Data extraction table
| Methods | Evaluation | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Author | Aims | Study design | Sample | Evaluation tools | Outcomes | Evaluation approach | Number of follow-ups—sustainability | Source of evaluation | Results |
| Mullins and Merriam14 | Measure impact of training programme | CRCT* with dissimilar levels of knowledge between groups | 4 nursing homes; 138 qualified and unqualified staff | Validated instrument; adapted non-validated instrument | Specialist knowledge, attitude change, death anxiety | Pre and post—query immediate? | None | Staff | Test group knowledge increased, attitudes were unchanged, anxiety about death increased |
| Dowding and Homer15 | Measure impact of workshop | UCBA† | 1 nursing home; 46 unqualified staff | Customised non-validated instrument; informal feedback | Training satisfaction | Unclear | None | Educators and organisation | Workshops were positively evaluated |
| Froggatt16 | Measure impact of education project | UCBA† with no baseline data | 4 nursing homes; 341 qualified and unqualified staff | Customised non-validated instrument; interviews and observation | Patient care, training satisfaction, organisational system | Post (no baseline data) | Follow-up postal survey after 12 months (end of 2-year project) | Organisation, staff, patients and relatives | Organisational practice was changed, but individual practice was unchanged |
| Thulesius et al17 | Measure impact of programme | CBA‡ | 2 nursing homes: 185 qualified and unqualified staff | Validated instrument | Attitude change, death anxiety | Pre-test and post-test 1 year apart | None | Staff | Improved attitudes towards end-of-life care and staff mental health well-being |
| Braun and Zir18 | Not stated | UCBA | 4 nursing homes; 144 qualified and unqualified staff | Customised non-validated instrument | Specialist knowledge, patient care | Pre and post | None | Staff | Self-rated knowledge increased after intervention |
| Parks et al19 | Measure impact of educational programme | UCBA with 12-month follow-up | 1 nursing home; 32 unqualified nurses, social workers and support staff | Customised non-validated instrument | Specialist knowledge, attitude change, staff confidence | Pre course. Immediate post course | 1-year follow-up with same questionnaire | Staff | Improved knowledge and attitudes to end-of-life care |
| Easom et al20 | Measure impact of educational sessions | UCBA | Number of nursing homes not disclosed; 9 nursing staff | Adapted non-validated instrument | Specialist knowledge and attitudes | Pre course. Immediate post course | None | Staff | The course was positively evaluated and there was change in attitude to what constitutes ‘good death’ |
| Knight et al21 | Assess impact of integrated care pathway | UCBA | 29 care homes; 320 nursing staff | Customised non-validated instrument; audit of case notes | Patient care | Unclear | None | Staff | Staff perceptions at care was good, but this result was not corroborated by case note audit |
| Waldron et al22 | Assess impact of course | UCBA | Number of nursing homes not disclosed; 30 nursing staff | Adapted non-validated instrument | Training satisfaction, specialist knowledge | Unclear | None | Staff | The course was well evaluated, but 83% staff had not cascaded education because of time pressures |
| Badger et al23 | Evaluation of gold standards framework | UCBA | 95 nursing homes; number of staff unclear | Audit of case notes | Patient care | Unclear | None | Unclear | Statistically significant result |
| Arcand et al24 | Assess family satisfaction | UCBA | 1 nursing home; number of staff unclear | Validated instruments | Family satisfaction with care | Pre–post | Post-intervention evaluation at 7 months | Relatives | No significant difference |
| Dryden and Addicott25 | Measure impact of study day | UCBA | Number of nursing homes not disclosed; 52 unqualified nurses and social workers | Customised non-validated instrument; interviews | Knowledge, staff confidence, training satisfaction | Pre and post—immediate | Telephone follow-up interview—6 weeks post-intervention | Staff | Self-reported knowledge and confidence increased, level of satisfaction with the study day was high |
| Hockley et al26 | Evaluate impact of two end-of-life packages | UCBA | 7 nursing homes; staff not disclosed | Audit of case notes; interviews | Patient care | Unclear | None | Staff, relatives | Improvement in all outcome measures |
| Raunkiaen and Timm27 | Improving staff and organisational competencies | Unclear | Number of nursing homes not disclosed; 22 nursing staff | Focus groups | Specialist knowledge | Unclear | None | Staff and educators | Competencies in palliative care were reported to have increased and there was improvement in organisational purpose (not defined) |
| Gatchell et al28 | Increased use of care concepts | UCBA | 5 nursing homes; 124 qualified and unqualified nursing home staff | Customised non-validated instrument | Patient care | Immediate post every session | None | Staff | Application of palliative care concepts increased and was better for staff attending three or more of a total of six sessions |
| Letizia and Jones29 | Evaluate an educational programme | UCBA | Number of nursing homes not disclosed; 107 nursing staff | Adapted validated instrument | Knowledge, staff confidence, training satisfaction | Pre and post | None | Staff | Knowledge and confidence increased, self-reported changes in practice were documented, the programme was well evaluated |
| Finucane et al30 | Follow-up of Hockley et al26 | Follow-up of Hockley et al26 | 7 nursing homes; 20 qualified and unqualified staff including managers, GPs and support staff | Audit of case notes | Patient care | Throughout intervention | None | Unclear | Quality of care on all outcome measures declined |
| Lee et al31 | Impact of educational programme | UCBA | Number of nursing homes not disclosed; 660 nursing staff | Customised non-validated instrument | Specialist knowledge, attitude change | Pre and post | None | Staff | Knowledge improved |
| Pitman32 | Measure impact of self-learning package | UCBA | 3 nursing homes; 33 nursing staff | Validated instrument | Knowledge confidence | Pre and post | 6-Month postal follow-up | Staff | Knowledge and confidence increased |
| Augustsson et al33 | Evaluate workplace learning intervention | UCBA with three follow-ups | 20 nursing homes; 240 support staff | Validated instrument | Staff satisfaction, organisational system | Pre and post | Questionnaires 6 and 12 months. Interview at 14 months | Staff and organisation | Mixed results. No direct impact on end-of-life care measured |
| Farrington34 | Assess impact of an intervention | UCBA | 1 nursing home; 21 unqualified nurses, clerical and support staff | Validated instrument; audit of case notes, interviews and observation | Knowledge, staff confidence, patient care | Pre and post | None | Staff, relatives and organisation | Confidence and self-reported practice improved: advance care planning, anticipatory care and communication. It was not possible to assess changes in death in preferred place |
*Cluster randomised control trial.
†Uncontrolled before and after study.
‡Controlled before and after.