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Lippe MP, Wingett G, Davis A, Jizba T, Ehrlich O, Cormack CL, Fasolino T, Glover TL, Meskis S, LeBlanc RG, Weiss D, Kirkpatrick AJ. Instruments for Evaluating Student Learning Outcomes in Palliative Care: A Literature Review. J Hosp Palliat Nurs 2024; 26:265-272. [PMID: 39016275 DOI: 10.1097/njh.0000000000001051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2024]
Abstract
Primary palliative care is a core component of nursing practice for which all students must receive formal education. Through competency-based education, nursing students develop the knowledge, attitudes, and skills to deliver quality primary palliative care before they transition to practice. Nurse educators in academic and practice settings should use reliable and valid means to evaluate student learning across cognitive, affective, and psychomotor domains. Expert faculty conducted a literature review to identify published instruments that evaluate primary palliative care student learning outcomes. Selected articles were required to include instrument reliability, validity, or both. The literature search yielded 20 articles that report on the development and testing of 21 instruments. Findings are organized into 3 learning domains that encompass 5 outcomes. Four instruments assess knowledge within the cognitive domain. In the affective domain, 3 instruments assess attitudes about caring for seriously ill or dying patients, 7 assess attitudes about death, and 5 assess self-efficacy. Competence and competency are evaluated in the psychomotor domain with 4 tools. Instrument implementation considerations within each domain are discussed. Faculty are encouraged to use robust evaluation measures such as those identified in the literature review to measure primary palliative care learning outcomes within a competency-based education framework.
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Yoong SQ, Wang W, Seah ACW, Chao FFT, Kumar N, Gan JON, Schmidt LT, Hong J, Zhang H. The impact of a student death doula service-learning experience in palliative care settings on nursing students: A pilot mixed-methods study. DEATH STUDIES 2024:1-13. [PMID: 39158318 DOI: 10.1080/07481187.2024.2391929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/20/2024]
Abstract
Through a mixed-methods approach (randomized controlled trial and thematic analysis of pre and post-service-learning reflections), this study evaluated the impact of a student death doula service-learning experience on nursing students' palliative competencies and learning experiences. The intervention group underwent a 2-day student death doula training workshop followed by a 6-month service-learning experience, while the control group received standard palliative care education. Attitudes toward the care of the dying significantly improved for the intervention group but not for compassion competence and palliative care knowledge. Six themes were developed: (1) Motivations for being a student death doula, (2) Improved perceptions of palliative care patients, (3) Perceptions of a good death, (4) Confidence in caring for palliative care patients, (5) Understanding the multifaceted nature of palliative care, and (6) Joys and challenges during service-learning. Service-learning helped students to understand palliative care patients and acquire confidence in engaging with them.
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Affiliation(s)
- Si Qi Yoong
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Alvin Chuen Wei Seah
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Felicia Fang Ting Chao
- Department of Psychology, Faculty of Arts and Social Sciences, National University of Singapore, Singapore
| | - Nivetha Kumar
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Joanne Oon Nee Gan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Assisi Hospice, Singapore
| | - Laura Tham Schmidt
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Hui Zhang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- St. Andrew's Community Hospital, Singapore
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Nabirye AK, Munabi IG, Mubuuke AG, Kiguli S. Perceptions and attitudes of Nursing students towards end-of-life care: a Phenomenological Study at a tertiary hospital in Uganda. RESEARCH SQUARE 2024:rs.3.rs-4594723. [PMID: 39108492 PMCID: PMC11302713 DOI: 10.21203/rs.3.rs-4594723/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/12/2024]
Abstract
Introduction Clinical practice is an important part of nursing education as it helps nursing students transition into competent health professionals who can provide quality services. However, research studies convey it as a significant stressor for nursing students when they are obliged to end of life during clinical practice. The perceptions of nursing students on caring for end-of-life care have not been exhaustively studied in the Ugandan context. This study was conducted to understand nursing students' perceptions of end-of-life care during clinical practice at Mulago Hospital. Methods It was a qualitative study with a phenomenology method carried out among 15 nursing students from Makerere University who were assigned to Mulago Hospital for clinical practice. Data was gathered using an in-depth interview guide, audio was captured, and transcriptions were analyzed thematically using Atlas.ti version 6. Results Three main themes emerged from the data; two themes on perceptions were (i) reactions when nursing students were informed about the physical process of caring for dying patients and (ii) how student ideas about the care changed during the process of caring for end-of-life. The third theme was the attitude of students towards patients when offering end of life care. participants described their reactions as chaotic, devastated and scared about their first-time encounter with caring for dying patients, the physical process also required preparation to handle the situation and understanding, and for positive personal values felt respected, appreciated, trusted and valued when informed about the physical process of caring for the end-of-life. Conclusion In this study, nursing students held divisive attitudes on care for dying patients. However, nursing students appear to transition from unfavorable impressions of the process and encounter of caring for dying patients to positive perceptions during the actual caregiving experience. Despite their differing perspectives on caring for dying patients, students were typically empathic towards them.
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Jiang J, Zhou J, Chen X, Zhu X, Zhang H, Zhang Q, Zhang J. The impact of clinical internship experience on nursing students' attitudes towards death and choices of end-of-life care: A self-control study. Nurs Open 2024; 11:e2214. [PMID: 38943259 PMCID: PMC11213817 DOI: 10.1002/nop2.2214] [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: 11/14/2023] [Revised: 04/30/2024] [Accepted: 06/05/2024] [Indexed: 07/01/2024] Open
Abstract
AIM This study aims to explore the impact of emergency department internships on the attitudes towards death among undergraduate nursing students and their preferences for end-of-life care settings. Additionally, the study analyzes the reasons behind nursing students' choices of end-of-life care settings and provides insights for improving undergraduate education on attitudes towards death and end-of-life care, and provide reference for the development of emergency hospice care. DESIGN This study adopts an observational design with a self-controlled before-and-after approach. METHODS A questionnaire survey was conducted with 96 nursing interns between July 2021 to June 2022. Demographic information and data on attitudes towards death, and preferences for end-oflife care location were collected by online questionnaire. Paired test were conducted to compare differences between groups. RESULTS The study included a total of 96 nursing students with an average age of 21.11 years. The scores for the avoidance-acceptance dimension of death attitudes before and after the internship were 2.40 (1.80, 3.00) and 2.20 (1.60, 3.00), respectively, showing a significant difference (Z = -2.084, p = 0.037). Factors such as gender, experience in caring for critically ill or dying patients, knowledge of death education, and discussions about death at home were found to influence nursing students' attitudes towards death. Nursing students expressed a preference for receiving end-of-life care and treatment in their homes or in hospice/palliative care wards, while the intensive care unit, emergency department, and nursing homes were the least preferred settings. There were significant differences in nursing students' preferences for end-of-life care settings before and after the internship (p = 0.000). Importantly, the number of nursing students expressing a desire to receive end-of-life care in the emergency department increased from 2 to 7 after the internship, while the number of students not wanting end-of-life care in the emergency department decreased by 5.
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Affiliation(s)
- Jingyuan Jiang
- Department of Emergency Medicine, West China Hospital, Sichuan University/West China School of NursingSichuan UniversityChengduChina
- Disaster Medical CenterSichuan UniversityChengduChina
- Nursing Key Laboratory of Sichuan ProvinceChengduChina
| | - Jing Zhou
- Department of Emergency Medicine, West China Hospital, Sichuan University/West China School of NursingSichuan UniversityChengduChina
- Disaster Medical CenterSichuan UniversityChengduChina
- Nursing Key Laboratory of Sichuan ProvinceChengduChina
| | - Xiaoli Chen
- Department of Emergency Medicine, West China Hospital, Sichuan University/West China School of NursingSichuan UniversityChengduChina
- Disaster Medical CenterSichuan UniversityChengduChina
- Nursing Key Laboratory of Sichuan ProvinceChengduChina
| | - Xiaolin Zhu
- Department of Emergency Medicine, West China Hospital, Sichuan University/West China School of NursingSichuan UniversityChengduChina
- Disaster Medical CenterSichuan UniversityChengduChina
- Nursing Key Laboratory of Sichuan ProvinceChengduChina
| | - Hao Zhang
- Department of Emergency Medicine, West China Hospital, Sichuan University/West China School of NursingSichuan UniversityChengduChina
- Disaster Medical CenterSichuan UniversityChengduChina
- Nursing Key Laboratory of Sichuan ProvinceChengduChina
| | - Qin Zhang
- Department of Emergency Medicine, West China Hospital, Sichuan University/West China School of NursingSichuan UniversityChengduChina
- Disaster Medical CenterSichuan UniversityChengduChina
- Nursing Key Laboratory of Sichuan ProvinceChengduChina
| | - Jianna Zhang
- Department of Emergency Medicine, West China Hospital, Sichuan University/West China School of NursingSichuan UniversityChengduChina
- Disaster Medical CenterSichuan UniversityChengduChina
- Nursing Key Laboratory of Sichuan ProvinceChengduChina
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Zhang X, Xie X, Xiao H. Effects of death education interventions on cancer patients in palliative care: A systematic review and meta-analysis. DEATH STUDIES 2024; 48:427-441. [PMID: 37432171 DOI: 10.1080/07481187.2023.2233450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
This review summarizes the best available evidence on the effects of death education in palliative care for cancer patients. A systematic literature review was conducted across 9 databases, revealing 22 eligible studies (N = 2,374). After two reviewers independently engaged in study selection, quality assessment, and data extraction, the results were synthesized through qualitative and quantitative analysis. Overall, the focus on death education for cancer patients showed an upward trend and consistently demonstrated significant positive effects with regards to the control of anxiety and depression, attitudes toward death, and quality of life. However, high-quality evidence regarding the effects of death education on cancer patients is lacking, warranting additional well-designed rigorous studies and standardized programs with specific and feasible steps.
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Affiliation(s)
- Xiaoling Zhang
- School of Nursing, Fujian Medical University, Fuzhou, China
- School of Nursing, Quanzhou Medical College, Quanzhou, China
| | - Xifeng Xie
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Huimin Xiao
- School of Nursing, Fujian Medical University, Fuzhou, China
- Research Center for Nursing Humanity, Fujian Medical University, Fuzhou, China
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Wang T, Cheung K, Cheng H. Death education interventions for people with advanced diseases and/or their family caregivers: A scoping review. Palliat Med 2024; 38:423-446. [PMID: 38634233 DOI: 10.1177/02692163241238900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
BACKGROUND People with life-threatening diseases and their family caregivers confront psychosocial and spiritual issues caused by the persons' impending death. Reviews of death education interventions in the context of life-threatening diseases are scarce and limited to certain intervention types. AIMS This study aims to ascertain existing evidence on death education interventions for the population of adults with advanced diseases and/or their family caregivers and identify gaps for future research. DESIGN A scoping review guided by Arksey and O'Malley's framework. DATA SOURCES Thirteen electronic databases were searched for experimental and qualitative studies on death education interventions for the advanced disease population and/or their family caregivers between 1 January 1960 and 25 October 2023. RESULTS Nine types of interventions were identified in 47 studies, which included 5 qualitative and 42 experimental designs, half of which were pilot and feasibility trials. Most of the studies focused on people with advanced cancer, and only seven investigated caregivers or families/couples. Death-related outcomes were less likely to be assessed relative to psychological outcomes, spiritual well-being, and quality of life. Life review interventions, cognitive-behavior therapy, narrative therapy, and general psychosocial interventions decreased depression and anxiety, but evidence was limited. Factors contributing to the interventions' success included intervention content, which enabled the disclosure of personal experience and death concerns comfortably, trained professionals, and connection to family caregivers. CONCLUSIONS This work identified a few potentially effective death education interventions for psychological outcomes for people with advanced cancer or their caregivers. Additional trials are needed to confirm the effectiveness of these interventions.
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Affiliation(s)
- Tong Wang
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, Hung Hom, China
| | - Kin Cheung
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, Hung Hom, China
| | - Huilin Cheng
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, Hung Hom, China
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Ben Natan M, Makhoul Khuri M, Hammer H, Yarkoni M. Nursing Students' Intention to Work in Hospice Care in the Future: A Cross-sectional Study. J Hosp Palliat Nurs 2024; 26:E55-E61. [PMID: 37815276 DOI: 10.1097/njh.0000000000000990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
Studies reveal that nursing students rank hospice nursing among their least preferred career choices. The purpose of this study was to explore the association between nursing students' intention to work in hospice care in the future and their attitudes toward caring for dying patients, death anxiety, personal and/or professional experience of caring for dying patients, and type of nursing program studied. In this cross-sectional study, 200 nursing students completed an online survey based on the Frommelt Attitude Toward Care of the Dying Scale and the Turkish Death Anxiety Scale. Only 11% of the respondents were found to express interest in working in hospice care in the future. Studying in the accelerated program for nonnursing Bachelor of Arts graduates predicted a higher intention to work in hospice care in the future, than studying in the generic program (β = 0.27, P < .001). Completion of clinical experience in a medical ward predicted lower intention (β = -0.21, P < .01). These findings suggest that nursing students in the accelerated program for nonnursing Bachelor of Arts graduates should be provided with appropriate experience and support to maintain their interest in hospice nursing. Clinical experience in medical wards does not seem to be a good substitute for clinical experience in hospice care.
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Zhang L. Middle-aged and older adults in Aids village: a mixed methods study on talking about death and well-being promotion based on social support theory. Front Psychol 2024; 15:1363047. [PMID: 38572204 PMCID: PMC10987812 DOI: 10.3389/fpsyg.2024.1363047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 03/07/2024] [Indexed: 04/05/2024] Open
Abstract
Introduction Will about talking about death bring well-being? This study aims to explore the impact of talking about death on the subjective well-being of the rural middle-aged and older adults in China's "Aids village" from five dimensions: the way of talking about death, the attitude towards talking about death, the objects of talking about death with, the frequency of talking about death and the content of the death talk, and investigate whether social support played a mediating role during this process. Methods A field survey and in-depth interviews were conducted in Wen Lou village (a famous Chinese "Aids village"), and valid questionnaires were completed by the HIV/Aids-affected middle-aged and older adults. A series of linear regression analyses were conducted to detect whether the way of talking about death, the attitude towards talking about death, the objects of talking about death with, the frequency of talking about death and the content of the death talk predict the subjective well-being of the HIV/Aids-affected middle-aged and older adults. An empirical test for mediation effect was performed to examine whether social support played a mediating role during the process. Results It was found that the more frequent the middle-aged and older adults talk about death, the higher level of their subjective well-being is (ΔR2 = 0.056, 0.05 < p < 0.10), and during which process social support played a mediating role. Discussion The author believes that using "talking about death" as a kind of medical intervention, carrying out corresponding life education and death education, and developing a suitable hospice care model, may be a valuable way for the HIV/Aids-affected middle-aged and older adults in the rural area.
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Affiliation(s)
- Lin Zhang
- Department of Journalism and Communication, Shanghai University, Shanghai, China
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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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Tian X, Zheng X, Peng Y, Zhou X, Huang B, Xie Y, Xiao W. The effects of hospice care education on first-year undergraduate nursing students in mainland China: A mixed-methods study. NURSE EDUCATION TODAY 2024; 134:106095. [PMID: 38266431 DOI: 10.1016/j.nedt.2024.106095] [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: 09/26/2023] [Revised: 12/18/2023] [Accepted: 01/14/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND With the rising number of people with end-stage chronic diseases, the demand for hospice care has increased dramatically. As the future health professionals for the implementation of hospice care, undergraduate nursing students in mainland China still lack knowledge and skills of hospice care, thus hospice care education plays a vital role in its development. OBJECTIVES To understand the effects of hospice care education on nursing students' death attitudes, end-of-life attitudes, humanistic care qualities, and their learning experiences. DESIGN This study used a mixed-methods design. SETTING A University of Chinese Medicine in mainland China. PARTICIPANTS The first-year undergraduate nursing students (n = 65). METHODS A mixed-methods study was conducted to evaluate the impact of a hospice care course from March to June 2021. The quantitative part included a quasi-experimental study designed with pre- and post-intervention measurements and the qualitative part included a descriptive qualitative study with semi-structured individual interviews. RESULTS The quantitative data revealed that after the course, nursing students experienced improvements in their death attitudes, end-of-life attitudes, and humanistic care qualities. Two categories were identified from the qualitative data. The category of "Gain from learning" included 4 themes (Confronting death and thinking about life; Understanding and agreeing with the idea of hospice care; Perceiving the humanistic spirit of medicine; Enhancing of the nursing discipline cognition and professional identity) and the category of "Course feedback" included 2 themes (Expressing recognition for the course arrangement; Making suggestions on the course optimization). CONCLUSIONS Hospice care education had a positive influence on nursing students. Students expressed satisfaction with the course arrangement. However, future hospice care courses should further optimize the curriculum designs by increasing the discussion of death-related topics, sharing more real clinical cases, recruiting students from different majors, and providing clinical practice, to provide high-quality nursing education for the development of hospice care.
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Affiliation(s)
- Xia Tian
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong, PR China
| | - Xiaoting Zheng
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong, PR China
| | - Yunyi Peng
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong, PR China
| | - Xiaojun Zhou
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong, PR China
| | - Baoxin Huang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong, PR China
| | - Yaqian Xie
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong, PR China
| | - Wenli Xiao
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong, PR China.
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Graham L, Emerson K. An Innovative Academic-Practice Partnership Using Simulation to Provide End-of-Life Education for Undergraduate Nursing Students in Rural Settings. Nurs Educ Perspect 2024; 45:126-128. [PMID: 36730757 DOI: 10.1097/01.nep.0000000000001073] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
ABSTRACT Innovations that foster academic-practice partnerships can fill direct clinical care gaps and supplement faculty expertise, particularly in rural settings. An end-of-life simulation was cocreated by nursing faculty and regional certified hospice and palliative care nurses (CHPNs) as a course improvement project for traditional baccalaureate students who lacked direct care experience. Groups of students experienced skills-based pain management and end-of-life conversation-based scenarios using CHPNs as standardized patients. The simulation conformed to current standards in health care simulation, including prebriefing and debriefing components. Feedback from students and CHPNs supports the partnership as an effective teaching/learning strategy.
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Affiliation(s)
- Lucy Graham
- About the Authors Lucy Graham, PhD, MPH, RN, is director of the department of health sciences and an associate professor of nursing, Colorado Mesa University, Grand Junction, Colorado. Kristy Emerson, MPH, BSN, RN, MCHES, is an instructor of nursing, Colorado Mesa University. For more information, contact Dr. Graham at
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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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Zhang L, Huang YL, Wu XQ, Liu CY, Zhang XL, Yang XY, Lai HM, Fu J, Yang MF. The impact of virtual clinical simulation on nursing students' palliative care knowledge, ability, and attitudes: A mixed methods study. NURSE EDUCATION TODAY 2024; 132:106037. [PMID: 37976886 DOI: 10.1016/j.nedt.2023.106037] [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: 07/21/2023] [Revised: 10/30/2023] [Accepted: 11/08/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Palliative care is fraught with numerous challenges when it comes to conducting practical teaching as it involves caring for people facing the complexities of end-of-life and death. Insufficient clinical practice hinders nursing students from mastering knowledge, attitude and ability of hospice care. Virtual clinical simulation has demonstrated its effectiveness as a valuable educational tool in nursing. However, there is a dearth of evidence supporting its utilization in the context of palliative care practice education. OBJECTIVE To develop a virtual clinical simulation education system and assess its impact on enhancing nursing students' knowledge, ability, and attitudes toward palliative care. DESIGN A single-group pretest-posttest design and focus group interviews were employed. SETTING The study was conducted at a medical university in southwest China. PARTICIPANTS A total of 76 third-year nursing students participated. METHODS Participants underwent a 1-hour learning session using the virtual clinical simulation education system. Pre-test and post-test evaluations were conducted to assess the participants' knowledge, ability, and attitudes toward palliative care. Survey questionnaire was administered to gauge the students' acceptance and perception of virtual clinical simulation. Focus group interviews were integrated to gain insight into students' subjective perceptions and feedback on the virtual clinical simulation. RESULTS There were notable enhancements in the students' overall scores of palliative care knowledge, ability, and attitudes after the learning session. Students positively evaluated the usefulness and usability of virtual clinical simulation. Students' feedback regarding virtual clinical simulation can be categorized into four themes: the value of virtual clinical simulation education system, its role as a complement to clinical practice teaching, the enjoyment and accessibility of learning, and the technological challenges encountered. CONCLUSION Virtual clinical simulation is an effective learning tool in palliative care practice education, which has the potential to enhance students' knowledge, ability, and attitudes toward palliative care.
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Affiliation(s)
- Lu Zhang
- School of Nursing, Southwest Medical University, Luzhou, China
| | - Yue-Lin Huang
- School of Nursing, Southwest Medical University, Luzhou, China; Department of Cardiology, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Xiao-Qin Wu
- School of Nursing, Southwest Medical University, Luzhou, China
| | - Chun-Yan Liu
- School of Nursing, Southwest Medical University, Luzhou, China
| | - Xiao-Li Zhang
- School of Nursing, Southwest Medical University, Luzhou, China
| | - Xin-Yu Yang
- School of Nursing, Southwest Medical University, Luzhou, China
| | | | - Jing Fu
- School of Nursing, Southwest Medical University, Luzhou, China.
| | - Mei-Fang Yang
- School of Nursing, Southwest Medical University, Luzhou, China.
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Haroen H, Mirwanti R, Agustina HR, Pahria T, Harun H, Akuoko CP, Nadirawati N. A Qualitative Study of Perception and Experience Toward End-of-Life Care Among Nursing Students Who Witnessed Dying People in Their Family. J Multidiscip Healthc 2023; 16:2261-2270. [PMID: 37588170 PMCID: PMC10426403 DOI: 10.2147/jmdh.s423198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 08/02/2023] [Indexed: 08/18/2023] Open
Abstract
Introduction This study aims to explore nursing students' perception and experience of end-of-life care (EoLC) in Indonesia, particularly in the family environment. Methods This study used a qualitative research design to explore the experiences and perceptions of nursing students who have witnessed the dying of their family members. The study recruited 15 nursing students using a purposive sampling method, who were then invited to reflect and write their experiences in witnessing death of their families, and perceptions towards EoLC. The written reflections were analyzed using thematic analysis. Results Thematic analysis showed that the experience of witnessing dying of a family member shaped nursing students' perceptions and attitudes towards EoLC. Some themes that emerged in this study included the importance of effective communication with patients and their families, symptom management, spiritual, emotional, and social support, as well as the need to improve nursing education and training. Conclusion This present study shows that the experience of witnessing the death of a family member shapes nursing students' perceptions of EoLC in Indonesia. This present study provides recommendations that the students must be prepared emotionally and psychologically in caring EoL or dying patients. How attitude and readiness to care EoL patients are shaped by the experience in witnessing the dying family or loved one. As such, palliative and EoL curriculum should be included methods that allow desensitization and naturalization of dying for the students in order to make them ready to provide better EoLC for patients and their families. The results of this study can contribute to improving the quality of EoLC in Indonesia.
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Affiliation(s)
- Hartiah Haroen
- Department of Community Health Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Indonesia
| | - Ristina Mirwanti
- Department of Critical Care and Emergency Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Indonesia
| | - Hana Rizmadewi Agustina
- Department of Fundamental Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Indonesia
| | - Tuti Pahria
- Department of Medical-Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Indonesia
| | - Hasniatisari Harun
- Department of Medical-Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Indonesia
| | - Cynthia Pomaa Akuoko
- Department of Nursing and Midwifery, Faculty of Health and Applied Science, Christian Service University College, Kumasi, Ghana
| | - Nadirawati Nadirawati
- Nursing Sciences Program, Faculty of Health Science and Technology, Universitas Jenderal Ahmad Yani, Cimahi, Indonesia
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Öcalan S, Kovanci MS, Uslu-Sahan F, Ozdemir L. First death experiences of newly graduated nurses: A qualitative phenomenological study. DEATH STUDIES 2023; 48:303-311. [PMID: 37296532 DOI: 10.1080/07481187.2023.2219648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Newly graduated nurses typically face death for the first time during the transition to their professional careers. This encounter can cause nurses to experience compelling emotions and make it difficult for them to manage and cope with the process of adaptation to the profession and the death process of the patient. This study aims to retrospectively examine and reveal the first death experiences of newly graduated nurses (N = 15) using a retrospective phenomenological method. Analysis of the responses of the newly graduated nurses revealed three themes: first encounter with death, nothing is like before, and support need. Newly graduated nurses realized that their first death experiences change their perspectives on life and profession and that nursing touches human life.
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Affiliation(s)
- Sinem Öcalan
- Faculty of Nursing, Psychiatric Nursing Department, Hacettepe University, Ankara, Turkey
| | - Mustafa Sabri Kovanci
- Faculty of Nursing, Psychiatric Nursing Department, Hacettepe University, Ankara, Turkey
| | - Fatma Uslu-Sahan
- Faculty of Nursing, Department of Obstetrics and Gynecologic Nursing, Hacettepe University, Ankara, Turkey
| | - Leyla Ozdemir
- Faculty of Nursing, Medical Nursing Department, Hacettepe University, Ankara, Turkey
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Yoong SQ, Wang W, Seah ACW, Kumar N, Gan JON, Schmidt LT, Lin Y, Zhang H. Nursing Students’ Experiences With Patient Death and Palliative and End-of-life Care: A Systematic Review and Meta-synthesis. Nurse Educ Pract 2023; 69:103625. [PMID: 37004470 DOI: 10.1016/j.nepr.2023.103625] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 03/06/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023]
Abstract
AIM To synthesise the experiences of nursing students encountering patient death and caring for patients under palliative care or at end-of-life and their families in clinical settings BACKGROUND: Nurses are pivotal in caring for dying patients and families. It has been reported that nursing students feel unprepared in caring for dying patients and handling patient death. Understanding their experiences would better inform how palliative care education can be improved and how students can be better supported in clinical settings. DESIGN A qualitative systematic review and meta-synthesis METHODS: PubMed, Embase, CINAHL, PsycINFO, ProQuest and Google Scholar were searched for peer-reviewed articles and theses/dissertations published between 1 January 2012-25 Feb 2023. Qualitative studies of any design reporting nursing students' experiences of patient death, caring for patients under palliative care, at end-of-life, or with time-limiting diseases in clinical settings in English were included. Study quality was evaluated using the Critical Appraisal Skills Programme tool. Data were synthesised using Sandelowski and Barroso's 2-step framework through a meta-summary using thematic analysis, which were then integrated into meta-syntheses using an event timeline. RESULTS The review included 71 studies from 26 countries (n = 1586 nursing students). The meta-summary contained 8 themes and 23 subthemes: (1) Communication experience with patients and families, (2) Satisfaction with care provided to patients and families, (3) Impact of the COVID-19 pandemic on death and dying, (4) Perceptions of death and dying, (5) Impact of death, (6) Nursing education on palliative end-of-life care, (7) Support systems and coping methods, (8) Learning outcomes. The meta-synthesis depicted nursing students' experiences before, during and after encountering dying patients, families and patient death. Suggestions for nursing faculty and clinical staff on how they could equip students with necessary skills and knowledge and support them in clinical settings were also provided. CONCLUSIONS While caring for dying patients and families was beneficial to nursing students' learning and professional development, they encountered many challenges. Governments, clinical and academic nursing leaders must prioritise the integration of palliative care content into the curricula across nursing schools in face of increasing palliative and end-of-life care needs in patients. Nursing schools should ensure that students are adequately prepared by designing culturally and socioeconomically relevant curricula, integrating theoretical and experiential learning and offering students a thorough understanding of palliative and end-of-life care. Clinical staff and nursing instructors should support students emotionally and guide them in patient care.
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Affiliation(s)
- Si Qi Yoong
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Wenru Wang
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Alvin Chuen Wei Seah
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Nivetha Kumar
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Joanne Oon Nee Gan
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Assisi Hospice, Singapore
| | - Laura Tham Schmidt
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yanjuan Lin
- Department of Nursing, Fujian Medical University Union Hospital, Fuzhou, China
| | - Hui Zhang
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; St. Andrew's Community Hospital, Singapore
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Implementation and evaluation of an end-of-life care education program for oncology nurses working in medical-surgical wards: A quasi-experimental study. Heliyon 2023; 9:e14096. [PMID: 37025828 PMCID: PMC10070522 DOI: 10.1016/j.heliyon.2023.e14096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 02/21/2023] [Accepted: 02/21/2023] [Indexed: 03/10/2023] Open
Abstract
Background The issue of a good death for cancer patients is becoming more prevalent. Hence, nurses' end-of-life work performance and stress levels in medical-surgical wards can significantly impact the quality of life of cancer patients and their caregivers. This study aimed to develop an end-of-life care education program for nurses taking care of cancer patients in medical-surgical ward and verify the program's preliminary effect. Method Quasi-experimental research using a one-group pretest-posttest design was carried out for this study. The end-of-life care manual for nurses in general wards were developed through expert validation. Initial in-person and follow-on online self-education sessions were conducted based on the end-of-life care manual. A total of 70 nurses participated in the end-of-life care education program. End-of-life care stress and end-of-life care performance were measured as preliminary program effects. An online survey was conducted before the initial in-person education and after the follow-up online education. Results The end-of-life care education program effectively improved general ward nurses' end-of-life care performance. This performance was improved in the physical and psychological domains. However, this program did not improve the nurses' performance in end-of-life care in the spiritual domain. Furthermore, it did not effectively reduce the stress on end-of-life care, indicating that improvements should be made. Conclusions The improvement of effective end-of-life care education programs for nurses caring for cancer patients in general wards is required. Most importantly, efforts at the hospital organization level are necessary to reduce the stress of end-of-life care by improving the working environment. Additionally, it is necessary to conduct preemptive tailored intervention programs for nurses, such as a resilience improvement program.
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18
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Wang Y, Huang Y, Zheng R, Yue X, Dong F. Intern nursing students’ perceived barriers to providing end-of-life care for dying cancer patients in a death taboo cultural context: A qualitative study. Asia Pac J Oncol Nurs 2023; 10:100210. [PMID: 37159608 PMCID: PMC10162947 DOI: 10.1016/j.apjon.2023.100210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 02/15/2023] [Indexed: 02/23/2023] Open
Abstract
Objective Internationally, intern nursing students' experiences with dying patients and death are an area of great concern. However, barriers to providing end-of-life care for dying cancer patients have not been extensively investigated in mainland China, where death remains a taboo issue. Therefore, this study aimed to elucidate intern nursing students' perceived barriers to their performance in providing end-of-life cancer care in the Chinese cultural context. Methods This was a descriptive, qualitative study. Twenty-one intern nursing students from three cancer centers in mainland China were interviewed between January 2021 and June 2022. A thematic analysis method was used to analyze the data. The theory of planned behavior was adopted to design the study and identify themes. Results A range of barriers related to attitudes, subjective norms, and perceived behavioral control that hindered intern nursing students from acquiring abilities to deal with patient dying and death were identified in the Chinese cultural context. Conclusions Chinese intern nursing students encountered many barriers that affected their provision of end-of-life care to dying cancer patients. Strategies to improve their ability to provide appropriate end-of-life care should focus on helping them develop appropriate attitudes toward dying and death and how to overcome subjective norms and behavioral control barriers.
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19
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Chiou RJ, Tsai PF, Han DY. Exploring the impacts of a coffin-lying experience on life and death attitudes of medical and nursing students: preliminary findings. BMC MEDICAL EDUCATION 2023; 23:6. [PMID: 36604738 PMCID: PMC9815673 DOI: 10.1186/s12909-022-03975-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 12/19/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Physicians and nurses often exhibit strong negative emotional and behavioral reactions when patients they care for die, and death education helps them cope with these difficulties. When implementing death education, the literature shows that experiential activities are more effective than lecturing, and progressive exposure is the best way to reduce death anxieties. This study examined the effects of coffin-lying, an activity sometimes seen in Asian cultures, on life and death attitudes of medical and nursing students. METHODS During a period from 2020 to 2021, 134 medical and nursing students from a medical university in northern Taiwan voluntarily participated in this study. Among them, 53 were in the experimental group, who participated in a coffin-lying activity for nearly 3 hours, and the other 81 were in the control group. All participants filled out questionnaires 1 week before the activity (T1), 1 week after the activity (T2), and 6 ~ 11 weeks after the activity (T3). Three waves of data were analyzed by a repeated-measure multivariate analysis of variance (MANOVA). RESULTS The effects of "love and care" and "feeling of existence" were only manifested at T2, however, the scores of "fear of death" and "death avoidance" between the experimental and control groups significantly differed at T2 and T3. In addition, there were no significant differences between the experimental and control groups in "neutral acceptance", "approach acceptance", or "escape acceptance". CONCLUSIONS The coffin-lying activity based on desensitization was effective in improving "fear of death" and "death avoidance", and the effects were sustained to 6 ~ 11 weeks. Coffin-lying is not only a well-designed activity that quickly reduces negative tendencies toward death, but it is also worth adopting by medical and nursing schools to make death education more comprehensive.
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Affiliation(s)
- Ruei-Jen Chiou
- Department of Anatomy and Cell Biology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Po-Fang Tsai
- Graduate Institute of Humanities in Medicine, College of Humanities and Social Sciences, Taipei Medical University, Taipei, Taiwan
- Department of Education and Humanities in Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Der-Yan Han
- Department of Education and Humanities in Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
- Section of Liberal Arts, Center for General Education, Taipei Medical University, Taipei, Taiwan.
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20
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Wang W, Wu C, Bai D, Chen H, Cai M, Gao J, Hou C. A meta-analysis of nursing students' knowledge and attitudes about end-of-life care. NURSE EDUCATION TODAY 2022; 119:105570. [PMID: 36182790 DOI: 10.1016/j.nedt.2022.105570] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 09/06/2022] [Accepted: 09/18/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES To synthesize nursing students' knowledge and attitudes about end-of-life care and to identify strategic directions for optimizing end-of-life care education. DESIGN A meta-analysis of observational studies. DATA SOURCES PubMed, Web of Science, EMBASE, CINAHL, PsycINFO, MEDLINE, CNKI, and WANFANG 8 electronic databases in English and Chinese were systematically searched from inception until 10 April 2022. REVIEW METHODS Two reviewers independently screened literature and extracted data using structured tables. The Agency for Healthcare Research and Quality (AHRQ) was used to appraise the methodological quality of included studies. The study outcomes were synthesized using a meta-analysis. RESULTS 26 cross-sectional studies of medium or high quality from 13 countries met the eligibility criteria, involving 9749 nursing students. In our review, nursing students demonstrated insufficient knowledge about end-of-life care, with a pooled mean score of 7.50 (95 % CI: 6.55-8.45); of these, knowledge about philosophy and principles, psychosocial and spiritual care, and pain and symptom management were all deficient, with pooled mean scores of 1.49 (95 % CI: 0.78-2.21), 1.00 (95 % CI: 0.35-1.65), and 3.44 (95 % CI: 2.25-4.63), respectively. Conversely, nursing students showed positive attitudes toward end-of-life care, with a pooled mean score of 102.97 (95 % CI: 99.43-106.51). The subgroup analysis revealed that male nursing students had lower pooled mean scores for end-of-life care knowledge and attitudes. CONCLUSION There is a mismatch between nursing students' knowledge and attitudes about end-of-life care, they have a positive attitude but lack the necessary knowledge. Male nursing students seem to have a greater deficit of knowledge and a relatively conservative attitude toward end-of-life care. These findings may provide a significant reference for nursing educators to adjust educational strategies promptly.
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Affiliation(s)
- Wei Wang
- College of Nursing, Chengdu University of Traditional Chinese Medicine, No.1166 Liutai Road, Wenjiang District, Chengdu City, Sichuan Province 611137, China
| | - Chenxi Wu
- College of Nursing, Chengdu University of Traditional Chinese Medicine, No.1166 Liutai Road, Wenjiang District, Chengdu City, Sichuan Province 611137, China
| | - Dingxi Bai
- College of Nursing, Chengdu University of Traditional Chinese Medicine, No.1166 Liutai Road, Wenjiang District, Chengdu City, Sichuan Province 611137, China
| | - Huan Chen
- College of Nursing, Chengdu University of Traditional Chinese Medicine, No.1166 Liutai Road, Wenjiang District, Chengdu City, Sichuan Province 611137, China
| | - Mingjin Cai
- College of Nursing, Chengdu University of Traditional Chinese Medicine, No.1166 Liutai Road, Wenjiang District, Chengdu City, Sichuan Province 611137, China
| | - Jing Gao
- College of Nursing, Chengdu University of Traditional Chinese Medicine, No.1166 Liutai Road, Wenjiang District, Chengdu City, Sichuan Province 611137, China.
| | - Chaoming Hou
- College of Nursing, Chengdu University of Traditional Chinese Medicine, No.1166 Liutai Road, Wenjiang District, Chengdu City, Sichuan Province 611137, China.
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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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22
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Nilsson S, Gibson J, Paterson C, Crookes P. Evidence informed generalist palliative care content for undergraduate nursing curriculum: An integrative review. Nurse Educ Pract 2022; 64:103447. [PMID: 36099725 DOI: 10.1016/j.nepr.2022.103447] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/15/2022] [Accepted: 08/29/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Clinicians delivering palliative care require the specific knowledge, skill and understanding to meet the needs of the dying. Research shows that undergraduate nursing students report feeling inadequately prepared to provide safe and effective palliative care. OBJECTIVES To identify existing empirical evidence on generalist palliative care content within international undergraduate nursing curricula and to synthesize existing generalist palliative care topics. DESIGN An integrative systematic review was conducted and reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and registered with the International Prospective Register of Systematic Reviews (PROSPERO). DATA SOURCES Keywords were searched in six electronic databases CINAHL, Medline, APA PsycINFO, SCOPUS, Cochran Library and ProQuest Nursing & Allied Health Database, between January 2000 and February 2022. REVIEW METHODS Studies were selected as per a pre-determined inclusion and exclusion criteria. Methodological quality was appraised using the Mixed Methods Appraisal Tool (MMAT). Tabulation of the author, year, country, aim, participants and setting, method, generalist palliative care content topics, additional findings and limitations were compiled. A thematic analysis of the data was conducted to organise and categorise generalist palliative care topics into an additional table followed by a narrative synthesis. RESULTS Of the n = 1014 papers retrieved, n = 13 studies of varying methodological quality were included in the analysis (n = 8 quantitative descriptive, n = 5 mixed method). Most studies were published in high income countries with developed economies. Methods used to obtain data include survey, extraction of secondary data and expert consensus. Generalist palliative care topics were presented as a list reporting frequency taught/discussed/cited (n = 10), recommended competencies (n = 2), and teaching modules (n = 1). A large variety of topics were identified with differing levels of detail and clear differences in topics identified globally. Overall, the most frequently mentioned generalist palliative care topics were pain and symptom management (n = 12), grief loss & bereavement (n = 12) and communication (n = 11). CONCLUSIONS This review demonstrates for the first time that international primary research evidence on generalist palliative care content in undergraduate nursing curriculum is minimal, of varying methodological quality, with visible inconsistencies among studies designed to inform curriculum verses studies reporting what is taught to students. More research is required to create evidence informed generalist palliative care content for undergraduate nursing curriculum. RECOMMENDATIONS It is recommended for future research to use international consensus-based methods to inform and develop internationally agreed educational topics to optimise patient care at the point of nurse registration.
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Affiliation(s)
- Sylvia Nilsson
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, ACT, Australia.
| | - Jo Gibson
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, ACT, Australia
| | - Catherine Paterson
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, ACT, Australia
| | - Patrick Crookes
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, ACT, Australia
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Türkben Polat H. Nurses' Perceptions on Good Death and Their Attitudes Towards the Care of Dying Individuals. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221100638. [PMID: 35544677 DOI: 10.1177/00302228221100638] [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: 11/15/2022]
Abstract
This study was conducted to determine the good death perceptions of intensive care and oncology inpatient unit nurses, their attitudes toward care of the dying and the correlation between them. The sample of this study consisted of 134 intensive care and oncology inpatient unit nurses. The data were collected using the Frommelt Attitudes Toward Care of the Dying Scale and the Good Death Scale. As the results of the study, the nurses had high good death perceptions. They had moderately positive attitudes toward care of the dying patients. As their good death perceptions increased, their positive attitudes toward care of the dying individual also increased. It is recommended to organize programs to raise awareness of nurses about good death and attitudes toward the dying patients and to strengthen their communication and coping methods.
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Affiliation(s)
- Hilal Türkben Polat
- Seydişehir Kamil Akkanat Faculty of Health Sciences, Department of Fundamentals of Nursing, 226846Necmettin Erbakan University, Konya, Turkey
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24
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Zhou S, Wei L, Hua W, He X, Chen J. A qualitative study of phenomenology of perspectives of student nurses: experience of death in clinical practice. BMC Nurs 2022; 21:74. [PMID: 35351123 PMCID: PMC8966360 DOI: 10.1186/s12912-022-00846-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 03/14/2022] [Indexed: 11/18/2022] Open
Abstract
Aim To describe the experiences of student nurses in confronting the death of their patients, and to understand how they cope with these events and to what extent there are unmet needs that can be addressed in their trainings. Methods Semi-structured interview method was used to collect data from Chinese nursing students and then Colaizzi’s seven-step analysis method was applied to identify recurrent themes in their responses to patient deaths. We listened the tape repeatedly combined with observations of their non-verbal behaviors, then transcribed them with emotional resonance, and entered them into Nvivo. After that, we extracted repeated and significant statements from the transcriptions, coded, then clustered codes into sub-themes and themes which were identified by the comparation with transcriptions and re-confirmation with our participants. Results After confirmation from the interviewees, five themes emerged: emotional experience, challenge, growth, coping and support. Supplementary Information The online version contains supplementary material available at 10.1186/s12912-022-00846-w.
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Affiliation(s)
- ShiShuang Zhou
- Department of Nursing Aministration, School of Nursing, Army Medical University, Chongqing, China
| | - LiZhen Wei
- XiangYa Nursing School of Central South University, 172 TongZiPou Rd, Yuelu District, Changsha, Hunan, 410000, China
| | - Wei Hua
- JiangNing Hospital, Nanjing, China
| | - XioaChong He
- Department of Nursing Aministration, School of Nursing, Army Medical University, Chongqing, China.
| | - Jia Chen
- XiangYa Nursing School of Central South University, 172 TongZiPou Rd, Yuelu District, Changsha, Hunan, 410000, China.
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25
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Nair S. We need a paradigm shift in oncology nursing. CANCER RESEARCH, STATISTICS, AND TREATMENT 2022. [DOI: 10.4103/crst.crst_366_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
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26
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Zahran Z, Hamdan KM, Hamdan-Mansour AM, Allari RS, Alzayyat AA, Shaheen AM. Nursing students' attitudes towards death and caring for dying patients. Nurs Open 2021; 9:614-623. [PMID: 34729934 PMCID: PMC8685863 DOI: 10.1002/nop2.1107] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 09/12/2021] [Accepted: 10/14/2021] [Indexed: 11/17/2022] Open
Abstract
Aim To examine the attitudes of undergraduate Jordanian nursing students towards death and caring for dying patients. Design A cross‐sectional correlational design. Methods The Frommelt Attitude Toward Care of the Dying and Death Attitude Profile‐Revised scales were used in this study with a convenience sample of 555 students from nursing schools in Jordan. Results Nursing students had positive attitudes towards death (M = 153.7, SD = 21.5) and a positive attitude towards caring for dying patients (M = 98.1, SD = 9.2). Fear of death, escape acceptance and death avoidance were significant negative predictors, while neutral acceptance, higher academic level and female gender were significant positive predictors of caring for dying patients (F = 4.5). Conclusion Nursing students had positive attitudes towards caring for dying patients that was influenced by university type, academic level and gender. Nursing education must further focus on death, dying and end‐of‐life care across the core courses of nursing curricula, theory and practicum.
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Affiliation(s)
- Zainab Zahran
- Faculty of Nursing, Al-Ahliyya Amman University, Amman, Jordan
| | | | | | - Rabia S Allari
- Faculty of Nursing, Al-Ahliyya Amman University, Amman, Jordan
| | | | - Abeer M Shaheen
- Community Health Nursing Department, School of Nursing, University of Jordan, Amman, Jordan
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Tang ML, Goh HS, Zhang H, Lee CN. An Exploratory Study on Death Anxiety and Its Impact on Community Palliative Nurses in Singapore. J Hosp Palliat Nurs 2021; 23:469-477. [PMID: 34183589 DOI: 10.1097/njh.0000000000000782] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Nurses working in palliative care settings encounter death and dying regularly and face a greater risk of developing death anxiety and negative attitudes than their counterparts. Such distress and apprehension can cause care fatigue and affect patients' quality of life. Death anxiety remains an underresearched area in Asia, where death and dying are still considered taboo. This study explored death anxiety and its impact on community palliative nurses in Singapore and was conducted at a community hospital in Singapore from January to June 2018. Purposive sampling was used to recruit 16 nurses of different job grades for the face-to-face interviews, which were transcribed verbatim and analyzed using the data analytical approach of Miles et al. Four overarching themes were generated: (1) intrinsic factors influencing death anxiety, (2) extrinsic factors influencing death anxiety, (3) emotional struggles and coping, and (4) need for death education and psychological support. Gaps in palliative care education and death education need to be contextualized to increase the community palliative nurses' awareness and acceptance of death and enhance their death literacy in a multicultural setting.
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