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Development and psychometric validation of a comprehensive end-of-life care competence scale: A study based on three-year surveys of health and social care professionals in Hong Kong

Published online by Cambridge University Press:  24 August 2020

Daiming Xiu Open the ORCID record for Daiming Xiu [Opens in a new window] ,
Amy Y.M. Chow  and
Iris K.N. Chan
Daiming Xiu
Affiliation:
Jockey Club End-of-Life Community Care Project, The University of Hong Kong, Hong Kong, Hong Kong Department of Social Work & Social Administration, The University of Hong Kong, Hong Kong, Hong Kong
Amy Y.M. Chow*
Affiliation:
Jockey Club End-of-Life Community Care Project, The University of Hong Kong, Hong Kong, Hong Kong Department of Social Work & Social Administration, The University of Hong Kong, Hong Kong, Hong Kong
Iris K.N. Chan
Affiliation:
Jockey Club End-of-Life Community Care Project, The University of Hong Kong, Hong Kong, Hong Kong
*
Author for correspondence: Amy Y.M. Chow, Department of Social Work & Social Administration, The University of Hong Kong, Pokfulam, Hong Kong. E-mail: chowamy@hku.hk
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Abstract

Objective

This study aimed to develop an assessment tool measuring comprehensive interdisciplinary competence in end-of-life care (EoLC) and investigate its content, construct validity, reliability, and their correlates.

Method

Items of the Comprehensive End-of-Life Care Competence Scale (CECCS) were developed according to a comprehensive core competence framework in EoLC and refined by a multi-disciplinary panel of experts. The psychometric properties were further tested through region-wide surveys of self-administered questionnaires completed by health and social care professionals in Hong Kong.

Results

Participants comprised social workers, nurses, physicians, and allied health care professionals (445 participants in 2016, 410 in 2017, and 523 in 2018). Factor analysis validated the construct of the questionnaire which encompassed 26 items describing EoLC core competences in seven domains with satisfactory internal reliability (confirmatory factor analysis: χ2/df = 3.12, GFI = 0.85, TLI = 0.93, CFI = 0.94, RMSEA = 0.07; Cronbach's alphas ranged from 0.89 to 0.97): overarching value & knowledge, communication skills, symptom management, psychosocial and community care, end-of-life decision-making, bereavement care, and self-care. Higher perceived levels in these competences were correlated with a higher level of job meaningfulness and satisfaction (r ranged from 0.17 to 0.39, p < 0.01) and correlated with lower perceived stress (r ranged from –0.11 to –0.28, p < 0.05). Regression analysis found that age and work involvement in EoLC were positively associated with the perceived competences in all domains; professionals working in hospices reported higher levels of competence than workers in other settings; social workers showed lower perceived competences in symptom management, but higher levels in bereavement care than other health care professionals.

Significance of results

The validity and internal reliability of CECCS were demonstrated. The levels of perceived competences working in EoLC were significantly associated with professionals’ job-related well-being. Practically, there is still room for improvement in comprehensive competences among health and social care workers in Hong Kong.

Keywords

End-of-life careHealth-care workersHong KongPerceived competenceSocial workers
Type
Original Article
Information
Palliative & Supportive Care , Volume 19 , Issue 2 , April 2021 , pp. 198 - 207
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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References

REFERENCES

Acker, GM and Lawrence, D (2009) Social work and managed care: Measuring competence, burnout, and role stress of workers providing mental health services in a managed care era. Journal of Social Work 9(3), 269–283.CrossRefGoogle Scholar
Bandura, A (1997) Self-efficacy: The Exercise of Control. New York: W.H. Freeman.Google Scholar
Banerjee, SC, Manna, R, Coyle, N, et al. (2017) The implementation and evaluation of a communication skills training program for oncology nurses. Translational Behavioral Medicine 7(3), 615–623.CrossRefGoogle ScholarPubMed
Bosma, H, Johnston, M, Cadell, S, et al. (2009). Canadian Social Work Competencies for Hospice Palliative Care: A Framework to Guide Education and Practice at the Generalist and Specialist Levels. Available at: http://www.chpca.net/interest_groups/social_workers-counselors/Social_Work_Competencies_July_2009.pdf (accessed 15 July 2009)Google Scholar
Carlson, J (2010) Not finished yet. Coalition wants end-of-life care to be a priority. Modern Healthcare 40(43), 17–18.Google ScholarPubMed
Chan, IKN and Chow, AYN (2019) End-of-life care competences for all: Building a cross-cutting core competency framework for health and social care professionals in the community. In Chan, CLW, Lou, VWQ, Chan, IKN, Fong, CHC & Wong, EY (eds.), Innovation, Impact: The Foundation of Community-based End-of-life Care in Hong Kong. Hong Kong: The Jockey Club End-of-Life Community Care Project, pp. 171–190.Google Scholar
Chan, WCH, Tin, AF and Wong, KLY (2015) Coping with existential and emotional challenges: Development and validation of the self-competence in death work scale. Journal of Pain Symptom Management 50(1), 99–107.CrossRefGoogle ScholarPubMed
Cheung, JTK, Au, DWH, Chan, WCH, et al. (2018) Self-competence in death work among health and social care workers: A region-wide survey in Hong Kong. BMC Palliative Care 17(1), 65. doi:10.1186/s12904-018-0317-1CrossRefGoogle ScholarPubMed
Chow, AYM (2013) Developing emotional competence of social workers of end-of-life and bereavement care. British Journal of Social Work 43(2), 373–393. doi:10.1093/bjsw/bct030CrossRefGoogle Scholar
Chung, RY-N and Yeoh, E-K (2019) Policy directions for end-of-life care in Hong Kong. In Chan, CLW, Lou, VWQ, Chan, IKN, Fong, CHC & Wong, EY (eds.), Innovation, Impact: The Foundation of Community-based End-of-life Care in Hong Kong. Hong Kong: The Jockey Club End-of-Life Community Care Project, pp. 41–56.Google Scholar
Connolly, M, Charnley, K and Regan, J (2012). A Review of Palliative Care Competence Frameworks: Prepared for the Palliative Care Competency Framework Development Project Steering Group. Available at: http://aiihpc.org/upload/education/files/1342606786_Palliative_Care_Competence_Framework_Report_R1.pdfGoogle Scholar
Cronbach, LJ (1951) Coefficient alpha and the internal structure of tests. Psychometrika 16(3), 297–334.CrossRefGoogle Scholar
Desbiens, J-F and Fillion, L (2011) Development of the palliative care nursing self-competence scale. Journal of Hospice & Palliative Nursing 13(4), 230–241.CrossRefGoogle Scholar
Frey, R, Gott, M, Banfield, R, et al. (2011) What questionnaires exist to measure the perceived competence of generalists in palliative care provision? A critical literature review. BMJ Supportive & Palliative Care 1(1), 19–32.CrossRefGoogle ScholarPubMed
Gamondi, C, Larkin, P and Payne, S (2013) Core competencies in palliative care: An EAPC white paper on palliative care education: Part 1. European Journal of Palliative Care 20(2), 86–91.Google Scholar
Giovanni, LA (2012) End-of-life care in the United States: Current reality and future promise-a policy review. Nursing Economics 30(3), 127–134.Google Scholar
Harding, R and Higginson, IJ (2014) Inclusion of end-of-life care in the global health agenda. Lancet Global Health 2(7), e375–e376.CrossRefGoogle ScholarPubMed
Health & Social Care Northern Ireland (2016). Palliative and end of life care competency assessment tool. Available at: https://aiihpc.org/wp-content/uploads/2015/02/Palliative-End-of-Life-Care-Competency-Assessment-Tool-Sept12.pdfGoogle Scholar
Luk, J, Liu, A, Ng, W, et al. (2011) End-of-life care in Hong Kong. Asian Journal of Gerontology and Geriatrics 6, 103–106.Google Scholar
Marsh, HW, Martin, AJ, Yeung, AS, et al. (2017) Competence self-perceptions. In Elliot, AJ, Dweck, C & Yeager, D (eds.), Handbook of Competence and Motivation: Theory and Application. New York, NY: Guilford Press, pp. 85–115.Google Scholar
Mason, S and Ellershaw, JJ (2004) Assessing undergraduate palliative care education: Validity and reliability of two scales examining perceived efficacy and outcome expectancies in palliative care. Medical Education 38(10), 1103–1110.CrossRefGoogle ScholarPubMed
Miller-Lewis, L, Tieman, J, Rawlings, D, et al. (2019) Correlates of perceived death competence: What role does meaning-in-life and quality-of-life play? Palliative & Supportive Care 17(5), 550–560.CrossRefGoogle ScholarPubMed
National Institute for Health and Care Excellence [NICE] (2017). End of Life Care for Adults – Quality standard [QS13]. Available at: https://www.nice.org.uk/guidance/qs13/chapter/Introduction-and-overviewGoogle Scholar
Nguyen, LT, Yates, P and Osborne, Y (2014) Palliative care knowledge, attitudes and perceived self-competence of nurses working in Vietnam. International Journal of Palliative Nursing 20(9), 448–456.CrossRefGoogle ScholarPubMed
Phillips, J, Salamonson, Y and Davidson, PMJ (2011) An instrument to assess nurses’ and care assistants’ self-efficacy to provide a palliative approach to older people in residential aged care: A validation study. International Journal of Nursing Studies 48(9), 1096–1100.CrossRefGoogle Scholar
Ryan, K, Connolly, M, Charnley, K, et al. (2014) Palliative Care Competence Framework. Dublin: Health Service Executive (HSE).Google Scholar
Thiel, M, Harden, K, Brazier, L-J, et al. (2019) Evaluation tools for interdisciplinary palliative care learning experiences: A literature review. Journal of Palliative Medicine 5(23), 698–702.Google Scholar
UK Department of Health (2009). Common Core Competences and Principles for Health and Social Care Workers Working with Adults at the End of Life. Available at: http://www.reading.gov.uk/media/1822/End-of-Life-Core-Competencies-Guide/pdf/End-of-Life-Core-Competencies-Guide.pdfGoogle Scholar
Wang, C-W, Chan, CL and Chow, AY (2018) Social workers’ involvement in advance care planning: A systematic narrative review. BMC Palliative Care 17(1), 5.CrossRefGoogle Scholar
Weissman, DE, Ambuel, B, Norton, AJ, et al. (1998) A survey of competencies and concerns in end-of-life care for physician trainees. Journal of Pain and Symptom Management 15(2), 82–90.CrossRefGoogle ScholarPubMed
Whittaker, B, Parry, R, Bird, L, et al. (2018) Development, validity and reliability testing of the East Midlands Evaluation Tool (EMET) for measuring impacts on trainees’ confidence and competence following end of life care training. BMJ Supportive & Palliative Care 8(4), 439–446.CrossRefGoogle Scholar
Worldwide Palliative Care Alliance, & WHO (2014) Global Atlas of Palliative Care at the End of Life. London: Worldwide Palliative Care Alliance. Available at: http://www.thewhpca.org/resources/global-atlas-on-end-of-life-careGoogle Scholar
Worthington, RL and Whittaker, TA (2006) Scale development research: A content analysis and recommendations for best practices. The Counseling Psychologist 34(6), 806–838.CrossRefGoogle Scholar
Wright, KB (2011) A communication competence approach to healthcare worker conflict, job stress, job burnout, and job satisfaction. Journal for Healthcare Quality 33(2), 7–14.CrossRefGoogle ScholarPubMed
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