A new approach to multi-professional end of life care training using a sequential simulation (SqS Simulation™) design: A mixed methods study

Weil, Anna; Weldon, Sharon Marie; Kronfli, Miranda; Watkins, Ben; Kneebone, Roger; Bello, Fernando; Cox, Sarah

doi:10.1016/j.nedt.2018.08.022

Cited by 14 publications

(15 citation statements)

References 27 publications

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“…Previous studies have shown mixed results about the effectiveness of education and training on healthcare workers’ attitudes towards death. This could be attributed in part to the teaching methods employed and other confounders (Hegedus, Zana, and Szabó, 2008; Jo and An, 2015; Weil et al, 2018). However, the comfort level of nurses during communication with patients and their families at the end of life was shown to be positively affected by exposure to communication skills training, which has been found to decrease nurses’ anxiety towards death (Black, 2007; Buller et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

“…Didactic lectures were commonly used in EOL teaching, although some included small group teaching with interactive discussions. In recent years, new approaches introduced to EOL teaching included sequential simulations and humanistic approaches which, while showing positive results in other healthcare professionals, did not appear to do so in nurses (Jo and An, 2015; Weil et al, 2018). A multimodal technique in palliative care education was shown to enhance attitudes and knowledge among learners (Henoch et al, 2017; McKinlay et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

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Attitudes towards the dying and death anxiety in acute care nurses – can a workshop make any difference? A mixed-methods evaluation

Cheong

Tan

et al. 2019

Pall Supp Care

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ObjectivesIn Singapore, the core curriculum for end-of-life (EOL) care used in nurse training courses is limited. Only 45% of nurses indicated familiarity with inpatient palliative care. Nurses who lack skills in palliative care may develop anxiety and negative attitudes towards caring for dying patients. We explored whether a two-day, multimodal EOL care workshop could reduce nurses’ death anxiety and improve nurses’ skills, knowledge, and attitude towards palliative care.MethodsForty-five nurses participated in the workshop. At baseline before and at six weeks after, a 20-item knowledge-based questionnaire and the Death Attitude Profile-Revised (DAP-R) were administered. Six weeks post-workshop, in-depth interviews were conducted. We employed descriptive statistics, student paired samples t-test and inductive thematic analysis.ResultsThere was a significant improvement in nurses’ knowledge score (p < 0.01) and reduction in their death anxiety score (p < 0.01). Fear of Death (p = 0.025) and Death Avoidance (p = 0.047) sub-scores decreased significantly. However, the remaining domains such as Neutral Acceptance, Approach Acceptance, and Escape Acceptance did not show any significant difference, although Escape Acceptance showed a trend towards a reduced score (p = 0.063). After the workshop, more nurses adopted the Neutral Acceptance stance (76.2%), and none of them fell into the Fear of Death subdomain. Most nurses interviewed reported a positive change in their knowledge, attitudes, and practice even after the workshop.Significance of resultsThe multimodal palliative care workshop was useful in improving nurses’ EOL knowledge and reducing their anxiety towards death. The positive change in nurses’ attitudes and practices were noted to be sustained for at least six weeks after the intervention.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Attitudes towards the dying and death anxiety in acute care nurses – can a workshop make any difference? A mixed-methods evaluation

Cheong

Tan

et al. 2019

Pall Supp Care

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“…This concern has been raised recently by other authors reporting that not even 50% of a large cohort of Italian and American critical care professionals surveyed confirmed that they had training in EOLC [8,14]. However, education in EOLC is not easy to implement, as to date a common international consensus does not exist regarding EOLC training methodology nor the measurement of its efficacy [15][16][17]. Flannery et al [18] reported a lack of consensus among healthcare professionals on defining the number and qualification of professionals taking part in the EOLC decision process.…”

Section: Discussionmentioning

confidence: 99%

Online education about end‐of‐life care and the donation process after brain death and circulatory death. Can we influence perception and attitudes in critical care doctors? A prospective study

Sandiumenge

Lomero²,

Ibáñez

et al. 2020

Transpl Int

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Impact of training on end-of-life care (EOLC) and the deceased donation process in critical care physicians' perceptions and attitudes was analysed. A survey on attitudes and perceptions of deceased donation as part of the EOLC process was delivered to 535 physicians working in critical care before and after completion of a online training programme (2015-17). After training, more participants agreed that nursing staff should be involved in the end-of-life decision process (P < 0.001) and that relatives should not be responsible for medical decisions (P < 0.001). Postcourse, more participants considered 'withdrawal/withholding' as similar actions (P < 0.001); deemed appropriate the use of pre-emptive sedation in all patients undergoing life support treatment adequacy (LSTA; P < 0.001); and were favourable to approaching family about donation upon LSTA agreement, as well as admitting them in the intensive care unit (P < 0.001) to allow the possibility of donation. Education increased the number of participants prone to initiate measures to preserve the organs for donation before the declaration of death in patients undergoing LSTA (P < 0.001). Training increased number of positive terms selected by participants to describe donation after brain and circulatory death. Training programmes may be useful to improve physicians' perception and attitude about including donation as part of the patient's EOLC.

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“…Having training and sharing sessions on end-of-life care with different professions promote trust and respect for another profession (Weil et al, 2018) and hence improves the overall end-of-life care for patients. Given the rise in telehealth care and telemedicine, technology-based support for new nurses can be developed to keep up with the digital age.…”

Section: Similar Religious Beliefs Between Nurses and Family Members Ap-mentioning

confidence: 99%

Experiences of new nurses dealing with death in a paediatric setting: A descriptive qualitative study

Chew

Ang

Shorey

2020

Journal of Advanced Nursing

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Aims To explore and describe the experiences, challenges and coping strategies of new nurses dealing with paediatric death in a clinical setting. Design A descriptive qualitative study design was used. Methods Semi‐structured interviews were conducted to explore the experiences of 12 new paediatric nurses from a tertiary public hospital in Singapore. Data were collected from September 2019‐December 2019. A thematic analysis was performed for data analysis. Results Four themes were generated: (a) a spectrum of emotions; (b) the ‘blame’ game; (c) getting through the grief; and (d) new nurses' wish list. The new nurses tended to be emotionally affected by their first death experience. They felt anxious and personally responsible for the death but eventually controlled their emotions. Colleagues, religion and self‐actualization were key in overcoming grief. Conclusion The experiences nurses go through at the early stages of their profession shape future workplace attitudes. Additional training and support should be provided to new nurses to build their confidence in managing end‐of‐life care. Training should include cultural awareness and communication skills to equip nurses with the necessary skills. Impact This research will have an impact on institutions, which develop culturally congruent training and support platforms that prepare new nurses for nursing practice. This research will drive future investigations on the long‐term effects of paediatric death on new nurses.

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A new approach to multi-professional end of life care training using a sequential simulation (SqS Simulation™) design: A mixed methods study

Cited by 14 publications

References 27 publications

Attitudes towards the dying and death anxiety in acute care nurses – can a workshop make any difference? A mixed-methods evaluation

Attitudes towards the dying and death anxiety in acute care nurses – can a workshop make any difference? A mixed-methods evaluation

Online education about end‐of‐life care and the donation process after brain death and circulatory death. Can we influence perception and attitudes in critical care doctors? A prospective study

Experiences of new nurses dealing with death in a paediatric setting: A descriptive qualitative study

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