Avaliação do conhecimento e da autoeficácia de profissionais de enfermagem sobre cuidados paliativos: estudo quase experimental

Abstract

Introduction: Palliative care is still not widely disseminated in the country, and the knowledge of healthcare professionals is scarce. Therefore, teams need to be trained to acquire the knowledge necessary for application in their practice. In this way, on-the-job education is considered a potential factor for improving professional knowledge. Objective: To evaluate the knowledge and self-efficacy about palliative care of nursing professionals working in a public teaching hospital, before and after an educational intervention. Method: Quasi-experimental, quantitative study, developed in a public teaching hospital in the interior of Minas Gerais, Brazil. The study was divided into three stages, in the first, an educational intervention was developed and the content was validated by three experts in the field. In the second stage, the intervention was applied in a pilot study, through expository presentation and participatory and dialogic methodology; and the sample calculation was carried out. In the third stage, the main study was carried out with the application of the educational intervention. The inclusion criteria were professionals from the nursing team from all sectors that serve adults and the elderly. The intervention was conducted by a nurse, in the hospital itself, in a reserved room, in three work shifts, from May to September 2024, with 51 classes being offered in total. Data collection was carried out in two moments: in the first, in small groups, the sociodemographic, training and professional experience questionnaire and the Bonn Palliative Care Knowledge Test instrument were applied, which assesses knowledge and self-efficacy in palliative care, which were completed individually. After delivery of the instruments, the intervention with education in health services took place. In the second moment, after four weeks, the Bonn Palliative Care Knowledge Test instrument was reapplied. The data were validated and imported into the Statistical Package for the Social Sciences version 21.0 for analysis. The study was approved by the Research Ethics Committee of that institution. Results: In content validation, the degree of agreement in the Content Validity Index by experts obtained the minimum recommended value of 80%. 179 professionals participated in the final sample of the main study, with an average age of 40.17 years and a predominance of Nursing Technician professionals. The majority of professionals reported that they had no previous experience with patients in palliative care, however 92.7% reported that they treat this population in their current work. The palliative care knowledge score had a significantly higher average after the educational intervention (pre-test=11.77; post-test=15.03), with a gain of three points in the average performance. The results regarding self-efficacy increased, but on a smaller scale (pre-test=3.21; post-test=3.38), with a gain of only 0.1. Both were considered statistically significant (p<0.01). Regarding the effect of the magnitude of the intervention, the knowledge test was considered large (0.8 to 1.0) and the self-efficacy test had a moderate effect (0.5 to 0.7). Conclusion: There was an improvement in knowledge and self-efficacy about palliative care among nursing professionals after the educational intervention, with greater emphasis on knowledge.