It is in accompanying the dying that palliative care nurses say they find meaning in their work. To further explore this phenomenon, consideration of coping strategies is proposed. The main objective of this correlational study was to describe the association between coping strategies (using a revised version of the COPE scale (Carver et al, 1999)), emotional outcomes (distress and vigour; profile of mood states (POMS)), and spiritual quality of life (using the Functional Assessment of Chronic Illness Therapy - Spiritual Wellbeing Scale (FACIT-sp)). A sample of 120 nurses providing palliative care in acute care hospitals and the community in Quebec was included. Positive reinterpretation (beta=.27; p<.01) and turning to religion (beta=.33; p<.001), two strategies related to meaning-making coping and disengagement (beta=-.19; p<.05), were the best predictors, accounting for 22% of variance of spiritual quality of life. These findings are consistent with recent studies and highlight the importance of meaning-making strategies in psychological adjustment to bereavement for palliative care nurses.

Perceived nursing self-competence refers to nurses' judgment about their own capabilities to offer quality care. This self-assessment process promotes professional practice and competence development. However, instruments measuring this construct in the domain of palliative care show reliability and validity limitations. The main objective of this project was to develop a new instrument measuring perceived palliative care nursing self-competence. The development process involved three phases and several specific objectives. The objectives of Phase I were (1) to select dimensions representing palliative care nursing from a literature review, (2) to validate the construct and the dimensions with different experts, and (3) to generate a set of items for each dimension with palliative care experts. The objectives of Phase II were to (1) qualitatively and (2) quantitatively validate the content of the instrument using palliative care experts. The objectives of Phase III were (1) to pretest the formulation of the items with clinical nurses and (2) to reduce the item content of the instrument. Following a thorough development process that optimizes the content and minimizes measurement error, the Palliative Care Nursing Self-competence Scale was created. The initial version of the Palliative Care Nursing Self-competence Scale includes 10 dimensions and 50 items.

To further demonstrate the relevance of this proposed shared theory in palliative care nursing contexts, empirical studies are recommended. This shared theory has the potential to provide a solid theoretical framework for evaluating nursing training programmes and, eventually, to improve quality of care and quality of life for patients with life-limiting illness.

Objective Family caregivers (FCs) of cancer patients often experience high distress. This randomized clinical trial assessed the feasibility and preliminary effects of an intervention to improve FC supportive care. Method A pragmatic and minimal intervention to improve FC supportive care was developed and pretested with FCs, oncology team, and family physicians to assess its relevance and acceptability. Then, FCs of lung cancer patients were randomized to the intervention or the control group. The intervention included (1) systematic FC distress screening and problem assessment in the first months after their relative cancer diagnosis, and every 2 months after; (2) privileged contact with an oncology nurse to address FC problems, provide emotional support and skills to play their caregiving role; (3) liaison with the family physician of FCs reporting high distress (distress thermometer score ≥4/10) to involve them in the provision of supportive care. Distress, the primary outcome, was measured every 3 months, for 9 months. Secondary outcomes included quality of life, caregiving preparedness, and perceived burden. At the end of their participation, a purposive sample of FC from the experimental group was individually interviewed to assess the intervention usefulness. Content analysis was performed. Results A total of 109 FCs participated in the trial. FC distress decreased over time, but this reduction was observed in both groups. Similar results were found for secondary outcomes. However, FCs who received the intervention felt better prepared in caregiving than controls (p = 0.05). All 10 interviewed FCs valued the intervention, even though they clearly underused it. Knowing they could contact the oncology nurse served as a security net. Significance of results Although the intervention was not found effective, some of its aspects were positively perceived by FCs. As many of them experience high distress, an improved intervention should be developed to better support them.

The behavior of cooperative teacher's for integration into professional life was largely influenced by human relationships with other teachers and administrative staff. Firstly, our studies aimed to identify the interactions developed during the presence of cooperative teacher's (CT) in the preparatory training for working life. Secondly, we ask to know how the masters of the course actually help to integrate training against the constraints that were imposed on his entourage. For this reason we base our analysis on a questionnaire consisting of ten questions that are the elements that make up the scale to clarify the latent construct "the integration of CT in professional life" and semi-directive interviews. The value of Cronbach alpha index is 0.772. Therefore, we can say that we get to this scale that consists of ten questions, satisfactory internal consistency. Our data were collected in the end of the course and interviews with ten physical education student teachers (PE-STs) at the Higher Institute of Sport and Physical Education (ISSEP) in Tunisia. They all mixed classes of Level 1 and 2 (first and second year of secondary school) teach. These interviews were semi-structured (30 minutes) and gave the PESTs opportunity to distribute their views on major issues such as the satisfaction of the integration, management, as well as more succinct topics such as difficulties that occurred all along the path of integration. The data were analyzed using a constant comparison. However, three main issues have emerged of responses that illustrate the PE-STs' satisfactions, and it's their integration into working life, the definition of the objectives of the course and the role of CT (monitors and internship supervisor). This study revealed three major advanced by PESTs conceptions: 1) the satisfaction of the integration (45%); 2) supervision (51.2%); and 3) knowledge of the objectives of the course (28.8%). The issues addressed in this paper will encourage educators to reflect on their own coaching practices and to include them in the process of accompanying PESTs. N. Bali & al.

ObjectivesPositive attitudes towards end-of-life care are essential among nursing students to adequately support terminally ill patients and enable students to feel confident about providing end-of-life care. This study aimed to determine nursing students’ attitudes towards caring for terminally ill patients, as well as the associations between these attitudes and year of study, exposure to terminally ill people, self-perceived nursing skills and subjective impact of instruction.DesignCross-sectional study.SettingA health sciences school in Switzerland.ParticipantsAll preparatory students, first-year nursing students and third-year nursing students were invited to participate; 178 agreed to participate.Primary outcome measureAttitudes towards terminally ill patients were assessed using the Frommelt Attitudes Toward Care of the Dying Scale, Form B (FATCOD, Form B), as the primary outcome. Secondary measures were gender, age, year of study, number of terminally ill persons encountered, self-perceived palliative care nursing skills and subjective impact of instruction.ResultsMean FATCOD, Form B score was 117.7 (SD: 9.8, median: 118.0). Better attitudes towards terminally ill patients were significantly associated with being aged 24–26 years (β=6.97, 95% CI 2.00 to 11.95, p=0.006), year of study (β=3.47, 95% CI 1.69 to 5.25, p<0.001), professional encounters with terminally ill patients (β=3.59, 95% CI 2.23 to 4.95, p<0.001) and self-perceived palliative care nursing competence (β=1.23, 95% CI 0.41 to 2.04; p=0.003). In the multivariate analysis, professionally encountering terminally ill patients remained significant (β=3.00; 95% CI 1.43 to 4.57; p<0.001).ConclusionsNursing students’ attitudes towards caring for terminally ill patients were positive and improved as their year of study progressed. Professional exposure to terminally ill patients was the strongest factor, followed by private encounters, self-perceived palliative care nursing skills, year of study and age.

Purpose: To review studies pertaining to the reliability and validity of observational pain assessment tools for use with nonverbal patients at the end-of-life, a field of research not documented by previous systematic reviews. Methods: Databases (PubMed, Embase, Epistemonikos, the Cochrane Library, and CINAHL) were systematically searched for studies from study inception to February 21, 2016 (update in May 9, 2018). Two independent reviewers screened study titles, abstracts, and full texts according to inclusion and exclusion criteria. Disagreements were resolved through consensus. Reviewers also extracted the psychometrics properties of studies of observational pain assessment instruments dedicated to a noncommunicative population in palliative care or at the end-of-life. A comprehensive quality assessment was conducted using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) to derive poor, fair, good or excellent ratings for the psychometric tests reported in each study. Results: Four studies linked to 4 different tools met the inclusion criteria. Study populations included dementia, palliative care and severe illness in the context of intensive care. All the studies included in this review obtained poor COSMIN ratings overall. Conclusions: At this point, it is impossible to recommend any of the tools evaluated given the low number and quality of the studies. Other analyses and studies need to be conducted to develop, adapt, or further validate observational pain instruments for the end-of-life population, regardless of the disease.

BackgroundFamily caregivers (FC) often experience higher distress levels than their relative with cancer. Many cancer centers have implemented distress screening programs, but most of them concentrate their efforts on patients, with little attention to their FC. To fill this gap, a pragmatic intervention has been designed to improve supportive care for FC of patients with lung cancer. This article describes the study protocol of a single-center randomized controlled trial to assess its effectiveness.Methods/designA total of 120 lung cancer patients and their FC are randomly assigned to the experimental group (exposed to intervention, N = 60) or to the control group (usual care, N = 60). The intervention includes: (1) systematic FC distress screening and problem assessment near their relative’s cancer diagnosis, and every 2 months, (2) privileged contact with an oncology nurse (ON) away from the patient to address FC problems and (3) liaison by the ON with the family physician of FC reporting high distress (thermometer score ≥5/10), or problems relying on FP expertise. In both groups, FC, patient and process-of-care outcomes are measured at baseline and every 3 months, up to 9 months. The primary endpoint is FC distress measured by the Hospital Anxiety and Depression Scale (HADS) and the Psychological Distress Index used in the Quebec Health Survey (PDQHS). Individual interviews with 10 FC and a focus group with the oncology team will be conducted at the study end to further document the effectiveness of the intervention and its impact on quality of life (for FC) and practice organization (for the oncology team).DiscussionThis trial will assess the effectiveness of an innovative intervention based on interprofessional collaboration between primary care and oncology care. It targets a population in great need, yet often neglected, and has the potential to clearly improve patient and caregiver experience of cancer care, and reduce the burden of disease.Trial registrationClinicalTrials.gov, ID: NCT02531464. Registered on 15 July 2015.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-017-2044-y) contains supplementary material, which is available to authorized users.