Development and Validation of a Tool to Assess the Structural Quality of Palliative Care Services.

CONTEXT: The current gap in access to palliative care requires the expansion of palliative care services worldwide. There is little information about the structural components required by palliative care services to provide adequate end-of-life care. No specific tools have been developed to assess the structural quality of these services. OBJECTIVE: To develop and validate a tool to assess the structural quality of palliative care services. METHODS: A scoping review of literature was performed to identify structural quality indicators of palliative care services. National experts participated in a two-round Delphi method to reach consensus regarding the importance and measurement feasibility of each proposed indicator. Consensus was reached for each indicator if 60% or more considered them both important and feasible. The selected indicators were tested among Chilean palliative care services to assess instrument psychometric characteristics. RESULTS: Thirty-one indicators were identified. Thirty-five experts participated in a two-round Delphi survey. Twenty-one indicators reached consensus and were included in the structural quality of palliative care services tool (SQPCS-21). This instrument was applied to 201 out of 250 palliative care services in Chile. Achievement for each indicator varied between 8% and 96% (mean 52%). The total SQPCS-21 score varied between 3 and 21 points (mean 11 points). CONCLUSION: The SQPCS-21 tool to assess structural quality of palliative care services, has good content and construct validity and its application provides information about institutions at the individual and aggregated level. This tool can provide guidance to monitor the structural quality of palliative care worldwide.

[Training in palliative care in nursing and medical schools in Chile]. / Estado de formación en cuidados paliativos a nivel del pregrado en las carreras de Medicina y Enfermería de Chile.

Training in Palliative Care (PC) at the undergraduate level has proven to be an effective strategy to expand access to this type of services. In Chile, the increase in magnitude of serious health-related suffering and the recently approved Law that guarantees universal access to Palliative Care, requires the extension of PC undergraduate training in medical and nursing schools. Therefore, this study assessed and described the characteristics of current PC training in the Schools of Medicine and Nursing of Chile through an online survey of their directors. Nursing schools report higher frequency of mandatory training hours and access to clinical training, while Medicine schools report higher frequency of elective internships. However, gaps persist in the number of teaching hours and the teaching methods used, which may be due to the scarcity of qualified professionals in PC, limited access to clinical fields and disciplinary differences. Strengthening and expanding PC training at the undergraduate level with practical and interdisciplinary methodologies are fundamental steps so that future medical and nursing professionals can provide adequate care and relief of serious health-related suffering to an aging population until the end of their life.

Estado de formación en cuidados paliativos a nivel del pregrado en las carreras de Medicina y Enfermería de Chile / Training in palliative care in nursing and medical schools in Chile

Training in Palliative Care (PC) at the undergraduate level has proven to be an effective strategy to expand access to this type of services. In Chile, the increase in magnitude of serious health-related suffering and the recently approved Law that guarantees universal access to Palliative Care, requires the extension of PC undergraduate training in medical and nursing schools. Therefore, this study assessed and described the characteristics of current PC training in the Schools of Medicine and Nursing of Chile through an online survey of their directors. Nursing schools report higher frequency of mandatory training hours and access to clinical training, while Medicine schools report higher frequency of elective internships. However, gaps persist in the number of teaching hours and the teaching methods used, which may be due to the scarcity of qualified professionals in PC, limited access to clinical fields and disciplinary differences. Strengthening and expanding PC training at the undergraduate level with practical and interdisciplinary methodologies are fundamental steps so that future medical and nursing professionals can provide adequate care and relief of serious health-related suffering to an aging population until the end of their life.