As we all know, nurses are often the professionals who are the closest to and who spend more time with patients and their loved ones. Therefore, nursing competencies have been highlighted as crucial to assuring high-quality palliative care.
The objective of our study was to systematically assess and synthesize the empirical evidence about (1) nursing competencies needed in palliative care and (2) whether these competencies differ across the levels of palliative care.1
A systematic integrative review with thematic synthesis was conducted. Our searches were performed in five databases and we included studies on nursing competencies linked to palliative care that were published between 1998 and 2019 in six languages (English, Swedish, Finnish, Spanish, Portuguese and German). A total amount of 21 articles were included in our analysis and synthesis.
Findings show that nursing competencies in palliative care can be categorised into six key themes or dimensions: (1) leadership, (2) communication, (3) collaboration, (4) clinical, (5) ethico-legal, and (6) psycho-social and spiritual competencies. Each of these competencies was composed of many subdimensions that are thoroughly explained in our article. Few studies focused on which competencies are relevant to a specific level of palliative care.1
In our perspective, our review has important implications for palliative care practice, education, policy and research. First, it shows the wide range of competencies that nurses have in palliative care. Second, it highlights that nursing competencies in palliative care, especially the ones that are more relevant to each level of palliative care provision, should be better outlined to enhance palliative care development, education and practice. Third, it emphasises the need for further research that addresses how nursing competencies differ across the levels of palliative care provision.
Based on these results, further development about nursing education is currently under way, some of which will be made in Finland as part of the EduPal-project, and others as part of ongoing international collaborations.
1. Hökkä M, Martins Pereira S, Pölkki T, Kyngäs H, Hernández-Marrero P. Nursing competencies across different levels of palliative care provision: a systematic integrative review with thematic synthesis. Palliat Med. 2020;34(7):851–870. doi: 10.1177/0269216320918798.
2. Radbruch L, Payne S. White paper on standards and norms for hospice and palliative care in Europe: part 1. Eur J Palliat Care. 2009;16(6):278–289. (If you wish to obtain a copy of this paper, please contact firstname.lastname@example.org.)
Celebrate the International Year of the Nurse and Midwife 2020 on the EAPC blog #nurses2020 #midwives2020.View the series here and join us again in September.
Further links and resources
Watch three YouTube videos on the EduPal project:
- EduPal-What is palliative care?
- EduPal – What is EduPal project?
- EduPal – project ensures palliative care competence.
- International Year of the Nurse and Midwife 2020.‘State of the World’s 2020 Nursing Report‘ Published by the World Health Organization, this report provides the most up-to-date evidence on and policy options for the global nursing workforce. It also presents a compelling case for considerable – yet feasible – investment in nursing education, jobs, and leadership. An online section available on the NHWA online portal contains individual country profiles presenting key statistics on nursing workforce.
More about the authors
Minna Hökkä, Research Unit of Nursing Science and Health Management, Medical Department, Oulu University, Oulu, Finland; School of Health, Kajaani University of Applied Sciences, Kajaani, Finland.
Sandra Martins Pereira, CEGE – Research Center in Management and Economics, Católica Porto Business School, Universidade Católica Portuguesa, Porto, Portugal; Instituto de Bioética, Universidade Católica Portuguesa, Porto, Portugal; UNESCO Chair in Bioethics, Institute of Bioethics, Universidade Católica Portuguesa, Porto, Portugal.
Pablo Hernández-Marrero, CEGE – Research Center in Management and Economics, Católica Porto Business School, Universidade Católica Portuguesa, Porto, Portugal; Instituto de Bioética, Universidade Católica Portuguesa, Porto, Portugal; UNESCO Chair in Bioethics, Institute of Bioethics, Universidade Católica Portuguesa, Porto, Portugal