Implementation of an education program in palliative care among nursing students: an action-research project in the outermost region of the Azores

Background: Most courses leading to a nursing degree do not meet the recommendations of the European Association for Palliative Care in palliative care. This may led to difficulties when caring for patients with palliative care needs. In outermost regions, investing in education is a keystone to ensure palliative care provision for all citizens. Objectives: To study the impact of an optional education program in palliative care among nursing students in their (i) knowledge, (ii) attitudes towards patients and families, and (iii) emotional coping. Methods: Research-action. Data was collected using the following instruments: pre and post-education program questionnaire; 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 with students after the same practicum. Questionnaires were analysed comparatively; content analyses were done inductively to the transcripts of field-notes, written reflections and focus groups. 24 nursing students participated in this study. Results: After the course completion, the students exhibited a more accurate and broader concept of palliative care. 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. 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). Conclusions: The education program in palliative care contributed significantly to students’ clinical practice, namely in terms of an increase of self-confidence 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.