Enhancing Cultural Congruence in Hospice Care

描述（由申请人提供）：低质量的医患沟通是导致临终差异的重要原因，特别是在来自不同种族或服务不足人群的个体中。本研究有三个特定目的：(1)评估基于网路的安宁疗护文化能力沟通干预对家庭照护者评估的安宁疗护沟通品质的影响；(2)评估基于网络的安宁疗护护士文化能力沟通干预对家庭照护者焦虑、照护者负担、照护者信任的影响；(3)评估基于网络的文化能力沟通干预对安宁疗护护士文化能力反映过程的影响。我们的跨学科研究团队将招募60名临终关怀护士和护理人员。临终关怀护士将被随机分配到文化能力沟通干预组或控制组，该控制组包括与他们的工作相关但不影响文化能力的相当长度的网络技能培训。护理人员将完成问卷，评估护士在提供符合文化的姑息治疗方面的技能。本研究将提供一个重要的新见解，以了解文化一致性照护对患者家属所感知的姑息照护体验的影响。本研究将为未来的研究项目提供必要的知识，该项目将根据护士的文化能力得分，根据个体的需求量身定制文化能力沟通干预。结果将有助于改善文化一致的姑息治疗。低质量的医患沟通会导致临终时的差异，特别是对于来自不同种族或服务不足人群的个体。公共健康相关性：本研究将评估安宁疗护护士基于网络的文化能力沟通干预对家庭照护者评估的沟通质量的影响。结果将有助于改善文化一致的姑息治疗。

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.