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With healthcare shifting to the community, the vast majority of homecare is provided by Certified Nursing Assistants. CNAs are a crucial connection in communication between the client and the Registered Nurse to implement early palliative care.The purpose of the study was to examine the effects of COMFORTTM SM palliative care communication training on the willingness to initiate communication, communication apprehension, and self-perceived communication competence, as well as relational social capital, among community-based homecare RNs and CNAs across time. The study used a one-group pre-/post-test within-subject repeated measures design. The sample included 32 CNAs. Eighteen CNAs completed all three time points. RNs were dropped from inferential analyses.In this study, communication training was operationalized by the COMFORTTM SM Model which represents the seven basic principles of palliative care and is based on narrative, relational communication. The curriculum was developed by Drs. Wittenberg-Lyles et al.While there appeared to be some descriptive changes over time, the vast majority of changes were statistically non-significant, but effect sizes were often moderate to large and would need to be validated in larger samples. Modest findings did provide initial support that community-based homecare CNAs may benefit from communication training to increase their WTC about palliative care to and for older adults. Modest findings also provided initial support that communication training may decrease CNAs’ apprehension depending on the context. Additionally, while SPCC decreased following training in all contexts, SPCC had modest improvements in communicating with strangers and acquaintances over time. Finally, trust significantly increased over time. Certified nursing assistants, as essential links between clients and RNs, may benefit from ongoing palliative care communication training to facilitate connection between the client and the RN. A willingness to initiate communication, both with the client and the RN, can increase palliative care referrals for homebound older adults who would benefit from an early and ongoing palliative approach to care. |
