Gaps in Understanding of Palliative Care Hinders Its Use Among Nurse Practitioners

Gaps in oncology nurse practitioner awareness and understanding of palliative care may explain why providing this care is lacking.

A pilot study addressed the level of knowledge and comfort regarding palliative care (PC) among nurse practitioners at a large Midwest cancer center and identified some gaps in awareness. Results of the study were reported in the Journal of the Advanced Practitioner in Oncology.

The study was led by Heidi Mason, DNP, ACNP-BC, of the University of Michigan in Ann Arbor, and colleagues. “Oncology advanced practice registered nurses (APRN) are often responsible for the care of patients with cancer at all stages of their disease, making it vital for them to be well-versed in the principles of PC,” the researchers wrote in their report. They also explained the possible benefits of initiating PC early in the course of care but noted that early PC can be a challenge in oncology due to limited training for providers in discussions involving prognosis and goals of care.

To evaluate knowledge and level of comfort among oncology nurse practitioners regarding PC, the research team used the Palliative Care Quiz for Nursing (PCQN), a tool that addresses the level of understanding of various aspects of PC. The PCQN includes 20 questions that focus on patient needs with PC. The researchers sent study participants the PCQN as an electronic survey.

Thirty-eight nurse practitioners from the teaching university were invited to participate in the pilot study, among whom 15 responded. Most respondents (93%) indicated awareness of PC being appropriate for patients who are showing a downhill trajectory or deterioration. However, just 38% of responses to a separate question indicated awareness of PC being compatible with aggressive treatment.

Although this specific survey was completed by a small sample, the results are consistent with the literature and clearly demonstrate the need for oncology APRNs to take a lead in making early PC available to all oncology patients.

Respondents generally seemed to understand symptom management. However, the researchers indicated that some areas that could be improved involved management of dyspnea, sedation, anxiety, and placebo use. Additionally, all respondents expressed a belief that the method of pain management should be determined by the extent of disease.

“Although this specific survey was completed by a small sample, the results are consistent with the literature and clearly demonstrate the need for oncology APRNs to take a lead in making early PC available to all oncology patients,” the researchers wrote in their report, also highlighting the role of nurses in patient advocacy. Their report also provided strategies for integrating early PC involving education, infrastructure, and culture.

This article originally appeared on Oncology Nurse Advisor

References:

Mason H, Derubeis MB, Hesseltine B. Early palliative care for oncology patients: how APRNs can take the lead. J Adv Pract Oncol. 2021;12(5):477-484. doi:10.6004/jadpro.2021.12.5.3