Development of a Standardized Simulation

Background In palliative care, registered nurses provide advanced nursing care to relieve patients’ symptoms and increase their quality of life based on physical, mental, social and existential dimensions. Conversations, often about existential issues, are an important part of nursing and can affect quality of life positively. Confidential conversations between patients and nurses occur naturally while other nursing activities are being performed. Despite their great importance for palliative care these are rarely described. Aim To gain a deeper understanding of how nurses in palliative care experience and describe confidential conversations with patients. Method Secondary analysis of data from 17 open-ended face-to-face interviews with registered nurses in palliative care was conducted. Qualitative content analysis using an inductive approach was used to gain a deeper understanding and analyse the latent content. Results The confidential conversation was considered an important part of palliative care and is the nurse’s responsibility. This responsibility was described as complex and placed various demands on the nurses, both personal and professional. A prerequisite for the conversation was the interpersonal relationship. The conversation allowed the patient to process important matters not previously addressed or put into words. It had no predetermined content, was unplanned and entirely on the patient's terms. For nurses the conversation could be experienced both as draining and a source of power and strength. The nurses also described safeguarding the patient through the conversation. Conclusion Confidential conversations are crucial and can support a good death. The context affects the content of the conversations when a patient needs to talk about existential issues. Confidential conversations require nurses to have experience and competence, and regular supportive mentoring. Discussing their situation, illness, losses, dependence on help and support, and life situation with nurses may lead to increased quality of life for patients.

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Psychometric Properties of The Thai Version of the Nurses’ Intention to Participate in Advance Care Planning Instrument

Pimsen,

Chung-Ying Lin,

Wirojratana

et al. 2023

PRIJNR

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Advance care planning is an essential process in healthcare that necessitates active participation from all involved professionals, particularly nurses. However, in Thailand, nurse involvement in ACP is limited. Assessment of nurses’ intention to participate inadvance care planning is necessary to organize training courses to improve their participation in this critical event. However, there is no tool to evaluate Thai nurses’ intention to participate in Advance care planning. Thus, we selected the Health Professionals’ Experience and Attitudes Questionnaire on Advance Care Planning to culturally adapt and validate it in the Thai context. We achieved this through a five-step process: (1) standard translation procedures, including forward translation, reconciliation, and back-translation; (2) item refinement through an expert panel; (3) conducting content validity and cognitive interviews; and (4) confirmation of the first culturally adapted tool by the expert panel on the factors. The panel of experts suggested adding the knowledge dimension and changing the name to the Nurses’ Intention to Participate in Advance Care Planning and (5) The Thai version was tested for validity and reliability using confirmatory factor analysis, average variance extracted, and the Fornell–Larcker criteria matrix, Cronbach’s α, and composite reliability. The final version achieved from testing with 260 registered nurses from a teaching hospital in Bangkok is comprised of 20 items distributed across five key dimensions, namely ‘intention,’ ‘attitude,’ ‘subjective norm,’ ‘perceived behavioral control,’ and ‘knowledge,’ demonstrating an excellent model fit, strong composite reliability, and robust internal consistency. This newly adapted tool is a resource for policymakers and nurse educators designing targeted training courses to enhance nurses’ competency in advance care planning. However, before this tool is widely implemented, it would be beneficial to test it further across diverse groups of nursing professionals.

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Development of a Standardized Simulation

Cited by 3 publications

References 24 publications

Palliative care competence development through simulation: Excellence & innovation to meet the AACN essentials

Palliative care competence development through simulation: Excellence & innovation to meet the AACN essentials

“Daring to deal with the difficult and unexpected” Registered nurses’ confidential conversations with patients with palliative care needs: a qualitative interview study.

Psychometric Properties of The Thai Version of the Nurses’ Intention to Participate in Advance Care Planning Instrument

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