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Evaluation of the currency of the D avies and O berle (1990) model of supportive care in specialist and specialised palliative care settings in E ngland
Author(s) -
Newton Jenni,
McVicar Andrew
Publication year - 2014
Publication title -
journal of clinical nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.94
H-Index - 102
eISSN - 1365-2702
pISSN - 0962-1067
DOI - 10.1111/jocn.12301
Subject(s) - nursing , focus group , palliative care , medicine , curriculum , qualitative research , family medicine , psychology , sociology , pedagogy , social science , anthropology
Aims and objectives To evaluate the extent to which the D avies and O berle (1990) model of supportive nursing has currency across specialist and specialised care settings in E ngland. Background The model describes attributes of palliative nursing for practice and associated educational curricula. It is influential but predates introduction of specialist/specialised care. Its applicability in contemporary care settings has not been evaluated. Design Evaluation was undertaken using sequential mixed methods, predominantly qualitative. Data collected during 2008–2009. Methods Four stages: (1) focus groups involving hospital and community palliative clinical nurse specialists and nurses from three hospice settings (total = 25) to identify setting‐specific characteristics, (2) survey of nurses ( n = 48 respondents/31%) with follow‐up interviews ( n = 25) to identify congruence with the model, (3) interviews with patients ( n = 6) and carers ( n = 13) for practice evidence and (4) reconvened focus groups ( n = 19 nurses) for confirmation. Results All major dimensions were evidenced. ‘ C onnecting’ had reduced emphasis in the hospital setting where specialist nurses spend limited time with patients, but diminishing time to ‘connect’ with patients and carers as service develops could potentially become problematic across all settings. Two new dimensions (‘ D isplaying expertise’ and ‘Influencing other professionals’) with subdimensions (e.g. ‘ A dvanced communication skills’) are proposed as additions to reflect advanced practice. Further new subdimensions (‘ M aking the assessment’, ‘ P rioritising’, ‘Agreeing the plan’) are suggested to be best aligned with the existing dimension ‘ C onnecting’. Conclusions A revised model of supportive care incorporating dimensions of advanced nursing has currency in contemporary specialist/specialised care settings, although evaluation is required as to the actual impact of the model on care outcomes. ‘ C onnecting’ is currently being affected by pace of work and lateness of referrals. Implications for practice ‘Spending time’ is increasingly difficult to sustain so challenging nurses as to how they may continue to ‘connect’ with patients as service delivery continues to change.