Effects of Self-Efficacy Enhancement Program on Perceived Self-Efficacy in Palliative Care for Terminally Ill Older Patients with Dyspnea among Registered Nurses in Medical Department, Tertiary Hospital

Abstract

This quasi-experimental research aimed to investigate the effects of a self-efficacy enhancement program on perceived self-efficacy in palliative care for terminally ill older patients with dyspnea among registered nurses, using Bandura’s self-efficacy theory and authentic learning concept as the conceptual framework.The participants were 45 registered nurses working in the inpatient ward, Medical Department in a tertiary hospital in the Northeastern region of Thailand. They were selected by a simple random sampling method and divided into an experimental group of 21 people and a control group of 24 people. The experimental group received the self-efficacy enhancement program, consisting of four activities over a period of four weeks: week 1: theoretical and practical training; week 2: practical training at the ward; week 3: self-practice training; and week 4: knowledge sharing and summary of learning. The control group did not receive the program. The instruments included (1) the research instrument, which was the self-efficacy enhancement program, and (2) the data collection instruments, which were the demographic information questionnaire and the nurses’ perceived self-efficacy questionnaire. All research instruments were tested for content validity. The content validity (CVI) of all instruments was 1.0 and the reliability value of the perceived self-efficacy questionnaire was 0.95. Data were analyzed using descriptive statistics, and hypotheses were tested using independent t-test and paired t-test. The research findings revealed that the nurses who received the self-efficacy enhancement program had higher perceived self-efficacy in providing palliative care for terminally ill older patients with dyspnea (mean±SD= 100.90±7.15) than the nurses who did not receive the program (mean±SD=74.58±9.55) with statistical significance (mean differences = 26.32, 95%CI: 21.28 to 31.36, p<0.001), and after receiving the self-efficacy enhancement program, the nurses had higher perceived self-efficacy in providing palliative care for terminally ill older patients with dyspnea (mean±SD = 100.90±7.15) than before receiving the program (mean±SD = 69.52±17.33) with statistical significance (mean differences = 31.38, 95%CI: 24.90 to 37.86, p-value<0.001). These findings indicate that the self-efficacy enhancement program in this study increased the nurses’ perceived self-efficacy in palliative care for terminally ill older patients with dyspnea. Therefore, this program should be used as a guideline to promote perceived self-efficacy among registered nurses providing palliative care for terminally ill older patients so that appropriate and quality care for terminally ill older patients with dyspnea will be provided.