Perceptions on the current content and pedagogical approaches used in end-of-life care education among undergraduate nursing students: a qualitative, descriptive study

Exploring Nursing and Medical Students' Experiences of Handling Challenging Conversations: A Qualitative Focus Group Study

Background

Handling challenging conversations remains a major challenge for both undergraduate and qualified nurses and medical doctors. However, challenging conversations are inevitable in daily patient-clinician encounters in clinical and care settings.

Aim

To explore nursing and medical students' experiences in handling challenging conversations with patients and their families.

Setting and Participants

The study was conducted among final-year undergraduate nursing and medical students selected from seven nursing and medical training schools and universities in Southwest, Midwest and Central Uganda.

Design and Methods

This was an exploratory qualitative study. Purposive and convenience sampling were used to select training schools/universities and participants respectively. Data were collected between November 2022 and February 2023 through 10 face-to-face audio-recorded focus group interviews and were analyzed using inductive thematic analysis.

Results

82 nursing and medical students participated in the study. The analysis yielded four major themes: (1) Students' understanding of bad news, (2) Emotional labor of handling challenging conversations, (3) Handling challenging conversations a theory but not a practice experience, (4) Sociocultural and medico-cultural dilemmas.

Conclusion

The study revealed that participants possessed limited theoretical knowledge, preparedness, and a significant unwillingness to engage in challenging conversations, particularly when communicating bad news or handling conversations related to death and dying. These issues are closely linked to inadequate training and particularly limited or deficient clinical exposure. Simulation-based learning and exposure to challenging conversations are required in clinical settings.

Nursing students' attitude toward euthanasia following its legalization in Spain

BACKGROUND

Euthanasia is a controversial practice in many countries. Since Spain's Euthanasia Law came into effect on March 24, 2021, healthcare providers have faced a new challenge since they must inform patients, provide care, accompany them, and implement the law. It also represents a new stumbling block at universities, which must adapt to regulatory changes and educate future professionals accordingly. Little is known about the attitude of nursing students in Spain toward euthanasia since this law was implemented.

OBJECTIVE

This study aims to answer the following research questions: What is the attitude of nursing students toward euthanasia? What factors influence this attitude?

RESEARCH DESIGN

A cross-sectional study was conducted using an online questionnaire.

PARTICIPANTS AND RESEARCH CONTEXT

The study population comprised all nursing students at a public university in Barcelona (n = 444), Spain, during the 2022-2023 academic year. The validated Spanish version of the Euthanasia Attitude Scale was employed. A bivariate analysis was performed.

ETHICAL CONSIDERATIONS

The university Ethics Committee (CEEAH 6247) approved this study. All participating students signed an informed consent form. Participation was voluntary, and data anonymity and confidentiality were guaranteed.

RESULTS

Two hundred and forty-four nursing students responded to the questionnaire. The mean total score was 79.64. Participants with religious beliefs presented lower scores, indicating a more negative attitude toward euthanasia. Participants in their second, third, or fourth year of the nursing degree scored higher, demonstrating a more positive attitude.

CONCLUSIONS

The attitude of nursing students toward euthanasia was remarkably positive. Working on ethical content during the degree course and clinical practice are factors that help to develop a more positive attitude. In addition, nursing education should encourage professional aspects to prevail over religious beliefs in euthanasia situations.

Knowledge, Self-Efficacy, and Correlates in Palliative and End-of-Life Care: Quantitative Insights from Final-Year Nursing and Medical Students in a Mixed-Methods Study

Introduction

About a decade after the introduction of palliative care teaching for undergraduate nurses and medical students in Uganda, no research has examined students' knowledge and self-efficacy to provide palliative and end-of-life care and their correlates.

Aims

To: (1) estimate final-year undergraduate nursing and medical students' knowledge of and self-efficacy to provide palliative and end-of-life care, (2) identify correlates of knowledge and self-efficacy to provide palliative and end-of-life care.

Design

A multicentre cross-sectional quantitative study.

Setting/participants

Final-year undergraduate medical and nursing students in eight medical and nursing schools in Uganda. Instruments included biodata sheet, the Palliative Care Quiz for Nursing questionnaire and the Palliative Care Self-Efficacy scale. Statistical analyses were performed using STATA version 14.0.

Results

The mean age of the participants (n = 466) was 24.45 ± 3.31 years. Participants' knowledge of palliative care scores was low in all domains 'Philosophy and principles of palliative care' 1.46 ± 0.93 (range: 0-4), 'Psychosocial and spiritual care' 0.61 ± 0.73 (range: 0-3) and 'Management of pain and other symptoms' 6.32 ± 1.75 (range: 0-13). Predictors of knowledge were Gender (p = 0.0242), course of study (p = 0.0001) and religion (p = 0.0338). Participants had very low self-efficacy scores in the three domains of the Palliative Care Self-Efficacy scale.

Conclusion

Participants generally demonstrated limited knowledge and insufficient self-efficacy in providing palliative and end-of-life care. There is a need to integrate and strengthen practical, pedagogical and experiential teaching, review the palliative care curriculum. Future evaluative, longitudinal and interventional as well as qualitative studies are needed to gain deeper insights into this topic.

Cognition and attitudes of hospice care among healthcare providers: a case study of Sichuan Province

BACKGROUND

Under the background of the increasing aging population and cancer burden in China, the role of hospice care has become increasingly prominent. The government has paid more attention to the development of hospice care and set up pilot hospitals to promote hospice care. Moreover, healthcare providers play a leading role in hospice care services. To improve the quality of hospice care, the National Health Commission of the People's Republic of China proposed to set up hospice care training bases in municipal or above-level hospitals with hospice care or relevant work foundations, and train healthcare providers on hospice care. This study aimed to investigate the current situation of cognition and attitudes about hospice care among healthcare providers and provide a theoretical basis for hospital training.

METHODS

We used a quantitative design. A questionnaire survey was conducted among 1591 healthcare providers from August 2022 to November 2022. SPSS 22.0 software was used to analyze the data.

RESULTS

As a significant way of continuing education for healthcare providers, hospital training hasn't been effectively exploited in hospice care education. The average score of hospice care knowledge among participants was (7.74 ± 2.242) and the average score of hospice care attitudes among participants was (4.55 ± 1.503). According to multivariate linear regression analysis, sex (p < 0.001), education levels (p < 0.001), and professional titles (p = 0.018) of participants had significant difference on the score of hospice care knowledge; education levels (p = 0.009) and professional titles (p = 0.016) of participants had significant difference on the score of hospice care attitudes.

CONCLUSIONS

There were some misunderstandings about hospice care among healthcare providers and their attitudes towards hospice care were inactive. It's suggested that hospitals should carry out professional and systematic education courses to help healthcare providers understand hospice care correctly, and participate in hospice care services actively.