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Jeon Y, Choi H, Lee U, Kim H. Technology-based interactive communication simulation addressing challenging communication situations for nursing students. J Prof Nurs 2024; 53:71-79. [PMID: 38997201 DOI: 10.1016/j.profnurs.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 05/03/2024] [Accepted: 05/08/2024] [Indexed: 07/14/2024]
Abstract
BACKGROUND Simulation-based interventions for nursing students addressing challenging communication situations involving geriatric patients and end-of-life care are limited. PURPOSE This study evaluated the effects of technology-based interactive communication simulations on nursing students' communication knowledge, self-efficacy, skills, compassion, and program satisfaction. METHOD A randomized controlled repeated-measures design was used with third- and fourth-year nursing students enrolled in five nursing colleges located in five regions in Korea as participants. Participants were randomly assigned to either a technology-based interactive communication simulation or an attention control group. Changes in communication knowledge, self-efficacy, skills, compassion, and program satisfaction were assessed using three self-reported measures and communication skills were measured by the raters. Statistical analyses included descriptive analyses, chi-square tests, t-tests, and a generalized estimating equation model. RESULTS Eighty students participated in one of the two programs, and 77 in the four-week follow-up test. The intervention group indicated significant improvements in communication knowledge, self-efficacy, skills, and compassion, as well as higher program satisfaction compared with the attention control group. Communication skills as assessed by raters also showed significant change at all assessment time points. CONCLUSION The technology-based interactive communication simulation program is effective in improving communication skills among nursing students managing geriatric patients and end-of-life care.
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Affiliation(s)
- Yeseul Jeon
- College of Nursing, Seoul National University, Jongno-gu, Seoul 03080, Republic of Korea.
| | - Heeseung Choi
- College of Nursing, Seoul National University, Jongno-gu, Seoul 03080, Republic of Korea; Research Institute of Nursing Science, Seoul National University, Jongno-gu, Seoul 03080, Republic of Korea.
| | - Ujin Lee
- College of Nursing, Incheon Catholic University, Yeonsu-gu, Incheon 21987, Republic of Korea.
| | - Hannah Kim
- College of Nursing, Seoul National University, Jongno-gu, Seoul 03080, Republic of Korea.
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Çakmak B, Inkaya B. The Effect of a Repeated Standardized Patient-Based End-of-Life Care Training Program on Nursing Students' Knowledge, Attitudes, and Emotions Toward End-of-Life Patients. Am J Hosp Palliat Care 2024:10499091241236921. [PMID: 38437522 DOI: 10.1177/10499091241236921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Sufficient knowledge of end-of-life care, positive attitudes, and emotions regarding death and dying are essential criteria for showcasing favorable palliative care educational results to undergraduate nursing students. However, nursing students have negative attitudes toward end-of-life care and know little about it. AIM This study aimed to examine the effect of a repeated standardized patient-based training program (intervention) on nursing students' knowledge, attitudes, and emotions about end-of-life patients. METHOD This study adopted a pretest-posttest quasi-experimental research design. The sample consisted of 50 fourth-year nursing students divided into intervention (n = 25) and control (n = 25) groups. All participants attended the intervention. The intervention group attended the intervention twice, while the control group attended it only once. Data were collected using a personal information form, the Frommelt Attitudes Toward Care of the Dying Scale, the Positive and Negative Affect Schedule, and the End-of-Life Care Nursing Questionnaire. The data were analyzed using descriptive statistics, Pearson's Chi-square test, dependent groups t test, Pearson-Spearman, Mann-Whitney test, Wilcoxon test, and Friedman test. RESULTS The intervention helped participants learn more about end-of-life care (χ2 = 27.167, P = .000; F = 42.725, P = .000) and develop more positive attitudes toward end-of-life patients (F = 13.279, P = .000; F = 6.934, P = .000). The intervention also helped participants develop communication skills. CONCLUSION Universities should integrate repeated standardized patient-based into nursing curricula.
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Affiliation(s)
- Betül Çakmak
- Department of Nursing, Faculty of Health Sciences, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Bahar Inkaya
- Department of Nursing, Faculty of Health Sciences, Ankara Yildirim Beyazit University, Ankara, Turkey
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Uzun LN, Cerit B. Effect of postmortem care education using a creative drama method on nursing students' knowledge, skills, and satisfaction: A randomized controlled trial. NURSE EDUCATION TODAY 2024; 133:106066. [PMID: 38070291 DOI: 10.1016/j.nedt.2023.106066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/27/2023] [Accepted: 11/27/2023] [Indexed: 01/28/2024]
Abstract
BACKGROUND Postmortem care is one of the most difficult aspects of the nursing profession and is frequently given in healthcare settings today. It is important to provide appropriate teaching experiences in order to prepare nursing students for their future professional roles in postmortem care. OBJECTIVES This study was conducted to examine the effect of a creative drama method on nursing students' postmortem care knowledge and skill levels, learning retention, and satisfaction with the education method. DESIGN A randomized controlled model with a pretest-posttest control group was used in this study. SETTINGS One university school of nursing in Turkey. PARTICIPANTS The sample consisted of 70 nursing students. METHOD Information about postmortem care was shared with the control group using the classical education method of lectures and demonstration techniques, while the experimental group was taught with a creative drama method. Research data were collected with the Descriptive Characteristics Form, Postmortem Care Knowledge Test, Postmortem Care Skills Checklist, and Education Methods Satisfaction Survey. RESULTS It was observed that the postmortem care education provided to both experimental and control group was effective in improving the knowledge and skill levels of nursing students regarding postmortem care (p < 0.05). However, the knowledge and skill levels of the experimental group regarding postmortem care, learning retention, and level of satisfaction with the education method were higher than those of the control group (p < 0.05). CONCLUSION Creative drama was thus found to be a more effective method than the classical education method in providing postmortem care education to nursing students. In addition, it was observed that the students were more satisfied with the education given with creative drama.
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Affiliation(s)
| | - Birgül Cerit
- Bolu Abant Izzet Baysal University, Faculty of Health Science, Fundamental of Nursing Department, 14280 Bolu, Turkey
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Foltz-Ramos K. Experiential Education About Patient Death Designed for Undergraduate Nursing Students. Nurs Educ Perspect 2023; 44:371-373. [PMID: 36877724 DOI: 10.1097/01.nep.0000000000001105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
ABSTRACT New graduate nurses are unprepared for patient death, leading to a potential negative impact on patient care and an increase in turnover. This study investigated the use of high-fidelity simulation to teach about patient death. Senior nursing students ( n = 124) were randomly assigned to rescue or failure-to-rescue scenarios. Outcomes included knowledge and emotional affect. Data analyses included comparative statistics, t -tests, and two-way analysis of variance. Both groups had equal knowledge gain. The failure-to-rescue group had significantly lower emotional affect following simulation but was equal to the rescue group following debriefing.
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Affiliation(s)
- Kelly Foltz-Ramos
- About the Author Kelly Foltz-Ramos, PhD, RN, FNP-BC, CHSE, RHIA, is director of simulation and an assistant professor, University at Buffalo School of Nursing, Buffalo, New York. For more information, contact her at
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Markiewicz A, Hickman RL, McAndrew NS, Reimer A. Enhancing Palliative Communication in the Intensive Care Unit Through Simulation: A Quality Improvement Project. Clin Simul Nurs 2023. [DOI: 10.1016/j.ecns.2023.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
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6
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Conley CE. Student nurses' end-of-life and post mortem care self-efficacy: A descriptive study. NURSE EDUCATION TODAY 2023; 121:105698. [PMID: 36549255 DOI: 10.1016/j.nedt.2022.105698] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 12/02/2022] [Accepted: 12/10/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Student nurses providing end-of-life care reported that caring for a person dying created anxiety, fear, and increased stress and reflected low self-efficacy. New nurses felt unprepared academically and emotionally. High self-efficacy is necessary to handle adverse emotional reactions. However, the literature lacks an instrument to evaluate nursing students' self-efficacy in caring for someone who is dying. OBJECTIVE The study aims to investigate the reliability and validity of the "End-of-Life and Postmortem Self-Efficacy Scale" and explore nursing students' self-efficacy associated with the nursing duties and responsibilities of caring for individuals during the active phase of dying and immediately after death. DESIGN The study was a quantitative descriptive, cross-sectional design. PARTICIPANTS National Student Nurses' Association members enrolled in undergraduate registered nurse associate's, bachelor's degree programs, or a nursing diploma program. METHOD National Student Nurses' Association members responded to an electronic survey containing 18 items related to end-of-life and post mortem nursing responsibilities. RESULTS A total of 498 responses were analyzed. Cronbach's alpha (α = 0.938) showed high reliability of the 18 items on the instrument. The Kaiser-Meyer-Olkin was 0.925 and indicated sampling adequacy. Bartlett's test of sphericity was highly significant (p = .001). The nursing students' mean end-of-life and post mortem self-efficacy score was 62 (scale of 0-100). CONCLUSION The "End-of-Life and Postmortem Self-Efficacy Scale" showed high reliability in evaluating the latent concept of end-of-life and post mortem self-efficacy. The low mean self-efficacy score indicated that nursing students might be underprepared to provide EOL and post mortem care as new graduates. Faculty can use the "End-of-Life and Postmortem Self-Efficacy Scale" to assess student readiness and identify gaps in knowledge in the care of someone who is dying. Future research is needed to determine how increasing nursing students' end-of-life and post mortem self-efficacy influences the perception of end-of-life preparedness.
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Affiliation(s)
- Carol E Conley
- Department of Nursing, Cox College, United States of America.
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Bahceli PZ, Donmez AA, Akca NK. Perceived barriers and motivators of undergraduate nursing students in end-of-life care: A qualitative study based on lived experiences. Perspect Psychiatr Care 2022; 58:2687-2696. [PMID: 35538600 DOI: 10.1111/ppc.13109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/26/2022] [Accepted: 04/29/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The aim of this study is to determine which barriers and motivators undergraduate nursing students perceived during their experience of providing end-of-life (EoL) care. DESIGN AND METHODS Qualitative phenomenological study leans on focus groups. The study was carried out with Zoom, a Web-based mobile video-conferencing application. Students were recruited from two universities in Turkey. Semistructured focus group interviews were conducted with 28 nursing students. The Heidegger phenomenological approach was adopted in this study. FINDINGS Three thematic categories and nine subcategories were determined. While the students stated that insufficient clinical experience, lack of knowledge, the inadequacy of communication techniques, and the insecurity of patients, relatives, and healthcare teams were barriers in EoL care, they stated they were motivated by witnessing the effect of nursing care on patients, integrating their theoretical knowledge into care, applying different communication techniques, and being positive role models of nurses in clinics. PRACTICE IMPLICATIONS As students were not adequately prepared to cope with clinical practices in EoL care, the nursing core curriculum needs revision in this regard. Providing adequate theoretical and clinical training in EoL care will help nursing students manage their emotions and provide high-quality care to patients and their families.
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Affiliation(s)
- Pinar Z Bahceli
- Nursing Department, Faculty of Health Sciences, Izmir Bakircay University, Izmir, Turkey
| | - Ayse A Donmez
- Internal Medicine Nursing Department, Faculty of Nursing, Hacettepe University, Ankara, Turkey
| | - Nazan K Akca
- Nursing Department, Faculty of Health Sciences, Izmir Bakircay University, Izmir, Turkey
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8
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Impact of a Transformed Curriculum on Knowledge and Attitudes Using EOL Simulation. Clin Simul Nurs 2022. [DOI: 10.1016/j.ecns.2022.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Fielding N, Latour JM, Kelsey J. Experiences of Paediatric End-of-Life Simulation in Undergraduate Children's Nursing Students: A Qualitative Study. Clin Simul Nurs 2022. [DOI: 10.1016/j.ecns.2022.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Ozpulat F, Tasdelen Bas M, Molu B. Nursing Students' Compassion and Their Attitudes Toward Death and the Care of the Dying: An Intervention Study ın Turkey. OMEGA-JOURNAL OF DEATH AND DYING 2022; 87:283-298. [PMID: 35167381 DOI: 10.1177/00302228211066982] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This pretest-posttest quasi-experimental study investigated the effect of an educational intervention on nursing students' compassion levels and their attitudes toward death and the care of the dying. Data were collected using the Death Attitude Profile - Revised (DAP-R), the Frommelt Attitude Toward Care Of The Dying (FATCOD) Scale, and the Compassion Scale (CS). The intervention improved participants' DAP-R scores. Participants had higher posttest FATCOD scores than the pretest scores. However, the difference was statistically insignificant. Participants had high CS scores. There was a slight increase in CS scores after the intervention. The results showed that the intervention improved participants' attitudes toward death and the care of the dying. The results also showed that compassion was an important factor.
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Affiliation(s)
- Funda Ozpulat
- Public Health Nursing, Selcuk University, Konya, Turkey
| | | | - Birsel Molu
- Child Health Nursing, Selcuk University, Konya, Turkey
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Köktürk Dalcali B, Taş AS. What Intern Nursing Students in Turkey Think About Death and End-of-Life Care? A Qualitative Exploration. JOURNAL OF RELIGION AND HEALTH 2021; 60:4417-4434. [PMID: 34282510 PMCID: PMC8288065 DOI: 10.1007/s10943-021-01330-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/28/2021] [Indexed: 06/12/2023]
Abstract
This descriptive qualitative study was planned to determine the views of intern nursing students about death and end-of-life care. The study was completed with 12 intern students based on the criterion of data saturation. As a result of the study, the categories of 'end,' 'uncertainty,' 'fear,' 'beginning,' 'helplessness' under the theme of death, 'ensuring peace,' 'continuing communication' 'providing psychosocial/spiritual support,' 'acting in conformity with principles of ethics/morality,' 'continuing to provide physical care,' 'supporting the family,' 'making the best use of the limited remaining time or helping the patient's last wishes come true' under the theme of end-of-life care emerged.
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Affiliation(s)
- Berna Köktürk Dalcali
- Department of Nursing Fundamentals, Faculty of Health Sciences, Bandırma Onyedi Eylül University, Bandırma, Balıkesir Turkey
| | - Ayşe Sinem Taş
- Department of Nursing Fundamentals, Faculty of Health Sciences, Bandırma Onyedi Eylül University, Bandırma, Balıkesir Turkey
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12
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Escribano S, Cabañero-Martínez MJ, Fernández-Alcántara M, García-Sanjuán S, Montoya-Juárez R, Juliá-Sanchis R. Efficacy of a Standardised Patient Simulation Programme for Chronicity and End-of-Life Care Training in Undergraduate Nursing Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111673. [PMID: 34770187 PMCID: PMC8583232 DOI: 10.3390/ijerph182111673] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/28/2021] [Accepted: 11/04/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Standardised patient simulations seem to be useful for improving the communication skills of health sciences students. However, it is important to define the effectiveness of these types of interventions in complex scenarios linked to disease chronicity and end-of-life contexts. METHODS A quasi-experimental study with pre- and post-intervention measures was carried out in a single group. A total of 161 nursing students completed different assessment instruments to measure their attitudes towards communication (Attitude Toward Communication Scale), self-efficacy (Self-Efficacy of Communication Skills, SE-12), and communication skills (Health Professionals Communication Skills Scale, EHC-PS) before and after simulation training with standardised patients. The objective of the program was to train students in non-technical skills for complex situations involving chronicity and end-of-life care. It comprised eight sessions lasting 2.5 h each. RESULTS The results showed notable baseline gender differences in attitudes towards communication and in the informative communication dimension, with women obtaining higher scores. The participants' self-efficacy and communication skills significantly improved after completing the intervention, with no significant differences being found for the attitudes towards communication variable. CONCLUSION The standardised patient simulation programme for complex scenarios related to chronicity and end-of-life contexts improved communication self-efficacy and communication skills in these nursing students. In future work it will be important to analyse the influence of gender and attitudes towards communication as variables in the learning of communication skills in nursing students.
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Affiliation(s)
- Silvia Escribano
- Department of Nursing, Faculty of Health Sciences, Institute for Health and Biomedical Research (ISABIAL), University of Alicante, 03690 San Vicente del Raspeig, Spain; (S.E.); (S.G.-S.); (R.J.-S.)
| | - María José Cabañero-Martínez
- Department of Nursing, Faculty of Health Sciences, Institute for Health and Biomedical Research (ISABIAL), University of Alicante, 03690 San Vicente del Raspeig, Spain; (S.E.); (S.G.-S.); (R.J.-S.)
- Correspondence:
| | - Manuel Fernández-Alcántara
- Department of Health Psychology, Faculty of Health Sciences, University of Alicante, 03690 San Vicente del Raspeig, Spain;
| | - Sofía García-Sanjuán
- Department of Nursing, Faculty of Health Sciences, Institute for Health and Biomedical Research (ISABIAL), University of Alicante, 03690 San Vicente del Raspeig, Spain; (S.E.); (S.G.-S.); (R.J.-S.)
| | - Rafael Montoya-Juárez
- Department of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain;
| | - Rocío Juliá-Sanchis
- Department of Nursing, Faculty of Health Sciences, Institute for Health and Biomedical Research (ISABIAL), University of Alicante, 03690 San Vicente del Raspeig, Spain; (S.E.); (S.G.-S.); (R.J.-S.)
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Condry HM, Kirkpatrick AJ. Simulation in End-of-Life Nursing Education: A Literature Review. Clin Simul Nurs 2021. [DOI: 10.1016/j.ecns.2021.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Gocmen Baykara Z, Keles S, Demir Karabulut S, Gul S, Eren H, Durmus Iskender M, Yildiz A, Kavas MV, Yalim NY. The effect of professional education on medical and nursing students' attitudes toward death. DEATH STUDIES 2020; 46:1728-1740. [PMID: 33287666 DOI: 10.1080/07481187.2020.1850546] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This qualitative study aims to reveal the effect of professional education on medical and nursing students' attitudes toward death. The study was carried out with nursing and medical students (N = 197). Research data was collected through semi-structured interview questions and 23 focus group interviews. The data was assessed using thematic analysis method. The themes were evaluated within the context of perception of death, ethical dilemmas, and, death education. To achieve professional competency in attitudes toward death, it is imperative to form a common educational curriculum and practice that would help students develop a mutual language and value system about death.
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Affiliation(s)
| | - Sukru Keles
- Department of Medical Ethics and History, Karadeniz Technical University, Trabzon, Turkey
| | | | - Senay Gul
- Fundamentals of Nursing Department, Hacettepe University, Ankara, Turkey
| | - Handan Eren
- Department of Nursing, Yalova University, Yalova, Turkey
| | | | - Abdullah Yildiz
- Department of Medical Ethics and History, Ankara University, Ankara, Turkey
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Measuring Compassionate Care among Interprofessional Health Care Teams: Developing and Testing the Feasibility of a Collaborative Behaviors Observational Assessment Tool. Clin Simul Nurs 2020. [DOI: 10.1016/j.ecns.2020.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Chover-Sierra E, Martínez-Sabater A. Analysis of Spanish nursing students' knowledge in palliative care. An online survey in five colleges. Nurse Educ Pract 2020; 49:102903. [PMID: 33086138 DOI: 10.1016/j.nepr.2020.102903] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 09/11/2020] [Accepted: 10/06/2020] [Indexed: 11/28/2022]
Abstract
Along their professional career, nurses can find patients who require palliative care (PC). It is necessary to have at least a basic education in this area, that should be acquired during their university education. The objective of this descriptive online-survey set in five nursing Colleges was to analyze Spanish nursing students' knowledge in PC, offering an image of the status of education in PC. 619 students took an online questionnaire with the Spanish version of the Palliative Care Quiz for Nurses (PCQN-SV), which also collected information about their education in the field of PC. Univariate and bivariate analyses were performed, and a predictive binary logistic regression model was developed. Students obtained an average 45.65% of right answers in PCQN-SV, with differences related to the college and academic year in which they were enrolled and to their education in PC. In the regression model having theoretical education in PC (OR = 1.70) and academic year (OR = 1.35) showed to be both predictors of getting a result in PCQN-SV over 45% of correct answers. This study showed that Spanish nursing students have a medium-low level of knowledge in PC, and it also supports the need to develop a common framework for nurses' education in PC.
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Affiliation(s)
- Elena Chover-Sierra
- Nursing Department, University of Valencia, Jaume Roig, s/n, 46010, Valencia, Spain; Consorcio Hospital General Universitario, Av. Tres Cruces, 2, 46014, Valencia, Spain.
| | - Antonio Martínez-Sabater
- Nursing Department, University of Valencia, Jaume Roig, s/n, 46010, Valencia, Spain; Hospital Clínico Universitario, Av. Blasco Ibañez, 17, 46010, Valencia, Spain.
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Carvalho LG, Hamilton HM, Burke ME, McDonald C, Griggs S. End-of-Life Nursing Knowledge Among Nursing Students. J Nurs Educ 2020; 59:154-157. [PMID: 32130417 PMCID: PMC7156273 DOI: 10.3928/01484834-20200220-06] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Accepted: 11/04/2019] [Indexed: 01/21/2023]
Abstract
BACKGROUND The U.S. health care system is poorly designed to meet the needs of patients at the end of life (EOL) and their families. Nursing students often have reported feeling inadequate to provide EOL care. METHOD Following an EOL simulation, reflective journals were collected from junior and senior nursing students and analyzed for themes using qualitative content analysis. The condensed meaning units were abstracted into codes based on Carper's fundamental patterns of knowing. RESULTS Thirty-one junior and senior nursing students (mean age, 21.04 ± 0.52 years, 96.2% female) in a baccalaureate program participated in the study. The broad themes of student reflections included empirics (theoretical or natural historical) aesthetics (transformative nursing action), personal (interpersonal process of nurse-patient interaction), and ethics (emotion influences actions). CONCLUSION Student perception and participation in all roles contributes to the gestalt of the experience of a highly emotional EOL simulation for both students and faculty. [J Nurs Educ. 2020;59(3):154-157.].
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Trowbridge A, Bamat T, Griffis H, McConathey E, Feudtner C, Walter JK. Pediatric Resident Experience Caring for Children at the End of Life in a Children's Hospital. Acad Pediatr 2020; 20:81-88. [PMID: 31376579 PMCID: PMC6944767 DOI: 10.1016/j.acap.2019.07.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 06/11/2019] [Accepted: 07/16/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Pediatric residents are expected to be competent in end-of-life (EOL) care. We aimed to quantify pediatric resident exposure to patient deaths, and the context of these exposures. METHODS Retrospective chart review of all deceased patients at one children's hospital over 3 years collected patient demographics, time, and location of death. Mode of death was determined after chart review. Each death was cross-referenced with pediatric resident call schedules to determine residents involved within 48 hours of death. Descriptive statistics are presented. RESULTS Of 579 patients who died during the study period, 46% had resident involvement. Most deaths occurred in the NICU (30% of all deaths); however, resident exposure to EOL care most commonly occurred in the PICU (52% of resident exposures) and were after withdrawals of life-sustaining therapy (41%), followed by nonescalation (31%) and failed resuscitation (15%). During their postgraduate year (PGY)-1, <1% of residents encountered a patient death. During PGY-2 and PGY-3, 96% and 78%, respectively, of residents encountered at least 1 death. During PGY-2, residents encountered a mean of 3.5 patient deaths (range 0-12); during PGY-3, residents encountered a mean of 1.4 deaths (range 0-5). Residents observed for their full 3-year residency encountered a mean of 5.6 deaths (range 2-10). CONCLUSIONS Pediatric residents have limited but variable exposure to EOL care, with most exposures in the ICU after withdrawal of life-sustaining technology. Educators should consider how to optimize EOL education with limited clinical exposure, and design resident support and education with these variable exposures in mind.
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Affiliation(s)
- Amy Trowbridge
- Division of Bioethics and Palliative Care, Seattle Children's Hospital and University of Washington (A Trowbridge), Seattle, Wash.
| | - Tara Bamat
- Pediatric Advanced Care Team, The Children's Hospital of Philadelphia (T Bamat, E McConathey, C Feudtner, and JK Walter), Philadelphia, Pa
| | - Heather Griffis
- PolicyLab, The Children's Hospital of Philadelphia (H Griffis), Philadelphia, Pa
| | - Eric McConathey
- Pediatric Advanced Care Team, The Children's Hospital of Philadelphia (T Bamat, E McConathey, C Feudtner, and JK Walter), Philadelphia, Pa
| | - Chris Feudtner
- Pediatric Advanced Care Team, The Children's Hospital of Philadelphia (T Bamat, E McConathey, C Feudtner, and JK Walter), Philadelphia, Pa; Department of Medical Ethics, The Children's Hospital of Philadelphia (C Feudtner and JK Walter), Philadelphia, Pa
| | - Jennifer K Walter
- Pediatric Advanced Care Team, The Children's Hospital of Philadelphia (T Bamat, E McConathey, C Feudtner, and JK Walter), Philadelphia, Pa; Department of Medical Ethics, The Children's Hospital of Philadelphia (C Feudtner and JK Walter), Philadelphia, Pa
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Dobrowolska B, Mazur E, Pilewska-Kozak A, Dońka K, Kosicka B, Palese A. Predicted difficulties, educational needs, and interest in working in end of life care among nursing and medical students. NURSE EDUCATION TODAY 2019; 83:104194. [PMID: 31493620 DOI: 10.1016/j.nedt.2019.08.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 07/05/2019] [Accepted: 08/15/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The need to provide care for the dying patient and his/her family may occur in every medical setting. Newly graduated nurses and physicians should therefore be prepared to deliver it at a high-quality level. OBJECTIVES To explore (a) the primary difficulties participants anticipate they will encounter whilst working with dying patients, (b) their interest in developing competencies in caring for dying patients, and (c) their interest in working in palliative/hospice settings or with dying patients in the future. DESIGN A cross-sectional study. SETTINGS A medical university in Poland. PARTICIPANTS Convenience sample of nursing (=112) and medical students (=101) at the end of their undergraduate education. METHODS Questionnaire distributed online and in hard-copy format. RESULTS Half of the participants anticipated experiencing various emotional and professional difficulties in caring for dying individuals, especially medical students. These difficulties pertained mostly the reaction of family members to the patient's death, addressing the psychological needs of the dying person, and coping with his/her own emotions when dealing with the patient's death. Students reported that working with dying patients could cause occupational stress - more so among medical students. The majority of them showed an interest in improving knowledge regarding palliative care and also in this case this was mostly true of medical rather than nursing students. However, more than half of the participants preferred avoiding work in palliative/hospice settings, with no differences between the two groups. Participants attributed this attitude to two factors: (a) the desire to avoid negative emotions and stress that could be triggered by dealing with death and dying; and (b) because they felt they lacked the required skills and personal abilities to handle such situations. CONCLUSIONS Undergraduate curricula that include strategies for coping with negative emotions associated with facing the process of death and dying should be developed. Interprofessional education should be encouraged, especially regarding the psychosocial aspects of end-of-life care.
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Affiliation(s)
- Beata Dobrowolska
- Department of Development in Nursing, Faculty of Health Sciences, Medical University of Lublin, Staszica Street 4-6, 20-081 Lublin, Poland.
| | - Ewelina Mazur
- Department of Infectious Diseases for Children in the Jan Boży Hospital in Lublin, Biernackiego Street 9, 20-089 Lublin, Poland
| | - Anna Pilewska-Kozak
- Chair and Department of Gynaecology and Gynaecological Endocrinology, The Faculty of Health Sciences, Medical University of Lublin, Staszica Street 4-6, 20-081 Lublin, Poland.
| | - Katarzyna Dońka
- Chair and Department of Paediatric Nursing, The Faculty of Health Sciences, Medical University of Lublin, Staszica Street 4-6, 20-081 Lublin, Poland.
| | - Bogumiła Kosicka
- Chair and Department of Management in Nursing, The Faculty of Health Sciences, Medical University of Lublin, Staszica Street 4-6, 20-081 Lublin, Poland.
| | - Alvisa Palese
- School of Nursing, Department of Medical Sciences, University of Udine, Viale Ungheria, 20, 33100 Udine, Italy.
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Nwosu AC, Sturgeon B, McGlinchey T, Goodwin CD, Behera A, Mason S, Stanley S, Payne TR. Robotic technology for palliative and supportive care: Strengths, weaknesses, opportunities and threats. Palliat Med 2019; 33:1106-1113. [PMID: 31250734 PMCID: PMC6691596 DOI: 10.1177/0269216319857628] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Medical robots are increasingly used for a variety of applications in healthcare. Robots have mainly been used to support surgical procedures, and for a variety of assistive uses in dementia and elderly care. To date, there has been limited debate about the potential opportunities and risks of robotics in other areas of palliative, supportive and end-of-life care. AIM The objective of this article is to examine the possible future impact of medical robotics on palliative, supportive care and end-of-life care. Specifically, we will discuss the strengths, weaknesses, opportunities and threats (SWOT) of this technology. METHODS A SWOT analysis to understand the strengths, weaknesses, opportunities and threats of robotic technology in palliative and supportive care. RESULTS The opportunities of robotics in palliative, supportive and end-of-life care include a number of assistive, therapeutic, social and educational uses. However, there are a number of technical, societal, economic and ethical factors which need to be considered to ensure meaningful use of this technology in palliative care. CONCLUSION Robotics could have a number of potential applications in palliative, supportive and end-of-life care. Future work should evaluate the health-related, economic, societal and ethical implications of using this technology. There is a need for collaborative research to establish use-cases and inform policy, to ensure the appropriate use (or non-use) of robots for people with serious illness.
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Affiliation(s)
- Amara Callistus Nwosu
- 1 Academic Palliative & End of Life Care Department, Royal Liverpool & Broadgreen University Hospitals NHS Trust, Liverpool, UK.,2 Palliative Care Institute Liverpool (PCIL), University of Liverpool, Liverpool, UK.,3 Marie Curie Hospice Liverpool, Liverpool, UK
| | - Bethany Sturgeon
- 4 Bristol Robotics Laboratory, University of Bristol, Bristol, UK
| | - Tamsin McGlinchey
- 2 Palliative Care Institute Liverpool (PCIL), University of Liverpool, Liverpool, UK
| | - Christian Dg Goodwin
- 2 Palliative Care Institute Liverpool (PCIL), University of Liverpool, Liverpool, UK.,5 US-UK Fulbright Commission, London, UK
| | - Ardhendu Behera
- 6 Department of Computer Science, Edge Hill University, Ormskirk, UK
| | - Stephen Mason
- 2 Palliative Care Institute Liverpool (PCIL), University of Liverpool, Liverpool, UK
| | | | - Terry R Payne
- 7 Department of Computer Science, University of Liverpool, Liverpool, UK
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Mathew R, Weil A, Sleeman KE, Bristowe K, Shukla P, Schiff R, Flanders L, Leonard P, Minton O, Wakefield D, St John K, Carey I. The Second Conversation project: -Improving training in end of life care communication among junior doctors. Future Healthc J 2019; 6:129-136. [PMID: 31363520 PMCID: PMC6616182 DOI: 10.7861/futurehosp.6-2-129] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Junior doctors describe a need for greater support and training in end of life care (EoLC) communication skills. The Second Conversation project was designed by a multi-professional steering group as a workplace based training intervention for junior doctors to improve their skills and confidence in undertaking EoLC conversations. Qualitative interviews were carried out with 11 junior doctors and five senior doctors across two sites who took part in, or facilitated, a 'second conversation'. This is a three-step training intervention that involves 1) observation - the junior doctor observes an EoLC conversation between a senior doctor and patient/caregiver; 2) direct experience - the junior doctor undertakes a follow-up second conversation with the patient/caregiver; and 3) reflection - the junior doctor discusses and reflects on the experience with a senior colleague. Interviews were analysed using framework analysis and findings informed iterative changes to the intervention and its implementation using 'Plan, Do, Study, Act' cycles. Benefits that were identified included the flexibility of the intervention and its positive impact on the confidence and skills of junior doctors. The Second Conversation was felt to be of most value to newly qualified doctors and worked well on wards where length of stay was longer and EoLC conversations frequently happen. Further evaluation and exploration of patient and caregiver experiences is required.
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Affiliation(s)
- Rammya Mathew
- Wembley Park Drive Medical Centre and Islington GP Federation, Wembley, UK
| | - Anna Weil
- North London Hospice and Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, London, UK
| | - Katherine E Sleeman
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, London, UK
| | - Katherine Bristowe
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, London, UK
| | | | | | - Lucy Flanders
- St George's University Hospitals NHS Foundation Trust, London, UK
| | | | - Ollie Minton
- Brighton and Sussex University Hospitals NHS Trust, Brighton UK
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23
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Glover TL, Åkerlund H, Horgas AL, Bluck S. Experiential Palliative Care Immersion: Student Nurse's Narratives Reflect Care Competencies. West J Nurs Res 2019; 41:1465-1480. [PMID: 30782099 DOI: 10.1177/0193945919833061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Many nurses report a lack of confidence providing care for patients facing a life-threatening illness. Palliative care leaders have devised primary palliative nursing care competencies (CARES [Competencies And Recommendations for Educating undergraduate nursing Students]) that all students should achieve. In this study, nursing students participated in an innovative palliative care immersion experience, the Comfort Shawl Project. We performed a reliable content analysis of their narrative reflections. The goal was to evaluate whether reflections on their interactions with patients/families were consistent with CARES competencies. Nine female students wrote reflections after gifting each of the 234 comfort shawls to patients. Four CARES-related categories were analyzed: Individual Values and Diversity, Compassionate Communication, Fostering Quality of Life, and Self-Insight and Emotion. Reflections were highly representative (41%) of recognizing Individual Values and Diversity, representing sensitivity for patients' unique differences in values, an integral component of palliative care. The Comfort Shawl Project shows promise as an experiential immersion for introducing nursing students to CARES competencies.
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Glover TL, Narvel NR, Schneider LA, Horgas AL, Bluck S. Nursing Students' Reactions to an Educational Experiential Immersion in Palliative Care. J Nurs Educ 2018; 57:675-679. [DOI: 10.3928/01484834-20181022-08] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 07/27/2018] [Indexed: 11/20/2022]
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Smith MB, Macieira TGR, Bumbach MD, Garbutt SJ, Citty SW, Stephen A, Ansell M, Glover TL, Keenan G. The Use of Simulation to Teach Nursing Students and Clinicians Palliative Care and End-of-Life Communication: A Systematic Review. Am J Hosp Palliat Care 2018. [PMID: 29514480 PMCID: PMC6039868 DOI: 10.1177/1049909118761386] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objectives: To present the findings of a systematic review on the use of simulation-based learning experiences (SBLEs) to teach communication skills to nursing students and clinicians who provide palliative and end-of-life care to patients and their families. Background: Palliative care communication skills are fundamental to providing holistic patient care. Since nurses have the greatest amount of direct exposure to patients, building such communication competencies is essential. However, exposure to patients and families receiving palliative and end-of-life care is often limited, resulting in few opportunities to learn these skills in the clinical setting. Simulation-based learning experiences can be used to supplement didactic teaching and clinical experiences to build the requisite communication skills. Methods: Searches of CINAHL, MEDLINE, PsychINFO, ERIC, and Web of Science electronic databases and Grey Literature returned 442 unique records. Thirty articles met the established criteria, including the SBLE must contain a nursing role. Results: Simulation-based learning experience are being used to teach palliative and end-of-life communication skills to nursing students and clinicians. Lack of standardization, poor evaluation methods, and limited exposure to the entire interprofessional team makes it difficult to identify and disseminate validated best practices. Conclusion: While the need for further research is acknowledged, we recommend this evidence be augmented by training programs that utilize SBLEs through (1) applying standards, (2) clearly specifying goals and objectives, (3) integrating externally validated scenarios, and (4) employing rigorous evaluation methods and measures that link the SBLE to the training objectives and desired clinician practice behaviors and patient outcomes.
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Affiliation(s)
- Madison B Smith
- 1 College of Nursing, University of Florida, Gainesville, FL, USA
| | | | - Michael D Bumbach
- 2 College of Nursing, Family, Community, and Health System Science, University of Florida, Gainesville, FL, USA
| | | | - Sandra W Citty
- 2 College of Nursing, Family, Community, and Health System Science, University of Florida, Gainesville, FL, USA
| | - Anita Stephen
- 4 College of Nursing, Biobehavioral Nursing Science, University of Florida, Gainesville, FL, USA
| | - Margaret Ansell
- 5 Health Science Center Libraries, University of Florida, Gainesville, FL, USA
| | - Toni L Glover
- 4 College of Nursing, Biobehavioral Nursing Science, University of Florida, Gainesville, FL, USA
| | - Gail Keenan
- 2 College of Nursing, Family, Community, and Health System Science, University of Florida, Gainesville, FL, USA
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