31\u2005Effectiveness of a palliative care resource toolkit for COVID 19 for low and middle income countries (LMICs) on health care workers knowledge and confidence levels

Abstract

Background Integrated palliative care (PC) has an important role in supporting those affected by the global COVID 19 pandemic. Communication and goals of care, symptom control and holistic support is needed particularly for patients and families living with multi-morbidity and populations in isolation and lockdown. Equipping health care workers (HCW) with core PC competencies is essential and often lacking. Building on models of integrated PC and effective response to humanitarian emergencies in Kerala, we developed and disseminated a Palliative Care in COVID-19 Resource Toolkit for LMICs comprising an e-book, webinars and ECHO platform interactive sessions for HCW. Objective To evaluate the impact of the Resource Toolkit on the knowledge and confidence levels of HCWs. Methods Participants registered for training package completed a pre and post course questionnaire with eighty percent attendance along with giving narrative feedback. Data collected from June to September 2020. Results A total of 388 participants from 8 countries including 24 Indian states; 27% male; median age 33 (20–65); 46% nurses & 27% doctors. There is statistically significant improvement in all factors assessed from pretest to post test. (p=0.000) ) Mean difference in knowledge & confidence in communication, goal setting, physical symptoms management, distress management and EOLC are as follows: 2.57 CI 95% ; (2.21 to 2.93), 2.34 CI 95%; (1.99 to 2.68), 2.72 CI 95%; (2.36 to 3.07), 2.55 CI 95%; (2.20 to 2.90), 2.42 CI 95%; (2.05 to 2.79), 2.38 CI 95%; (2.01 to 2.75), 2.88 CI 95%; (2.51 to 3.24),2.63 CI 95%; (2.27 to 2.99), 3.01 CI 95%; (2.65 to 3.38),2.76 CI 95% (2.39 to 3.13). Conclusion The Toolkit when combined with online interaction can support the integration of PC competencies in health care workers many of whom have no previous exposure to PC. Narrative feedback also supported the place of a safe forum to share. Further study is planned to assess the educational impact on practice. Funding Self-funded.