Nurses’ perceptions of early person‐centred palliative care: a cross‐sectional descriptive study

Patients Receiving Palliative Care and Their Experiences of Encounters With Healthcare Professionals

The study aimed to explore experiences of encounters with health care professionals among patients receiving palliative cancer care in specialist palliative care inpatient units. A qualitative explorative study design was conducted in a specialist palliative care inpatient setting. Data collection was implemented using semi-structured individual interviews (20 palliative care cancer patients) and analysed with inductive content analysis. Palliative care patients experienced both meaningful and disrespectful encounters with healthcare professionals. The meaningful encounters encompassed authentic and supportive experiences, while the disrespectful encounters included indifferent and inadequate experiences. Caring for a patient receiving palliative care requires care beyond tending to a patient's physical needs. Patients should be encountered holistically and as equal human beings without highlighting their roles as patients. The healthcare professionals and the organisations should also acknowledge the importance of time and effort spent for encounters and conversations with the patients instead of concentrating resources mainly on physical care.

Simulation-based learning in palliative care in postgraduate nursing education: a scoping review

BACKGROUND

Nurses require advanced competence in palliative care, but they face wide variations in education and a shortage in opportunities for clinical placement. Simulation-based learning (SBL) can enable students to develop clinical skills, critical thinking and confidence. No scoping reviews to date have mapped the use of SBL in palliative care within postgraduate nursing education.

METHODS

The aim of this scoping review was to systematically map published studies on the use of SBL in palliative care in postgraduate nursing education. A scoping review was conducted using Arksey and O'Malley's (Int J Soc Res Meth 8(1):19-32, 2005) methodological framework. A systematic and comprehensive search of the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Education Resources Information Center (ERIC), Ovid MEDLINE, Ovid EMBASE, Allied and Complementary Medicine and PsycINFO was performed for studies published between January 2000 and April 2022. Two authors independently assessed papers for inclusion and extracted data. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. The protocol was registered on the Open Science Framework.

RESULTS

This review includes 10 studies. Three thematic groupings were identified: enhanced understanding of the importance of teamwork, interdisciplinarity and interpersonal skills; preparedness and confidence in one's ability to communicate during emotionally challenging situations; and impact and relevance to one's own clinical practice.

CONCLUSIONS

The use of SBL in palliative care in postgraduate nursing education seems to enhance students' understanding of the importance of teamwork and interdisciplinarity. The review shows contradictory results regarding whether SBL in palliative care increases students' confidence in their communication skills. Postgraduate nursing students experienced personal growth after participating in SBL. Because our findings indicate that limited research has been conducted within this field, future research should (1) explore postgraduate nursing students' experiences with SBL in palliative care with a focus on more practical content such as symptom management, (2) examine the relevance and application of SBL in clinical practice, and (3) be reported in line with recommendations on the reporting of simulation research.

Doživljanje umiranja z vidika medicinskih sester

Uvod: V enotah intenzivne terapije se medicinske sestrednevno soočajo z umiranjem. To jim predstavlja velike obremenitve, ki vodijo do stiske. Namen pregleda literature je ugotoviti, kaj doživljajo medicinske sestre ob umirajočih pacientih v enotah intenzivne terapije in kako se soočajo z umiranjem.Metode: Uporabljena je metoda pregleda literature. Iskanje je bilo izvedeno v bazah podatkov: PubMed, ScienceDirect, SAGE, Web of Science in CINAHL na osnovi vključitvenih in izključitvenih kriterijev. Proces iskanja literature je prikazan z diagramom PRISMA. Za analizo in sintezo podatkov je bila uporabljena metoda tematske analize.Rezultati: Od 1.886 zadetkov smo v končno analizo vključili 10 člankov. Na podlagi tematske analize smo oblikovali dve glavni temi: (1) doživljanje medicinskih sester ob hudo bolnih in umirajočih pacientih; (2) profesionalni odnos medicinskih sester.Diskusija in zaključek: Izvajanje zdravstvene nege v enotah intenzivne terapije je za medicinske sestre zelo stresno. Pri zdravstveni negi kritično bolnih pacientov se najpogosteje srečujejo s stalnimi fizičnimi obremenitvami, čustvenimi pretresi, pomanjkanjem čustvene podpore, žalostjo, izgorevanjem, depresijo, težavami v komunikaciji s pacientovimi sorodniki ter pomanjkljivim sodelovanjem in zagotavljanjem podpore v timu. Izpostavljene so številnim dejavnikom, ki prispevajo k doživljanju lastne stiske. Potrebni so ukrepi za zaščito, učinkovitejšo pomoč in podporo medicinskim sestram, ki se dnevno soočajo z umiranjem in zagotavljanjem podpore pacientovi družini oziroma svojcem. 

Innovative teaching strategies in palliative care: Reading of a phenomenological text on the experience of living with advanced cancer

BACKGROUND

Pedagogical strategies in palliative care are diverse and mainly aimed to understand patients with advanced disease and improving their care. Phenomenological texts are stories intended to evoke lived experiences and help understand complex situations.

AIM

To determine what thoughts, experiences and feelings nursing students have when reading a phenomenological text about the experience of a person living with advanced cancer.

DESIGN AND METHOD

A descriptive qualitative study with palliative care students of the nursing degree at two university centres. The students reflected on a phenomenological text. A thematic analysis of the 14 reflections was performed. The reflections were analysed inductively and independently, and periodic sessions were held to discuss the identified categories and topics.

RESULTS

The students' writings showed that reading the phenomenological text caused them to reflect and feel moved and challenged. The impact on the students is grouped into three categories: the experience of the corporeality of patients with advanced disease makes students aware of the importance of the body; the disease as an individual transformative process challenges students; and the experiences of people with advanced cancer make students aware of the importance of how they care for patients and their families.

CONCLUSION

The reading of a phenomenological text on the experience of living with advanced cancer may be a teaching method that can generate experiences that promote reflective and experiential learning in nursing students. It seems to be a useful tool for teaching in subjects focusing on person-centred care.

Roles and Responsibilities of Nurses in Advance Care Planning in Palliative Care in the Acute Care Setting: A Scoping Review

Palliative care focuses on symptom management, discussion of treatment and care decisions, network organization, and support of the family. As part of the advance care planning (ACP) process, staff nurses in the acute care setting are often involved in all of the above areas. It is yet unclear what nurses' roles and responsibilities are and what skills are needed in the ACP process. The themes that staff nurses and advanced practice registered nurses (APRNs) discuss in relationship to ACP are manifold. This scoping review demonstrates that staff nurses' core role is advocating for the wishes and values of patients with any life-limiting disease. Staff nurses also serve as facilitators, educators, and advocates to help start ACP conversations and ease patients' transitions between settings based on well-discussed decisions. To be able to engage in ACP discussions, APRNs must have excellent communication skills. Continuous training to improve these skills is mandatory. In the future, clarifying the contribution of staff nurses and APRNs in the ACP process in relation to other members of the interprofessional team can lay the groundwork for improved interprofessional collaboration.