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Oba K, Tanimura C, Noguchi Y, Chujo M, Yoshioka SI. Perspectives of nursing students on end-of-life nurse education: A qualitative study of the guided death experience. NURSE EDUCATION TODAY 2023; 126:105834. [PMID: 37167831 DOI: 10.1016/j.nedt.2023.105834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 04/11/2023] [Accepted: 04/23/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND Although various studies reported on educational methods for end-of-life care, there is lack of evidence on how nursing students experience simulated death. OBJECTIVES This study explored the experiences of undergraduate nursing students who participated in a guided death experience. DESIGN The research utilized a qualitative descriptive design. SETTINGS The research was conducted at a Japanese university nursing school. PARTICIPANTS A total of 82 nursing students were recruited to complete an end-of-life course in which they participated in a guided death experience as part of their third-year curriculum. METHODS Descriptions of the guided death experience were analyzed using content analysis. RESULTS Nursing students' experiences in the guided death experience fell into two main categories: "subjective experience of immersing oneself in the world of the patient who is dying" and "formation of nursing perspectives of end-of-life care." The former focused on subjective experiences of nursing students vividly expressing their own emotions such as grief, anger, fear, and depression during the guided death experience process. The latter expressed recognition of the essence of end-of-life-care through the guided death experience, such as thinking about needs of the person who is dying, being present, and listening to the individual. CONCLUSIONS In end-of-life nurse education, the guided death experience allows students to face first-person death. This fosters a core view of nursing in palliative and end-of-life care. Overall, the guided death experience is an important means of preparatory education for relevant clinical practice.
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Affiliation(s)
- Keiko Oba
- Department of Adult & Elderly Nursing, School of Health Science, Faculty of Medicine, Tottori University, 86 Nishi-Cho, Yonago, Tottori 683-8503, Japan.
| | - Chika Tanimura
- Department of Adult & Elderly Nursing, School of Health Science, Faculty of Medicine, Tottori University, 86 Nishi-Cho, Yonago, Tottori 683-8503, Japan
| | - Yoshimi Noguchi
- Department of Adult & Elderly Nursing, School of Health Science, Faculty of Medicine, Tottori University, 86 Nishi-Cho, Yonago, Tottori 683-8503, Japan
| | - Masami Chujo
- Department of Adult & Elderly Nursing, School of Health Science, Faculty of Medicine, Tottori University, 86 Nishi-Cho, Yonago, Tottori 683-8503, Japan
| | - Shin-Ichi Yoshioka
- Department of Adult & Elderly Nursing, School of Health Science, Faculty of Medicine, Tottori University, 86 Nishi-Cho, Yonago, Tottori 683-8503, Japan
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Flanagan B, Warren-James M, Young J. Evaluation of the CARES Skills Framework as a Peer Support Model in the Paramedic Undergraduate Curriculum: Facilitating Challenging Discussions in a Safe Environment. PREHOSP EMERG CARE 2022; 27:971-977. [PMID: 36103240 DOI: 10.1080/10903127.2022.2125136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 09/07/2022] [Indexed: 10/14/2022]
Abstract
OBJECTIVE Infant or child death is reported as being the most distressing type of case paramedics attend. Student paramedics also identify supporting bereaved families as an area associated with low confidence. This study evaluated the CARES skills framework (Connect to emotion, Attention training, Reflective listening, Empathy, Support help seeking) as a peer support model to encourage student paramedics to talk about grief and death related to infants and children. METHOD A convenience sample of first-year paramedic students (target n = 154) was recruited from a single Australian regional university. A modified nominal group technique method was used following a student debriefing session designed to identify problems, generate solutions, and make decisions regarding the efficacy of the CARES skills framework. RESULTS Of 154 eligible participants, 141 participated (92% response rate). Peer social support normalized students' emotions related to death and dying. Although naming emotions was challenging, students reported that the CARES model facilitated a safe environment to talk about death and dying. Students reported feeling heard and connected to their peers during the exercise and an enhanced sense of belonging after the exercise. CONCLUSIONS Findings contribute to evidence that suggests the CARES model is a useful mechanism to enhance peer social support in paramedic students.
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Affiliation(s)
- Belinda Flanagan
- Director of Paramedicine, School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Matthew Warren-James
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia
| | - Jeanine Young
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia
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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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Eltaybani S, Igarashi A, Yamamoto-Mitani N. Palliative and end-of-life care education in prelicensure nursing curricula: A nationwide survey in an Arab country. NURSE EDUCATION TODAY 2021; 96:104644. [PMID: 33242705 DOI: 10.1016/j.nedt.2020.104644] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 10/06/2020] [Accepted: 10/17/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND In the Arab and Islamic world, data on palliative and end-of-life (PEOL) care education are minimal. OBJECTIVES The current study's primary aim was to identify what PEOL care education is delivered to undergraduate nurses in Egypt and the teaching strategies used to deliver this education. A secondary aim was to assess the feasibility of using online surveys in nursing research in Egypt. DESIGN This is a cross-sectional survey. SETTINGS Ten randomly selected faculties of nursing across Egypt. PARTICIPANTS Nursing educators who were working at three academic departments; Medical-Surgical Nursing, Critical Care Nursing, and Gerontological Nursing; in the participating faculties. METHODS After face-to-face recruitment of participants, data were collected using an online questionnaire with an adjunctive use of paper questionnaires. The questionnaire assessed participants' and courses' characteristics, the inclusion of the PEOL Care Index content in the surveyed courses, and teaching strategies used to deliver this content. RESULTS A total of 95 nursing educators were involved in the current study (response rate = 86.4%). All participants were female, and 87.4% responded via online questionnaires. The overall coverage of the PEOL care content ranged from 76% to 100%. End-of-life care and spiritual care were the least frequently reported PEOL care topics; on average, by 19.6% and 36% of the educators, respectively. Lecture was the most frequently used teaching strategy, followed by clinical field practice (mean percentages of utilization: 77.7% and 53.6%, respectively). CONCLUSIONS In Egypt, most PEOL care topics are covered in undergraduate nursing curricula. Yet, educating these topics is predominantly theoretical. End-of-life care and spiritual care are the least frequently covered PEOL care topics. Online surveys are feasible for multisite curricular assessment, and this feasibility may be augmented by face-to-face recruitment of participants and adjunctive use of paper questionnaires.
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Affiliation(s)
- Sameh Eltaybani
- Department of Gerontological Home Care and Long-term Care Nursing, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo 113-0033, Japan; Department of Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University, Egypt.
| | - Ayumi Igarashi
- Department of Gerontological Home Care and Long-term Care Nursing, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo 113-0033, Japan.
| | - Noriko Yamamoto-Mitani
- Department of Gerontological Home Care and Long-term Care Nursing, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo 113-0033, Japan.
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Hutchinson C, Tieman J, Devery K. Evaluation of a toolkit resource package to support positive workplace behaviours in relation to quality end-of-life care in Australian hospitals. BMJ Open Qual 2018; 7:e000286. [PMID: 30515465 PMCID: PMC6231109 DOI: 10.1136/bmjoq-2017-000286] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 10/03/2018] [Accepted: 10/09/2018] [Indexed: 11/05/2022] Open
Abstract
Background The study aimed to determine the effectiveness of an action-orientated toolkit in supporting behaviour change in relation to quality end-of-life care in acute hospital settings. The toolkit was developed to complement a programme of online end-of-life care education. Methods A toolkit was developed from an international review of peer-reviewed literature on end of life. Toolkits were distributed (n=428) to Australian healthcare professionals over a 4-week period. An online survey was sent to all recipients; 65 responses were received (16% response rate, excluding emails returned as undeliverable). Semistructured interviews (n=10) were conducted using purposeful sampling to ensure a range of views were captured. The focus of the evaluation was on investigating (1) users’ responses to the toolkit and (2) individuals’ reported behaviour change. Findings The toolkit was well received by users who reported increased confidence in communication around end-of-life matters. 59.3% of users reported making a behaviour change over the previous 4 weeks; 70.8% of those who had not made a change reported they intended to in the near future. Against expectation, the toolkit’s appeal went beyond its intended audience in acute hospital settings, for example, personal care workers in aged care settings. Conclusions Despite study limitations (self-report of a small, self-selected sample), these early findings suggest that the toolkit has potential to positively impact on end-of-life care practices. However, additional evaluation is needed to determine whether such a toolkit can positively impact on practice and on patient experience at the end of life.
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Affiliation(s)
- Claire Hutchinson
- Palliative and Supportive Services, Flinders University Faculty of Medicine, School of Health Sciences, Adelaide, South Australia, Australia
| | - Jennifer Tieman
- Palliative and Supportive Services, Flinders University Faculty of Medicine, School of Health Sciences, Adelaide, South Australia, Australia
| | - Kim Devery
- Palliative and Supportive Services, Flinders University Faculty of Medicine, School of Health Sciences, Adelaide, South Australia, Australia
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Bakan AB, Arli SK. Comparison of Attitudes Toward Death Between University Students Who Receive Nursing Education and Who Receive Religious Education. JOURNAL OF RELIGION AND HEALTH 2018; 57:2389-2397. [PMID: 29569110 DOI: 10.1007/s10943-018-0609-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This study aims to compare attitudes toward death between university students who receive nursing education and who receive religious education. This study is cross-sectional in nature. It was conducted with the participation of 197 university students in a university located in the Eastern part of Turkey between June and August, 2017. Data were collected using the socio-demographic form and Turkish form of Death Attitudes Profile-Revised. Of all the students participating in the study, 52.8% received nursing education and 47.2% received religious education. It was found that majority of both groups had no education about death, or found the education they received insufficient. Besides, no significant differences were found between the students who received nursing education and who received religious education in terms of their attitudes toward death (p > 0.05). Results showed that students who received nursing education and who received religious education had similar attitudes toward death. In conclusion, the education given to students about the religious or health aspects of death in accordance with the curriculum seemed to have no effects on students' developing positive attitudes toward death.
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Affiliation(s)
- Ayse Berivan Bakan
- Department of Nursing, Agri Ibrahim Cecen University School of Health, Agrı, Turkey.
| | - Senay Karadag Arli
- Department of Nursing, Agri Ibrahim Cecen University School of Health, Agrı, Turkey
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Breen LJ, Szylit R, Gilbert KR, Macpherson C, Murphy I, Nadeau JW, Reis E Silva D, Wiegand DL. Invitation to grief in the family context. DEATH STUDIES 2018; 43:173-182. [PMID: 29733763 DOI: 10.1080/07481187.2018.1442375] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Grief is a family affair, yet it is commonly viewed as an individual phenomenon. As an international, interdisciplinary team, we explore grief within a family context across theoretical, research, practice, and educational domains. Families are complex and working with this complexity is challenging but necessary for a holistic view of grief. We therefore encourage an increased focus on theorizing, researching, practicing, and educating using innovative approaches to address the complexities of grief within the context of families. Learnings from within each domain will affirm and enhance the development of family-level thinking and approaches.
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Affiliation(s)
- Lauren J Breen
- a School of Psychology , Curtin University , Perth, Western Australia, Australia
| | - Regina Szylit
- b School of Nursing, University of São Paulo , São Paulo , Brazil
| | | | - Catriona Macpherson
- d Fife Specialist Palliative Care, Victoria Hospice, Kirkcaldy , Fife , Scotland
| | - Irene Murphy
- e Marymount University Hospital and Hospice , Cork , Ireland
| | | | - Daniela Reis E Silva
- g Laboratory for Research and Intervention on Grief and Bereavement, Pontifical Catholic University of São Paulo, São Paulo , Brazil
| | - Debra L Wiegand
- h School of Nursing , University of Maryland , Baltimore, Maryland, USA
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Garrino L, Contratto C, Massariello P, Dimonte V. Caring for Dying Patient and Their Families. J Palliat Care 2017; 32:127-133. [DOI: 10.1177/0825859717745169] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: The literature from recent decades persistently suggests that nurses are not adequately trained in caring for the dying. Numerous studies call for enhanced education in end-of-life care. Objective: To explore student nurses’ experience of caring for dying persons and their families and how this experience was influenced by their undergraduate education, with a view to improving end-of-life training. Methods: Narrative interviews were administered to a purposive sample of 18 undergraduate students at Turin University’s School of Nursing and analyzed following Giorgi’s qualitative phenomenological methodology. Results: The students’ accounts featured 4 main themes: emotions and feelings, reactions and coping strategies, growth in personal and professional awareness, and the professional nursing model. Students reporting positive experience of end-of-life care in clinical settings displayed the expected learning outcomes for undergraduate nursing education. Conclusion: This study’s strength lies in the fact that it draws on student nurses’ lived experience to assess training in end-of-life care. It confirms the need to invest in targeted end-of-life education and support for nursing students.
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Affiliation(s)
- Lorenza Garrino
- Department of Public Health and Paediatrics, University of Turin, Turin, Italy
| | - Claudia Contratto
- Corso di Laurea in Infermieristica, A.S.L. “Città di Torino,” Turin, Italy
| | | | - Valerio Dimonte
- Department of Public Health and Paediatrics, University of Turin, Turin, Italy
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Österlind J, Prahl C, Westin L, Strang S, Bergh I, Henoch I, Hammarlund K, Ek K. Nursing students' perceptions of caring for dying people, after one year in nursing school. NURSE EDUCATION TODAY 2016; 41:12-16. [PMID: 27138476 DOI: 10.1016/j.nedt.2016.03.016] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2015] [Revised: 02/20/2016] [Accepted: 03/15/2016] [Indexed: 06/05/2023]
Abstract
AIM To describe Swedish nursing students' perceptions of caring for dying people after the first year of a three year in a nursing programme at three university nursing schools in Sweden. METHODS Interviews (n=17) were undertaken with nursing students at the end of their first year. A phenomenographic approach was used to design and structure the analysis of the nursing students' perceptions. RESULTS The analysis resulted in five categories: 1) from abstract to reality, 2) from scary to natural, 3) increased knowledge can give bad conscience, 4) time limits versus fear of end-of-life conversations, and 5) meeting with relatives. CONCLUSION Nursing students need to be prepared both theoretically and within practice to encounter death and dying and to care for dying persons. By combining their theoretical knowledge of dying and death with their own encounters of death and dying people in practice, the students can be supported to develop an understanding of dying and death as a natural part of life rather than something frightening.
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Affiliation(s)
- Jane Österlind
- Ersta Sköndal University College and Ersta Hospital, Palliative Research Centre, Stockholm, Sweden; Ersta Sköndal University College, Department of Health Care Sciences, Stockholm, Sweden.
| | - Charlotte Prahl
- Ersta Sköndal University College and Ersta Hospital, Palliative Research Centre, Stockholm, Sweden; Ersta Sköndal University College, Department of Health Care Sciences, Stockholm, Sweden
| | - Lars Westin
- University of Skövde, The School of Health and Education, Sweden
| | - Susann Strang
- Sahlgrenska Academy, University of Gothenburg, Institute of Health and Care Sciences, Sweden; Angered Hospital, Sweden
| | - Ingrid Bergh
- University of Skövde, The School of Health and Education, Sweden
| | - Ingela Henoch
- Ersta Sköndal University College and Ersta Hospital, Palliative Research Centre, Stockholm, Sweden; Angered Hospital, Sweden; University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Kina Hammarlund
- University of Skövde, The School of Health and Education, Sweden
| | - Kristina Ek
- University of Skövde, The School of Health and Education, Sweden
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Bassah N, Cox K, Seymour J. A qualitative evaluation of the impact of a palliative care course on preregistration nursing students' practice in Cameroon. BMC Palliat Care 2016; 15:37. [PMID: 27036409 PMCID: PMC4815205 DOI: 10.1186/s12904-016-0106-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 03/10/2016] [Indexed: 11/29/2022] Open
Abstract
Background Current evidence suggests that palliative care education can improve preregistration nursing students’ competencies in palliative care. However, it is not known whether these competencies are translated into students’ practice in the care of patients who are approaching the end of life. This paper seeks to contribute to the palliative care evidence base by examining how nursing students in receipt of education report transfer of learning to practice, and what the barriers and facilitators may be, in a resource-poor country. Methods We utilised focus groups and individual critical incident interviews to explore nursing students’ palliative care learning transfer. Three focus groups, consisting of 23 participants and 10 individual critical incident interviews were conducted with preregistration nursing student who had attended a palliative care course in Cameroon and had experience caring for a patient approaching the end of life. Data was analysed thematically, using the framework approach. Results The results suggest that nursing students in receipt of palliative care education can transfer their learning to practice. Students reported recognizing patients with palliative care needs, providing patients with physical, psychosocial and spiritual support and communicating patient information to the wider care team. They did however perceive some barriers to this transfer which were either related to themselves, qualified nurses, the practice setting or family caregivers and patients. Conclusion The findings from this study suggest that nursing student in receipt of palliative care education can use their learning in practice to provide care to patients and their families approaching the end of life. Nevertheless, these findings need to be treated with some caution given the self-reported nature of the data. Demonstrating the link between preregistration palliative care education and patient care is vital to ensuring that newly acquired knowledge and skills are translated and embedded into clinical practice. This study also has implications for advocating for palliative care policies and adequately preparing clinical placement sites for students’ learning and transfer of learning.
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Affiliation(s)
- Nahyeni Bassah
- School of Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, UK.
| | - Karen Cox
- School of Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Jane Seymour
- School of Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, UK
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Gillan PC, van der Riet P, Jeong S. Australian nursing students' stories of end-of-life care simulation. Nurs Health Sci 2016; 18:64-9. [DOI: 10.1111/nhs.12233] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 05/24/2015] [Accepted: 05/29/2015] [Indexed: 12/17/2022]
Affiliation(s)
| | | | - Sarah Jeong
- University of Newcastle; Ourimbah NSW Australia
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Cavaye J, Watts JH. Student Nurses Learning about Death, Dying, and Loss: Too Little, Too Late? ACTA ACUST UNITED AC 2014. [DOI: 10.2190/il.22.4.c] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Concerns about the care provided to people dying from life-threatening illness have prompted a number of international reforms to improve the quality of palliative and end-of-life (EOL) care. The majority of this care is provided by nurses. They spend more time with dying patients than any other health professionals and therefore, need specific clinical skills and knowledge. Palliative and EOL care education is increasingly being positioned as a specialism, available only to a small number of registered nurses as part of continuing professional development. However, increasing numbers of patients with life-threatening illness are being treated in non-specialist settings by nurses with a generalist education. Furthermore, undergraduate nurse education has traditionally had a limited focus on palliative and EOL care, hence claims that undergraduate nursing curricula are inadequate. Drawing on an international literature, this review explores the evidence about the adequacy of undergraduate curricula in this area. It considers the extent to which palliative and EOL curriculum is included in undergraduate nurse education and draws upon evidence from students and registered nurses, who as consumers of education, report feeling unprepared to care for and communicate with, dying patients.
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O’Connor M, Breen LJ. General Practitioners' experiences of bereavement care and their educational support needs: a qualitative study. BMC MEDICAL EDUCATION 2014; 14:59. [PMID: 24670040 PMCID: PMC3986890 DOI: 10.1186/1472-6920-14-59] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 03/17/2014] [Indexed: 05/28/2023]
Abstract
BACKGROUND General Practitioners (GPs) are well-positioned to provide grief support to patients. Most GPs view the provision of bereavement care as an important aspect of their role and the GP is the health professional that many people turn to when they need support. We aimed to explore GPs' understandings of bereavement care and their education and professional development needs in relation to bereavement care. METHODS An in-depth qualitative design was adopted using a social constructionist approach as our aims were exploratory and applied. Nineteen GPs (12 women and 7 men) living in Western Australia were interviewed; 14 were based in metropolitan Perth and 5 in rural areas. GPs were invited, via a letter, to participate in a semi-structured interview. The interviews occurred within each GP's workplace or, for the rural GPs, via telephone, and all interviews were digitally audio-recorded and transcribed. RESULTS Analysis was based upon constant comparison and began as soon as possible after each interview. The data revealed four tensions or opposing views concerning bereavement and bereavement care. These were (1) whether grief is a standardised versus an individual process, (2) the role of the GP in intervening versus promoting resilience, (3) the GP as a broker of services versus a service provider, and (4) the need for formal education and professional development versus 'on-the-job' experiential learning. CONCLUSIONS GPs have a critical role in exploring distress, including grief. However, changes need to be made to ensure GPs have up-to-date knowledge of contemporary theories and approaches. GPs urgently need education both at the undergraduate and postgraduate degree levels, and in continuing professional development. Otherwise GPs will rely on out-dated theories and constructions of grief, which may be detrimental to patient care.
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Affiliation(s)
- Moira O’Connor
- School of Psychology and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth, WA Australia
| | - Lauren J Breen
- School of Psychology and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth, WA Australia
- School of Psychology and Social Science, Edith Cowan University, Perth, WA Australia
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Gillan PC, van der Riet PJ, Jeong S. End of life care education, past and present: a review of the literature. NURSE EDUCATION TODAY 2014; 34:331-42. [PMID: 23838297 DOI: 10.1016/j.nedt.2013.06.009] [Citation(s) in RCA: 119] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Revised: 06/10/2013] [Accepted: 06/12/2013] [Indexed: 05/21/2023]
Abstract
BACKGROUND Research on end of life care education suggests that undergraduate nursing students are largely unprepared to provide end of life care to dying patients and their families. Although there have been attempts to address the issue of lack of preparedness, little is known on how to improve this. LITERATURE REVIEW AIMS To examine how end of life care education has been delivered to undergraduate nursing students and to critically discuss the research on modes of delivery and teaching strategies. REVIEW METHODS An extensive literature search on end of life care education in the undergraduate nursing curriculum was conducted in CINAHL, Mosby's Index, Cochrane Database, Scopus, Eric via Proquest, and Medline. 18 research papers published between 1984 and 2012 that met the selection criteria are included in the review. FINDINGS Findings of these 18 articles are reported under two main themes: Modes of End of Life Education Delivery and End of Life Care Education Initiatives. CONCLUSION This review highlights issues with end of life care education and suggests that end of life care simulation is an innovative strategy that may help to prepare undergraduate nursing students to provide quality end of life care.
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Affiliation(s)
- Pauline C Gillan
- University of New England, P.O Box U90, Armidale, NSW 2351, Australia.
| | | | - Sarah Jeong
- University of Newcastle, P. O. Box 127, Ourimbah, NSW 2258, Australia.
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An Integrated Literature Review of Death Education in Pre-Registration Nursing Curricula: Key Themes. ACTA ACUST UNITED AC 2014. [DOI: 10.1155/2014/564619] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Recent policy has raised the profile of end-of-life care internationally, with the aim of increasing access to quality care for everyone experiencing life-limiting illness. This reflects an international shift in the provision of palliative care to encompass chronic conditions other than cancer. Nurses have an important role in delivering this care and need to be equipped with particular knowledge and skills. However, pre-registration nursing curricula have traditionally had a limited emphasis on death and dying and nurses report feeling unprepared to care for dying patients. This has led to claims that death education in pre-registration curricula is inadequate. This integrated review explores the published literature that reports on death education within pre-registration nurse education. Presenting an international overview, the aim of the review is to contribute to knowledge about the nature and extent of death education in pre-registration curricula. In the context of this paper, death education encompasses both palliative and end-of-life care. Electronic searches of major bibliographic databases found inconsistencies across educational provision with variations in quantity, content, and approach. Despite an increasing amount of death education in pre-registration curricula, there remains a deficit in key areas such as knowledge, skills, organisation of care, and teamwork.
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Watts T. The media critique of the Liverpool Care Pathway: some implications for nursing education. Int J Palliat Nurs 2013; 19:275-80. [PMID: 24151738 DOI: 10.12968/ijpn.2013.19.6.275] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
End-of-life care pathways are championed around the globe as tools that might be used to enhance the quality of care at the very end of a person's life. This paper examines recent negative media discourse in the UK about the Liverpool Care Pathway for the Dying Patient (LCP). This media coverage may have had damaging effects, but it has also served to highlight inappropriate and even suboptimal end-of-life care. While recognising the pervading influence of organisational structures and cultures, some implications for initial and ongoing education of nurses are identified.
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Affiliation(s)
- Tessa Watts
- College of Human and Health Sciences, Swansea University, SA2 8PP, Wales.
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Gillan PC, Parmenter G, van der Riet PJ, Jeong S. The experience of end of life care simulation at a rural Australian University. NURSE EDUCATION TODAY 2013; 33:1435-1439. [PMID: 23260617 DOI: 10.1016/j.nedt.2012.11.015] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Revised: 11/11/2012] [Accepted: 11/20/2012] [Indexed: 06/01/2023]
Abstract
Providing end of life care is a challenging and anxiety provoking prospect for many undergraduate nursing students and many students report a lack of preparedness in providing care. The limited availability of appropriate clinical placements limits the opportunities for nursing students to gain experience in end of life care. Advances in simulation techniques using high fidelity mannequins enable the mimicking of complex patient scenarios such as cessation of life in the provision of end of life care. A group of nursing academics at a rural Australian University designed, developed and implemented end of life care simulation to a group of 3rd year nursing students. The aim of this paper is to report on the evaluation of this educational innovation. Five major themes were identified through analysis of student evaluations: 1) Linking of theory to practice; 2) Approaching families of dying patients; 3) An encounter with death; 4) 'Hands on' experience in a 'protected environment'; and 5) Importance of post simulation discussion and debriefing. End of life care simulation has provided a valuable experience that can be difficult to obtain in clinical practice settings. However, the challenges discussed in this paper need to be taken into consideration for future use.
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Affiliation(s)
- Pauline C Gillan
- P.O Box U90, University of New England, Armidale, NSW 2351, Australia.
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Breen LJ, Fernandez M, O'Connor M, Pember AJ. The preparation of graduate health professionals for working with bereaved clients: an Australian perspective. OMEGA-JOURNAL OF DEATH AND DYING 2013; 66:313-32. [PMID: 23785983 DOI: 10.2190/om.66.4.c] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Students enrolled in health profession courses require grief education so that, upon graduation, they are able to meet the needs of clients living with loss and grief. We investigated grief and loss education in six Australian university programs--medicine, nursing, counseling, psychology, social work, and occupational therapy--drawing from course documents and face-to-face interviews with key staff and final-year students. Only the counseling course included a dedicated grief and loss unit. The nursing, medicine, and occupational therapy courses emphasized end-of-life issues rather than a breadth of bereavement experiences. The social work course taught grief as a socially-constructed practice and the psychology course focused on grief and loss in addiction. Several factors influenced the delivery of grief education, including staffing, time, placement opportunities, student feedback, and needs of each profession. The study provides an indication as to how future health professionals are prepared for grief and loss issues in their practice.
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Affiliation(s)
- Lauren J Breen
- School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia.
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Arantzamendi M, Addington-Hall J, Saracibar M, Richardson A. Spanish nurses’ preparedness to care for hospitalised terminally ill patients and their daily approach to caring. Int J Palliat Nurs 2012; 18:597-605. [DOI: 10.12968/ijpn.2012.18.12.597] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Maria Arantzamendi
- School of Nursing, University of Navarra, C/Irunlarrea, 1 31.008, Pamplona, Spain
| | | | | | - Alison Richardson
- Cancer Nursing and End of Life Care, University of Southampton & Southampton University Hospitals NHS Trust
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Disaster nursing: A descriptive survey of Australian undergraduate nursing curricula. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/j.aenj.2011.02.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Current World Literature. Curr Opin Support Palliat Care 2010; 4:207-27. [DOI: 10.1097/spc.0b013e32833e8160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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