(a)Universidade dos Açores, Escola Superior de Enfermagem de Angra do Heroísmo, Angra do Heroísmo, Azores, Portugal; (b)Gabinete de Investigação em ...
Implementation of an Education Program in Palliative Care among Nursing Students: An Action-Research Project in the Outermost Region of the Azores Timothy Lima(a); Sandra Martins Pereira(b, c); Pablo Hernández-Marrero(d, b) (a)Universidade
dos Açores, Escola Superior de Enfermagem de Angra do Heroísmo, Angra do Heroísmo, Azores, Portugal; (b)Gabinete de Investigação em Bioética, Instituto de Bioética, Universidade Católica Portuguesa, Porto, Portugal; (d)Universidad de Las Palmas de Gran Canaria, Facultad de Ciencias de la Salud, Dpto. de Enfermería, Las Palmas de Gran Canaria, Las Palmas, Spain. (c) Participation
at the EAPC Congress 2015 partially supported by the ‘Associação Portuguesa de Cuidados Paliativos’ (APCP). The authors declare no conflict of interest.
Most courses leading to a nursing degree do not meet the recommendations of the European Association for Palliative Care (1). This may lead to difficulties when caring for patients with palliative care needs. The Azorean archipelago (Portuguese islands sited in the Northern area of the Atlantic Ocean) is compounded by 9 islands, all inhabited. According to the Portuguese National Census of 2011 (2), this region had a total of 246.102 inhabitants. Based on the causes of death mentioned in the Azorean death certificates in 2012 (3), 76% of the diseased people could have benefited from palliative care. Nevertheless, this region has only 3 palliative care teams (4). In outermost regions such as the Azorean islands, investing in education is a keystone to ensure palliative care provision for all citizens. AIMS To study the impact of an optional education program in palliative care among nursing students on their: (i) knowledge, (ii) attitudes towards patients and families, and (iii) emotional coping. METHODS
Action-research project.
A 21-hour education program in palliative care was implemented at the University of Azores in 2011. 24 nursing students of the second academic year participated in this program and study.
Instruments for data collection: Pre and post-education program questionnaire (Q); Field-notes of the participant students and course leaders; Written reflections provided by the participant students during the practicum that followed the course completion; Focus groups (FG) with students after the same practicum.
Questionnaires were analyzed comparatively; content analyses was done inductively to the transcripts of field-notes, written reflections and focus groups. RESULTS
Impact of the education program on their knowledge: After the course completion, the students exhibited a more accurate and broader concept of palliative care (Results from Q). Impact of the education program on their attitudes towards patients and families: The major impact of the course on the students’ attitudes towards patients and families referred to an improvement in the students’ ability to identify palliative care needs and to better communicate. “This course also helped me to better understand patients and families… how to communicate and relate myself with them… (…) I feel more prepared now.” (Student 14 during FG) Impact of the education program on their emotional coping: The course had a major impact on the awareness of students concerning their emotions. Also, the students became more able to cope with difficult situations (e.g., end-of-life care and decisions). “After participating in this course, I feel more able to respect and accept patients’ choices (...)” (Student 6 during FG) “Today, I felt impotent, not knowing what to say to that patient... Then, I thought about the course we had about palliative care, what we learned there, and I found an answer, a way-out of that impotence-stage... I feel that this course is helping me to better cope with my emotions...” (Student 21 in his written reflections) CONCLUSIONS The education program in palliative care contributed significantly to students’ clinical practice, namely in terms of an increase of selfconfidence while caring for terminally ill patients. By participating in this course, students expanded their knowledge on palliative care, which had an impact also in the development of their competences. REFERENCES: (1)De Vlieger, M. et al. (2004). A Guide for the Development of Palliative Nurse Education in Europe. http://www.eapcnet.eu/LinkClick.aspx?fileticket=e9JnEa7YZDM%3d&tabid=229. (2) SERVIÇO REGIONAL DE ESTATÍSTICA DOS AÇORES. Censos 2011. [Consult. March 27, 2015]. Available online:
