PhD Study : Building consensus on the development and delivery of a palliative care education intervention for Health Care Assistants in the nursing home setting: a feasibility study

Summary

COVID-19 morality has disproportionally affected nursing homes (1), creating pressures on palliative care. Healthcare assistants (HCAs) are responsible for the vast majority of direct care, and play a key role in palliative care provision (2-4), yet they are not trained to any national standard with training delivered ad-hoc and not aligned to their specific skills and duties.  The impact of COVID 19 pandemic has intensified the need to ensure this frontline worker is supported to provide high quality compassionate palliative care to older people.  However, the available evidence upon which to develop a palliative care education model to support them is limited and of variable quality.

Aim: To develop and gain consensus on the core components of a palliative care educational intervention, delivery and framework for effectiveness for HCAs in nursing home setting.

Objectives: 1.To synthesise existing evidence/policy relating to palliative care provision and associated education programs for HCAs in nursing homes. 2.To explore the HCA’s role in the delivery of palliative care in nursing homes. 3.To develop a palliative care educational intervention for HCAs in nursing homes. 4.To undertake a consensus exercise to agree on the key components of the educational curriculum, structure, framework for implementation and effectiveness. 5.To pilot test the feasibility and acceptability of the educational intervention and to obtain preliminary data to enhance the conduct of a future definitive study.

Method and Design: A incremental mixed methods design, will be used.

Phase 1: Evidence base.  This phase will involve three components a) scoping policy/evidence review to examine current educational palliative care programmes and policy guiding HCA practice.   b) semi-structured interviews with HCAs, nursing managers and other staff (N=25-30) to gather information about which tasks undertaken by the HCA workers relate to palliative care; and c) an online survey with nursing home providers across the UK will determine the knowledge and skills needed, preferred learning styles, and delivery modes as well as reviewing the barriers and facilitators associated with the provision of and educational intervention.

Phase 2: Intervention development: A purposive sample of key stakeholders including staff (HCAs, RNs and mangers) from the nursing home sector, experts in palliative care, and educationalists will be invited to take part in an online modified three round Delphi (N=30-50).  This will seek consensus on four topics (a) key components of the education intervention; (2)  delivery mode; (3) optimal framework for  successful implementation and (4) framework to assess the effectiveness of training.

Phase 3: Pilot and  feasibility: A local nursing home will be recruited to take part in this phase, all HCAs will recieve the educational intervention.  The primary outcome will be a descrption of the study feasibility and acceptability (recruitment and retention rates, knowledge, confidence and stakeholder acceptability).  Secondary outcomes will include participant satisfaction.  Mixed methods will be used to collect data from older people living in nursing homes, next-of-kin, staff and managers.

References will be requested for shortlisted candidates.

AccessNI clearance required

Please note, the successful candidate will be required to obtain AccessNI clearance prior to registration due to the nature of the project.

Essential criteria

Applicants should hold, or expect to obtain, a First or Upper Second Class Honours Degree in a subject relevant to the proposed area of study.

We may also consider applications from those who hold equivalent qualifications, for example, a Lower Second Class Honours Degree plus a Master’s Degree with Distinction.

In exceptional circumstances, the University may consider a portfolio of evidence from applicants who have appropriate professional experience which is equivalent to the learning outcomes of an Honours degree in lieu of academic qualifications.

• Experience using research methods or other approaches relevant to the subject domain
• Sound understanding of subject area as evidenced by a comprehensive research proposal
• A demonstrable interest in the research area associated with the studentship

Desirable Criteria

If the University receives a large number of applicants for the project, the following desirable criteria may be applied to shortlist applicants for interview.

• First Class Honours (1st) Degree
• Sound understanding of subject area as evidenced by a comprehensive research proposal
• Relevant professional qualification and/or a Degree in a Health or Health related area

Funding and eligibility

The University offers the following levels of support:

Vice Chancellors Research Studentship (VCRS)

The following scholarship options are available to applicants worldwide:

• Full Award: (full-time tuition fees + £19,000 (tbc))
• Part Award: (full-time tuition fees + £9,500)
• Fees Only Award: (full-time tuition fees)

These scholarships will cover full-time PhD tuition fees for three years (subject to satisfactory academic performance) and will provide a £900 per annum research training support grant (RTSG) to help support the PhD researcher.

Applicants who already hold a doctoral degree or who have been registered on a programme of research leading to the award of a doctoral degree on a full-time basis for more than one year (or part-time equivalent) are NOT eligible to apply for an award.

Please note: you will automatically be entered into the competition for the Full Award, unless you state otherwise in your application.

Department for the Economy (DFE)

The scholarship will cover tuition fees at the Home rate and a maintenance allowance of £19,000 (tbc) per annum for three years (subject to satisfactory academic performance).

This scholarship also comes with £900 per annum for three years as a research training support grant (RTSG) allocation to help support the PhD researcher.

• Candidates with pre-settled or settled status under the EU Settlement Scheme, who also satisfy a three year residency requirement in the UK prior to the start of the course for which a Studentship is held MAY receive a Studentship covering fees and maintenance.
• Republic of Ireland (ROI) nationals who satisfy three years’ residency in the UK prior to the start of the course MAY receive a Studentship covering fees and maintenance (ROI nationals don’t need to have pre-settled or settled status under the EU Settlement Scheme to qualify).
• Other non-ROI EU applicants are ‘International’ are not eligible for this source of funding.
• Applicants who already hold a doctoral degree or who have been registered on a programme of research leading to the award of a doctoral degree on a full-time basis for more than one year (or part-time equivalent) are NOT eligible to apply for an award.

Due consideration should be given to financing your studies. Further information on cost of living