Table 4.
Competencies Required for Specialist Palliative Care Level with the Number of Codes Included in Each Category (f)
| Findings of the first part of the specialist level analysis | |
| Main category | Subcategory |
|
(4) Competence in encountering the patient and her/his closest one (f = 64
a
)
(f = 70 b from both basic and specialist level data) |
Three subcategories on the basic level (see
Table 3) (76) Encounters with children (f = 3c) (77) Confidence in constructive encounters (f = 2c) (78) Patient-based encounters (f = 1c) |
|
(7) Competence in pharmacological treatment (f = 39
a
)
(f = 42 b from both basic and specialist level data) |
Four subcategories on the basic level (see
Table 3) (79) Extensive expertise in pharmacological treatment (f = 3c) |
|
(9) Competence in setting goals of care and advanced care planning (f = 31
a
)
(f = 36 b from both basic and specialist level data) |
Five subcategories on the basic level (see
Table 3) (80) Advanced expertise in setting of care goals (f = 1c) (81) Participation as an expert in advanced care planning and setting goals of care (f = 4c) |
|
(13) Competence in care of an end-of-life patient and her/his closest ones (f = 25
a
)
(f = 31 b from both basic and specialist level data) |
Four subcategories on the basic level (see
Table 3
)
(82) Addressing patient's convictions at the end of life and after death (f = 2 c ) (83) Supporting the closest ones after the patient's death (f = 3 c ) (84) Assessment of unnecessary nursing practices (f = 1 c ) |
|
(15) Ethical and juridical competence
(f = 18 a ) (f = 21 b from both generalist and specialist level data) |
Six subcategories on the basic level (see
Table 3) (85) Assessment of ethical issues and discussing them with the patient (f = 3c) |
|
(17) Competence in existential questions (f = 8a) (f = 13bfrom both basic and specialist level data) |
Two subcategories on the basic level (see
Table 3) (86) Advanced expertise in dealing with death (f = 1c) (87) Addressing existential suffering (f = 4c) |
| Findings of the second part of the specialist level analysis | |
| Main category | Subcategory |
| (18) Competence in maintaining expertise and taking care of own well-being at work (f = 34 d ) |
(88) Active self-development (f = 5
c
)
(89) Postgraduate education (f = 6 c ) (90) Strong clinical know-how (f = 4 c ) (91) Autonomous decision-making and expertise (f = 10 c ) (92) Critical thinking and reflection (f = 2 c ) (93) Recognition of one's own limits and acceptance of support (f = 7 c ) |
| (19) Advanced symptom management in nursing care of patients in palliative care (f = 26 d ) |
(94) Extensive know-how in symptom management (f = 4
c
)
(95) Assessment and management of advanced symptoms (f = 4 c ) (96) Palliative sedation and the issues related to it (f = 6 c ) (97) Special techniques for the management of symptoms (f = 6 c ) (98) Autonomous management of symptoms (f = 1 c ) (99) Acute situations in palliative care (f = 5 c ) |
| (20) Teaching, development and research competence in palliative care (f = 20 d ) |
(100) Educating about palliative care (f = 12
c
)
(101) Development of palliative care (f = 6 c ) (102) Researching phenomena linked to palliative care (f = 2 c ) |
| (21) Extensive competence in palliative nursing care of special groups (f = 20 d ) |
(103) Palliative care for different special groups (f = 10
c
)
(104) Palliative care for children and adolescents (f = 7 c ) (105) Palliative care for mentally retarded persons (f = 2 c ) (106) Palliative care for lonely persons (f = 1 c ) |
| (22) Competence in advanced support to patient in palliative care, and her/his closest ones (f = 19 d ) |
(107) Assessment of the need for social support in patients and their closest ones, along with the provision of support (f = 6
c
)
(108) Provision of support for grief work (f = 5 c ) (109) Advanced psychosocial support (f = 3 c ) (110) Specialized support for families with children (f = 5 c ) |
| (23) Extensive competence in coordination of palliative care (f = 19 d ) |
(111) Collaboration with the third sector (f = 1
c
)
(112) Coordination of the patient's care chain and ensuring the continuity of patient's care (f = 10 c ) (113) Coordination of large networks and management of the collaboration of networks (f = 6 c ) (114) End-of-life care at home (f = 1 c ) (115) Effects of the care environment on the patient (f = 1 c ) |
| (24) Advanced competence in patient education and consultations (f = 12 d ) |
(116) Advanced patient education in different situations (f = 3
c
)
(117) Strong competence in consultations (f = 3 c ) (118) Consultative support for different palliative care provision levels and health care settings (f = 6 c ) |
| (25) Advanced competence in pain management and pain management nursing (f = 11 d ) |
(119) Extensive expertise in pain management (f = 3
c
)
(120) Management of special techniques in pain management (f = 8 c ) |
| (26) Special competence in palliative care (f = 8 d ) |
(121) Extensive expertise in palliative care as a part of nurse's work (f = 4
c
)
(122) Assessment and anticipation of the patient's needs in special situations and anticipation of them in palliative nursing (f = 4 c ) |
| (27) Competence in demanding social interactions (f = 7 d ) |
(123) Management of demanding social interaction situations (f = 6
c
)
(124) Breaking bad news with an active approach (f = 1 c ) |
Categories identified from the basic level data are marked with italics; categories identified from the specialist level data are given in bold.
a
Codes included in the basic level main category.
b
Codes included in the main categories from both basic and specialist level data.
c
Codes included in each subcategory unique to specialist level.
d
Codes included in each main category unique to specialist level.
f, number of codes.