Assessing Adult Palliative Care Nurses’ Perceived Knowledge, Self-Efficacy, and Clinical Practice Before and After Paediatric Palliative Care Training

The global need for paediatric palliative care is increasing, driven by factors such as the advancements in medicine and the broader eligibility criteria to access this care. However, these specialised services are small compared to adult services and are not accessible to all children. Leading to those working in the community sector such as adult specialist palliative care professionals having to fill in this role and provide palliative care to children in the community (Health Service Executive, 2020; Whitla et al., 2020). In light of this, there has been global recognition within bodies such as the World Health Assembly Resolution on Palliative Care (World Health Organisation, 2014), the Children’s Palliative Care Education and Training Action Group (Neilson et al., 2021) and Ireland’s National Adult Palliative Care Policy (Department of Health, 2024) of the urgent need to standardise paediatric palliative care training for those working in adult palliative care in the community. However, little is known about how adult palliative care nurses currently perceive their knowledge or self-efficacy in paediatric palliative care, and whether additional training can have an impact on their knowledge, self-efficacy and clinical practice. This study used a quantitative longitudinal pretest-post-test research design in order to assess adult palliative care nurses’ perceived knowledge and self-efficacy levels, and the changes to these levels and to their practice after training in paediatric palliative care. Throughout the thesis, the study sample is described as “adult palliative care nurses” but it is important to clarify that this includes adult specialist palliative care nurses and adult palliative care postgraduate nursing students. The results indicated that adult palliative care nurses perceived they had low levels of knowledge and self-efficacy in paediatric palliative care. The training did improve their perceived knowledge and self-efficacy levels, but these levels decreased overtime and there was minimal impact on their clinical practice, primarily due to their lack of exposure to child patients. This study contributes to the limited body of research on the perceived gaps in knowledge and self-efficacy among adult palliative care nurses in paediatric palliative care. It identifies specific areas of PPC where these professionals struggle in, as well as the possible rationale for their lack of knowledge or self-efficacy. In addition, this study provides recommendations for education, practice and future research in this topic.