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Education in advanced disease: professionals' knowledge, attitudes and ability
  1. K Flemming1,
  2. S J Closs2,
  3. R Foy2 and
  4. M I Bennett3
  1. 1The University of York, York, UK
  2. 2The University of Leeds, Leeds, UK
  3. 3Lancaster University, Lancaster, UK


Introduction and aims The management of symptoms and lifestyle in advanced disease are essential for the maintenance of patients' quality of life. Health care professionals can facilitate patients to optimise disease management by providing appropriate education. While the provision of education by health professionals for patients with advanced cancer is reasonably well documented, less attention has been paid to other advancing progressive diseases. The aim of this review was to synthesise qualitative research which examined health care professionals' knowledge, attitudes and ability towards delivering educational interventions to patients with the following advanced progressive diseases: heart failure, chronic respiratory disease, end stage renal disease and neuromuscular disorders.

Methods The synthesis was conducted using meta-ethnography. Systematic searching of five electronic databases (CINAHL, Medline, PsychInfo, Web of Science Social Science Citation Index and EMBASE) occurred. Included papers were data extracted and assessed for quality.

Results The searches identified 911 records, of which 17 met the inclusion criteria for the review. Three key themes influencing the delivery of education to patients with advanced disease were identified:

  1. Capacity (to educate and aid decision-making)

  2. Context (of educational delivery)

  3. Timing (of education).

Conclusion A range of enablers and barriers identified by health care professionals influence their ability to deliver education at the end of life. Therefore, any interventions to change practice need to have multiple components, rather than targeting sole aspects such as knowledge or motivation alone. Strategies for improving educational practice should explicitly target factors judged as important and potentially amenable to change.

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