The Effects of a Competency Development Program in Community-Based Palliative Care for Terminally Ill Patients by Professional Nurses at Sub-District Health Promoting Hospitals, Kra Buri District, Ranong Province

Abstract

                This quasi-experimental study aimed to compare the knowledge, skills, and attitudes of professional nurses toward community-based palliative care for terminally ill patients at sub-district health-promoting hospitals in Kra Buri District, Ranong Province, before and after participating in a competency development program. Additionally, it sought to compare the outcomes between the experimental and comparison groups. A total of 32 participants were purposively selected and divided into two groups: an experimental group (n = 16) and a comparison group (n = 16). The intervention consisted of a competency development program based on Ralph W. Tyler's theory and the Nursing Council of Thailand's competency framework (2015). Assessment instruments included a 30-item knowledge questionnaire (KR-20 = 0.71), a 65-item skills assessment form (Cronbach's alpha = 0.95), and a 30-item attitude assessment form (Cronbach's alpha = 0.80). Content validity was verified by five experts, yielding IOC values of 0.80, 0.94, and 0.80, respectively. Data were analyzed using descriptive statistics, the Chi-square test, the Wilcoxon signed-rank test, and the Mann-Whitney U test.

               The results showed that the experimental group's mean scores significantly increased after the program: knowledge scores increased from 17.44 (SD = 3.22) to 24.56 (SD = 2.34), skills scores increased from 151.56 (SD = 24.11) to 188.69 (SD = 10.59), and attitude scores increased from 47.19 (SD = 7.52) to 69.06 (SD = 4.96), with all three domains showing statistically significant differences (p < .001). When comparing between groups, the experimental group demonstrated significantly higher mean scores in knowledge, skills, and attitudes than the comparison group (p < .001). In conclusion, the competency development program for community-based palliative care for terminally ill patients effectively enhanced professional nurses' knowledge, skills, and attitudes at sub-district health-promoting hospitals.