Abstract

An interprofessional training session for health professionals was designed to optimize practice regarding goals of care at the end-of-life with patients and their families. The training session supported implementation of a new unified format, used in all healthcare establishments in Quebec since 2018, to document treatment preferences of persons with serious illness or advanced frailty. Three months after the training, participants revealed three main changes in their professional practices: (1) better use of the unified form as a communication tool to discuss end-of-life care with patients; (2) improved interprofessional practices in complex goals of care conversations situations through better affirmation of their role along with recognition of other professionals’ roles in this decision-making process; and (3) assumption improved recognition of advocacy, support and enabler roles with patients and families during goals of care conversations. Change facilitators are related to the participants’ personal characteristics, whereas the change constraints identified by participants mainly concern organizational factors. This implies potential recommendations to optimize patients’ ability to mobilize in order to make informed decisions about their end-of-life care.

摘要

为卫生专业人员举办的跨专业培训课程旨在优化与患者及其家人在临终护理目标方面的实践。培训课程支持实施新的统一格式，自 2018 年以来在魁北克的所有医疗机构中使用，以记录重病或晚期虚弱者的治疗偏好。培训三个月后，参与者发现了他们专业实践的三个主要变化：（1）更好地使用统一表格作为与患者讨论临终关怀的沟通工具；(2) 通过更好地肯定他们的角色以及承认其他专业人士在这个决策过程中的角色，在护理对话情境的复杂目标中改进跨专业实践；(3) 假设在护理对话的目标中提高了对患者和家属的倡导、支持和推动作用的认识。变革推动者与参与者的个人特征有关，而参与者确定的变革约束主要涉及组织因素。这意味着潜在的建议可以优化患者的活动能力，以便对他们的临终护理做出明智的决定。