Nursing students’ attitudes toward care of dying patients: A pre- and post-palliative course study

Abstract

BackgroundMany nursing students are not prepared to encounter death and care for patients who are at the end of life as newly educated nurses. The Frommelt Attitude Toward Care of Dying Scale (FATCOD) has been used to assess nursing students’ attitudes during their education and changes have been noted.ObjectiveTo examine nursing students’ attitudes towards care of dying patients before and after a course in palliative care.DesignA descriptive study with a pre and post design.Settings & participantsNursing students (n = 73) enrolled in a mandatory palliative course in the nursing programme at a Swedish university.MethodsData were collected before and after a palliative care course using FATCOD and qualitative open-ended questions. Data from FATCOD were analysed using descriptive and analytical statistics. The open-ended questions were analysed with qualitative content analysis.ResultsThe students’ mean scores showed a statistically significant change toward a more positive attitude toward care of dying. Students with the lowest pre-course scores showed the highest mean change. The qualitative analysis showed that the students had gained additional knowledge, deepened understanding, and increased feelings of security through the course.ConclusionsA course in palliative care could help to change nursing students’ attitudes towards care of patients who are dying and their relatives, in a positive direction. A course in palliative care is suggested to be mandatory in nursing education, and in addition to theoretical lectures include learning activities such as reflection in small groups, simulation training and taking care of the dead body.

Effectiveness of Lecture-Simulation-Combined Palliative Care Course to Improve Nursing Students' Knowledge, Attitude and Coping

“…Our study shows a statistically significant positive change in palliative care attitude after the course by 10.45 points. This result is in line with Berndtsson's finding that the mean score increased by 9.6 points after a dedicated five-week course, including 12 lectures [7]. Also, Henoch improved nursing students' attitudes by 6 points after five weeks of palliative care theoretical education [17].…”

“…Our course focused on nine of the AACN (2019) palliative care competencies and classified them into two aspects: 1) caring dying patients and their families (including competency 5,6,7,8,10,11,12), and 2) self-recognizing/self-coping (including competency 3, 15). Nursing students should be trained to have the competencies of assessing and treating physically, psychologically, socially, and spiritually with evidence-based pharmacologic and non-pharmacologic approaches (competency 7,10,11,12), through effective communication with the patients, patients' families, and the colleagues in the inter-professional team (competency 5, 6, 11), and by practicing ethical principles (competency 8). Nursing students also should be trained to identify their own ethical, cultural, and spiritual values and beliefs about death (competency 3) and implement the self-care strategies to cope with suffering, moral distress, and compassion fatigue (competency 15).…”

“…For example, Berndtsson used a dedicated five-week palliative care course for the year three nursing students. Their courses included 12 lectures: the most common palliative diagnoses, relief from distressing symptoms, ethical issues, care of relatives, physical and mental changes in the dying patient, and the importance of advocating for the patient and their relatives [7]. Jafari used a 4-hour lecture, film, and a group discussion to improve nursing students' attitude.…”

The palliative care difficulty levels of the nursing students during clinical practices

“…The systematic review and meta‐synthesis study by Wang 57 on nursing students’ experience of providing care for dying patients and their families reported that students had problems in managing the patients’ symptoms and ensuring their comfort. Berndtsson et al, 58 in their study, found that nursing students had difficulties in developing an appropriate care plan for the management of pain and other symptoms of dying patients. Accordingly, nursing students experience difficulties and need support in theoretical training and clinical practices in symptom management of palliative care patients.…”

Lecture-simulation-combined Education Improve Nursing Undergraduates’ Knowledge and Attitude for Palliative Care

“…Initially, palliative care education predominantly carried out by theoretical lectures which may be complained by both students and educators for lacking in practising. For example, Berndtsson used a didactic five-week palliative care course for the year three nursing students (Berndtsson, Margareta & Rejnö, 2019). Their study included 12 lectures: physical and psychological changes in the dying process, palliative diagnoses, terminal symptoms management, ethical issues, caring for families, and nurses' advocating roles in palliative care.…”