Overview of Environmental Scan Findings

1. Overview of Environmental Scan Findings

2. Environmental Scan – Year 1 • Quantitative and qualitative research methods: Surveys, Interviews, Focus Groups, Participant Observations, Document Reviews • Participants: Residents, Family members, Physicians, PSWs, RNs, RPNs, Spiritual Care, Social Work, Recreation, Dietary, Housekeeping, Maintenance, Administration, Volunteers and Community Partners

3. Participants and Data Collection • Surveys • All LTC home staff completed surveys • Sample sizes across 4 homes are approximately: • 205 PSWs • 69 Licensed Nurses • 79 Support Staff • 32 Administration • 39 Residents • 64 Family Members

4. Summary of Survey Results that All Staff Completed

5. FATCOD Survey(Frommelt Attitudes Toward the Care of Dying) • 30-item scale designed to measure participants’ attitude toward providing care to dying people • Has no subscales • Each item is scored on a scale of 1 (strongly disagree) to 5 (strongly agree) • 15 items are scored positively and 15 negatively (lower scores consistent with PC philosophy)

6. Findings of the FATCOD Survey • Average scores across: 4.075 • All four homes: 4.075 • PSWs: 3.82 • Licensed nurses: 4.21 • Support Services: 3.89 • Management: 4.16 • On average, staff demonstrated a positive attitude about providing care for dying residents

7. QiAS (Quality in Action Scale) • 43-item scale designed to measure aspects of work culture related to quality: • Six subscales: • improvement orientation • patient focus • personal influence/performance • management style • mission and goals orientation • team work orientation • participants’ attitude toward providing care to dying people • Each item is scored on a scale of 1 (strongly disagree) to 7 (strongly agree)

8. Findings of the QiAS Maple; n= 181 out of a possible 242 respondents Birch; n= 135 out of a possible 202 respondents Elm; n= 52 out of a possible 135 respondents Pine; n = 55 out of a possible 104 respondents

9. Summary of PSW Survey Results

10. Psychological Empowerment in the Workplace (PEiW) Survey • PEiW is a 12-item scale that measures direct care workers’ sense of personal empowerment within their workplace • Each item is scored on a scale of 1 (strongly disagree) to 7 (strongly agree) • Four dimensions are measured: • meaning • competency • self-determination • impact

11. Findings of the PEiW Survey Pine; n= 24 out of a possible 44 respondents Birch; n= 72 out of a possible 102 respondents Maple; n= 86 out of a possible 124 respondents Elm; n= 47 out of a possible 53 respondents

12. Supervisory Support Survey • SSS is a 15-item scale that assesses aspects of supervisory support • Each item is scored on a scale of 1 (never) to 5 (always) • Three dimensions are measured: • empathy • reliability • nurturing connections

13. Findings of Supervisory Support Survey Birch; n= 73 out of a possible 102 respondents Maple; n= 86 out of a possible 124 respondents Pine; n= 24 out of a possible 44 respondents Elm; n= 31 out of a possible 53 respondents

14. Summary of Nurses Survey Results

15. Self-Efficacy in End-of-Life Care (S-E EOLC) • This 25-item survey measures confidence in the ability to provide palliative care • Each item is scored on a scale of 0 (Cannot do at all) to 7 (Certain can do) • Includes 3 subscales: • patient management • communication • multidisciplinary teamwork

16. Findings of Self-Efficacy in End-of-Life Care Survey Maple; n= 27 out of a possible 43 respondents Birch; n= 22 out of a possible 42 respondents Elm; n= 11 out of a possible 16 respondents Pine; n= 8 out of a possible 18 respondents

17. Palliative Care Quiz (PCQ) • The PCQ is a 20-item scale that measures knowledge of palliative care nursing • It can be use to stimulate discussion of palliative care nursing and to identify misconceptions about the delivery of palliative care.

18. Findings of the Palliative Care Quiz • Overall, nurses scored an average of 60.22 % on the PCQ. Scores for the individual homes are listed below: • Higher scores were achieved on questions related to use of pain medications Birch average score = 63.4% Maple average score = 62.98% Elm average score = 62% Pine average score = 52.5% Birch; n= 22 out of a possible 42 respondents Maple; n= 27 out of a possible 43 respondents Elm; n= 12 out of a possible 16 respondents Pine; n= 8 out of a possible 18 respondents

19. Family and Resident Results

20. Quality of Life in Life-Threatening Illness – Family Caregiver Quality of Life in Life-Threatening Illness – Family Caregiver • What is the QOLLTI-F survey? • The Quality of Life in Life-Threatening Illness – Family Caregiver Version (QOLLTI-F) survey assesses the quality of life of caregivers for people with life-threatening chronic or terminal health conditions. • There are five dimensions to this survey; • environment, • patient state, • own state, • outlook, • quality of care, • relationships and • financial worries.

21. QOLLTI-F Maple; n= 15 respondents Birch; n= 23 respondents Elm; n= 22 respondents Pine; n= 14 respondents

22. McGill Quality of life Survey • What is the MQoL survey? • The McGill Quality of Life Questionnaire (MQoL) was developed to measure five dimensions of quality of life which are: physical symptoms, physical well-being, psychological, existential and support. • What is quality of life? • Quality of life is defined as an individual’s subjective well-being.

23. MQOL Maple; n= 5 residents Birch; n= 2 residents, 17 proxies Elm; n= 1 resident, 6 proxy Pine; n= 6 resident, 2 proxy

24. Group Discussion What surprised you most/least about the results of the environmental scan? What practices and strategies are you aware of that have been effective in providing palliative care in long-term care homes?

25. Acknowledgement Funding Provided By: Social Sciences and Humanities Council of Canada Thank you to our partners:

26. Contact Us Visit our website: www.palliativealliance.ca Email us: palliativealliance@lakeheadu.ca Call us: 807-766-7228 Thank You 