All ETDs from UAB

Advisory Committee Chair

Marie Bakitas

Advisory Committee Members

Adelais Markaki

Nataliya Ivankova

Eulalia Kahwa

Peng Li

Dingle Spence

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Nursing


Universal access to palliative care (PC) is a human right that much of the world has not accomplished and educating a PC workforce is critical to PC advancement. Higher PC disparities exist in low-and-middle income countries, such as Jamaica. The World Health Organization Public Health Model and the International PC Initiative’s PC roadmap emphasize the importance of PC education. The purpose of this mixed methods dissertation study was to investigate the PC experiences and educational needs of healthcare interprofessionals who provide care for patients with late-stage serious illnesses in Jamaica. Three specific aims incorporated quantitative investigation of physicians’, nurses’, and social workers’ PC educational needs using the Jamaica-adapted End-of-Life Professional Caregiver Survey (EPCS-J), a qualitative multiple case study of discipline-specific PC experiences and educational needs, and data integration to determine facilitators and barriers to education. This study included four manuscripts; two complemented an integrative review of literature, and two encompassed the Jamaican adaptation and psychometric testing of the EPCS and the qualitative analyses and results. We surveyed 180 health professionals with the EPCS-J and strategically sampled 13 who engaged in interviews. Interview results were corroborated with reflection notes, clarifying communications, and existing educational materials. We integrated quantitative and qualitative results using joint displays and synthesized findings to determine iii facilitators and barriers and to formulate recommendations. The psychometric properties of the EPCS-J resulted in acceptable reliability and validity. Survey results indicated physicians had higher PC educational needs than nurses and social workers. Qualitative results suggested physicians were most knowledgeable about PC and social workers least. Nurses equated PC with end-of-life care. All disciplines experienced barriers to PC service delivery and education but were motivated to learn about PC, preferring interprofessional platforms to improve collaboration and communication. Facilitators to PC education included health professional motivation, interprofessionalism, funding opportunities, and capitalizing on existing skillsets. Barriers included resource and policy limitations, emigration, and misconceptions about the scope of PC. Recommendations included capitalizing on synergistic international academic partnerships to promote inclusive PC interprofessional educational opportunities and empowering healthcare professionals to lead efforts to diffuse PC across settings.

Included in

Nursing Commons