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Healthcare professionals and volunteers education in palliative care to promote the best practice-an integrative review.

BACKGROUND
Family caregivers' empowerment can assume strategic importance in palliative care. Healthcare professionals and volunteers have been showing significant gaps in this field. Hence, education has been advocated as an effective strategy to fill this gap. While several educational initiatives exist, a comprehensive evidence synthesis on the effectiveness of educational training on healthcare professionals and volunteers is lacking.


AIMS
An integrative review was conducted to explore worldwide initiatives, aiming to improve healthcare professionals and volunteers' competence in a palliative care setting especially in relation to the family caregiver.


METHOD
A scoping literature review was conducted with systematic searches in multiple databases - REDALYC, CINAHL, SCIELO, EBSCO, ERIC and MEDLINE since January 2012. Studies were selected based on programmes content and its impact evaluation. Four researchers assessed the studies regarding their eligibility with reference to the inclusion and exclusion criteria.


FINDINGS
Twenty-two studies met the eligibility criteria. Multi-professional learning was reported, emphasising nurses and physician's enrolment. Only few studies showed participants' learning outcomes. Inconsistencies in delivery mode and duration were identified. Impact evaluations were heterogeneous and relied on no validated instruments. Family caregiver's content was addressed only in three initiatives.


CONCLUSIONS
Further research is needed using a more reliable design, mode of delivery and impact measurement of educational training. In addition, more initiatives associated with cost-effectiveness, shorter- and longer-term clinical impact are needed. Despite the strides already made towards the establishment of an evidence base for healthcare professionals in the field of palliative care, either greater consideration is required for family care providers in the education of healthcare professionals and respect for the cultural diversity.