The impact of a palliative care educational component on attitudes toward care of the dying in undergraduate nursing students

Abstract

Nurse educators have identified that historically nurses have not been prepared to care for dying patients. Research also has identified that nursing students have anxieties about death, dying, and caring for dying patients. Several factors have been identified as affecting nurses' and nursing students' attitudes toward care of the dying. Factors addressed in this research were current and previous death education. This research incorporated experiential learning using a model of death education and transformative learning theory. The educational experiences were geared to help students understand the skills needed to care competently and compassionately for the dying. The use of the End of Life Nursing Education Consortium (ELNEC) education package along with experiences at the hospice, the funeral home, the anatomy laboratory, and role play helped facilitate transformative learning in the nursing students. The study examined the effects of an educational experience to determine if a one-time educational experience provides sufficient, lasting effects in a 6-week format. Results of this study indicate that education can have a positive effect on nursing students' attitudes toward care of the dying. Nursing students in the intervention group had a significant positive increase in their attitudes toward care of the dying after the intervention. The attitude change increased slightly after a 4-week period.

Cuidando de pacientes em fase terminal: a perspectiva de alunos de enfermagem

“…The data found are similar to those in the literature. Feelings of hopelessness and frustration regarding this inefficient care, which ends in the moment of the patient's death; students, in other studies on this subject (9)(10)(11) , also report their perception of how unprepared they are, technically, in addition to their inability to deal with their own feelings. Two studies (9)(10) …”

“…Some studies point at the need to guide and support nursing students in the difficult task of learning how to deal with the patient's death (6,11,15) . In addition to the theoretical learning, the practical learning with experienced and confident practitioners would be the most appropriate form of preparing and supporting future practitioners for this service.…”

“…Some find out, after the first impact, that it is possible to see other objectives for this care, which, different from cure, can be the goal of helping the patient to live these final moments in the best possible way. These care actions, called palliative (2)(3)(4)(5)11) , have specific objectives and strategies that aim to meet that patient's particular needs, identifying what could improve his life condition. It is what Celina realized:…”

“…The students' descriptions show their concern with the deficiencies in their professional development, especially regarding the technical-scientific education, which corresponds to the biomedical model that prevails in health care (8)(9)(10)(11)(15)(16) . Paula reflects about this issue in a critical way and realizes that the professionals lack preparation for the psychosocial aspects of palliative care.…”

“…Their difficulties are related with their own lack of preparation to deal with death, as well as with the lack of theoretical and practical instruction to work with the patient's death process. Other studies indicate that most undergraduate schools dedicate a small part of their curriculum to studying the psychosocial aspects of care, and even less to issues concerning the patient's death (6)(7)(8)(9)(10)(11) . These results suggest that the following contents should be included in the curriculum: themes concerning human finitude; the most appropriate forms of care in this stage of life; philosophical, ethical, and moral aspects about death; accepting the limits of science in view of a terminal disease (5,(7)(8)(9)(10)(11) .…”