INDONESIAN PALLIATIVE CARE NURSES KNOWLEDGE

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Corey Morris
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1 INDONESIAN PALLIATIVE CARE NURSES KNOWLEDGE Ns. Dame Elysabeth T.A Tarihoran, S.Kep., M.Kep. Sp.Kep.MB Sandra Sembel, SE., Spd., MM Wilda Gunawan, S.Kp UNIVERSITAS PELITA HARAPAN INDONESIA

2 OUTLINE Background Objectives Methods Result Recommendation

3 INDONESIA

5 PALLIATIVE CARE IN INDONESIA

6 Background Indonesia population around 251 million people Islands, 700 languages, 300 Ethnicities, 6 Religions (CIA, 2013) High Number of patients with palliative status (Riskesdas, 2007) Support systems: Facilities, human resources, health care standards insufficient (6 from 33 provinces) Palliative care training and education are informally given in clinical setting

7 OBJECTIVES Lacks of significance studies to evaluate palliative nursing knowledge and skills The limited resources in palliative care Therefore, there is an urgent call to analyze the palliative care learning needs of nurses by Identifying Nurses knowledge about palliative care and also it is necessary to identify the factors associated with palliative care knowledge Nurses have not been received specific palliative care education Palliative care training and education for nurses are informally given only in clinical setting

8 OBJECTIVES Identify the level of Palliative care nurses knowledge in Indonesia Identify the need of development of palliative care education in Indonesia

Palliative Care quiz for Nursing (PCQN) (Ross et al, 1996 in Andriaansen, 2007)

9 METHODOLOGY Quantitative descriptive study with cross-sectional design Total respondent are 30 nurses from private hospitals June- July items Palliative Care quiz for Nursing (PCQN) (Ross et al, 1996 in Andriaansen, 2007) With the characteristics: Age, Work experience, Department, Culture Chi-square analysis.

10 RESULT

11 Table 1. Demographic characteristics (N=30) June- July 2012 VARIABLE FREQUENCY PERCENTAGE (%) GENDER FEMALE MALE WARD IN-PATIENT SPECIALIST WARD OUT- PATIENT EXPERIENCE <15 YEARS >15 YEARS ETHNICITY BATAKNESSE JAVANESSE SUNDANESSE OTHERS AGE YEARS YEARS >45 YEARS

12 Table 2. Palliative Care Knowledge (N=30) mean (49.33%) June- July 2012 Level of Palliative Care knowledge < mean (49.33%) >Mean (49.33%) n % n %

13 Table 3. Palliative care knowledge based on Demographic characteristic Variable Below mean (49.33%) Above mean (49.33%) P Value n % n % Gender Female Male Ward unit In-patient Specialist Out-patient Experience <5 years >5 years Ethnicity Bataknesse Javanesse Sundanesse Others Age years years >45 years

14 CONCLUSION That most of nurses have low level of Palliative care knowledge. Most of them (53%) are above mean (49.33) out of 100%. There is no correlation between level of knowledge and those nurses characteristics (gender (p=0.724), work experience (p=0.073), department (p=0.740), culture (p=0.282), and age (p=0.560)

15 (Nakazawa et al, 2009). DISCUSSION This probably happened because there has been no formal palliative care education and training in clinical setting, nursing curriculum about palliative care in nursing education setting even though Palliative care nursing has been regulated in Ministry of Health decree No: 812/Menkes/SK/VII/2007 about palliative care policy (KEMENKES, 2007). If this phenomenon continues, the lack of knowledge of palliative care among nurses will be one of the most common barriers to quality palliative care

16 DISCUSSION Nurses, who are knowledgeable about palliative care in the form of symptom management, will be able to ensure optimal symptoms relief, promote patient-centered quality of life, help maintain physical functioning, reduce disease exacerbations and support a coordinated cost effective approach to the management of chronic disease (Pitta et al (2006).

17 DISCUSSION Till date, studies of palliative care educational programmes such as Palliative care training and course (Andriaansen, Achterberg, Borm, 2004), (End-of-life Nursing Education Consortium (ELNEC), in foreign countries have shown that knowledge and skills can be improved. A number of studies have supported the value of educational program in improving both knowledge and attitudes towards palliative care to develop competence and confidence in practice (knowing how) alongside skill-based learning (knowing that).

18 RECOMMENDATION A palliative care education provider needs to be established by Ministry of health in collaboration with higher nursing education to introduce palliative care from early on. Future studies can evaluate palliative care knowledge across a curriculum, comparison between nurses from different work settings or educational background and also may assess such relationship between knowledge, attitudes, beliefs, and behaviors of nurses in real life palliative care situations.

19 REFERENCES Andriaansen, MM., Achterberg, TV., Borm, G. (2004). Effects of a postqualification course in palliative care. Journal of Advanced Nursing, 49(1), Adriaansen, MM. (2007). Nursing education in Palliative Care: Effects, contents, and implementation. Retrieved from KEMENKES (Keputusan Menteri Kesehatan) No: 812/Menkes/SK/VII/2007 (2007). Kebijakan perawatan paliatif. Retrieved from Kompas. (2012). Satu juta Jiwa idap Kanker. Retrieved from Kanker on March 26, 2012 Pitta, F., Trooster, T., Probst, V., Spruit, M.,Decramer, M and Gosselink, R. (2006). Physical activity and hospitalization for exacerbation of COPD. Chest, 129,3,

20 REFERENCES Riset Kesehatan Dasar (RISKESDAS). (2007). Laporan Nasional 2007, Badan Penelitian dan Pengembangan Kesehatan Departemen Kesehatan, Republik Indonesia. Retrieved on March 19, 2012, from Kemenkes RI website. Ross, M., Mc Donald, B., Mc Guinnes, J. (1996). The palliative care quiz for nursing: The development of an instrument to measure nurse s knowledge of palliative care. Journal of Advanced Nursing (23) Singer, PA., Bowman, KW. (2002). Quality care at the end of life; should be recognized as a global problem for public health and health system. BMJ 324:1291. Tejawinata. (2010). Seri 1st seminar paliatif UGM: perawatan paliatif: penerapannya di indonesia, tantangan dan hambatannya. Retrieved from on March 26, World Health Organization (2002) National cancer control programmes: policies and guidelines. Retrieved from on March 22, 13.