Enhancing Cultural Congruence in Hospice Care

描述(由申请人提供)：糟糕的患者提供者沟通质量极大地导致了生命末期的不平等，特别是在来自不同种族或服务不足的人群中。本研究有三个具体目标：(1)评估基于网络的临终关怀护士文化能力沟通干预对家庭照顾者评估的沟通质量的影响；(2)评估基于网络的临终关怀护士文化能力沟通干预对家庭照顾者焦虑、照顾者负担和护士信任的影响；(3)评估基于网络的文化能力沟通干预对反映临终关怀护士文化能力的过程的影响。我们的跨学科研究团队将招聘60名临终关怀护士和护理员。临终关怀护士将随机接受文化能力交流干预或控制计划，该计划包括与其工作相关但不影响文化能力的技能的同等长度的基于网络的培训。护理员将完成问卷调查，评估护士在提供文化上一致的姑息治疗方面的技能。这项研究将提供一个重要的新视角，以了解文化一致性护理对患者家属照顾者感知的患者姑息护理体验的影响。这项研究将产生未来项目所需的知识，该项目将根据护士个人的需求，基于他们的文化能力得分，量身定做文化能力沟通干预。这一结果将有助于改善文化一致性的姑息治疗。低质量的患者提供者沟通导致了生命末期的不平等，特别是对来自种族多样性或服务不足的人群的个人。公共卫生相关性：这项研究将评估基于网络的临终关怀护士文化能力沟通干预对家庭照顾者评估的沟通质量的影响。这一结果将有助于改善文化一致性的姑息治疗。

DESCRIPTION (provided by applicant): Poor quality patient provider communication contributes significantly to disparities at end of life, particularly among individuals from ethnically diverse or underserved populations. The proposed cluster-randomized trial has three specific aims: (1) Evaluate the effect of a web-based cultural competence communication intervention for hospice nurses on quality of communication as assessed by family caregivers; (2) Evaluate the effect of a web-based cultural competence communication intervention for hospice nurses on family caregiver outcomes of anxiety, caregiver burden, and trust of the nurse; and (3) Evaluate the effect of a web-based cultural competence communication intervention on the processes reflective of hospice nurse's cultural competence. Our interdisciplinary research team will recruit 60 hospice nurse and caregiver dyads. Hospice nurses will be randomized to either a cultural competence communication intervention or to a control program consisting of a comparable length web-based training in a skill relevant to their work but not affecting cultural competence. Caregivers will complete questionnaires assessing the nurse's skill at providing culturally congruent palliative care. This study will provide an important new insight into the effect of culturally congruent care on patients' palliative care experiences as perceived by the patients' family caregivers. This study will generate the knowledge required for a future project that will tailor the cultural competence communication intervention according to the needs of individual nurses based on their cultural competence scores. The results will be instrumental in improving culturally congruent palliative care. Poor quality patient provider communication contributes to disparities at end of life, especially for individuals from ethnically diverse or underserved populations. PUBLIC HEALTH RELEVANCE: This research will evaluate the effect of a web-based cultural competence communication intervention for hospice nurses on quality of communication as assessed by family caregivers. The results will be instrumental in improving culturally congruent palliative care.