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      Adquisición de conocimientos en cuidados paliativos mediante un plan de estudios transversal en enfermería Translated title: Acquisition of Palliative Care Knowledge Through a Transversal Approach in Nursing Studies

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          Abstract

          RESUMEN: La implementación de los cuidados paliativos en las universidades ha sido paulatina. Su reciente implantación requiere de su evaluación para la mejora en la formación de nuestros futuros profesionales. Por tanto, el objetivo de este trabajo es valorar el conocimiento en paliativos, en estudiantes de enfermería de la Universidad Jaume I, tras la implementación de un plan de estudios de enseñanza transversal y evaluación mediante una asignatura de carácter obligatorio. Método: Estudio observacional, de corte transversal, durante el curso académico 2017/2018 mediante la escala Palliative Care Quiz for Nursing. Análisis descriptivo, comparativo de las variables cuantitativas y cualitativas global y según aciertos/errores, significación estadística p-value <0,05. Resultados: La muestra de n=155, edad 22,21±6,61 años, con predominio del sexo femenino en el 80% (n=124). La esfera con mayor número de aciertos fue la relacionada con el control de dolor y los síntomas 69,1% y la esfera con más fallos la relacionada con la filosofía y los principios 46,9%. El conocimiento en paliativos viene explicado en un 16% por el curso académico y con la experiencia previa en paliativos. Conclusiones Mediante nuestros resultados observamos, que la educación en paliativos desarrollada de forma transversal con la culminación de una asignatura obligatoria en cuarto curso, resulta ser efectiva en estudiantes de enfermería, donde el 63% ostentó una buena tasa de aciertos en conocimientos de paliativos.

          Translated abstract

          ABSTRACT: The inclusion of palliative care content in university curricula has been gradual. Due to the recent incorporation of palliative care as a subject, an evaluation is necessary in order improve the education of our future health professionals. The objective of this study was thus to assess palliative care knowledge in nursing students at Jaume I University after the transversal inclusion of palliative care content throughout the program, culminating in a subject of an obligatory nature. Method: This observational cross-sectional study was undertaken over the 2017/2018 academic year using the Palliative Care Quiz for Nursing. A descriptive and comparative analysis of the quantitative and qualitative global variables was performed with respect to correct/incorrect responses. Statistical significance was set at p <0.05. Results: The sample included 155 participants, with a mean age of 22.21±6.61 years. Females (n=124) were predominant in the sample (80%). The domain which received the highest number of correct responses was related to the control of pain and symptoms (69.1%) and the domain which received the highest number of incorrect responses was related to philosophy and principles (46.9%). Academic year and prior palliative care experience explained 16% of the variance in knowledge. Conclusions Through our results, we observed that palliative care education, implemented in a transversal manner and with the completion of compulsory subject in the fourth year, was effective in nursing students, with 63% achieving good scores with respect to palliative care knowledge.

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          Evaluating an evidence-based curriculum in undergraduate palliative care education: piloting a phase II exploratory trial for a complex intervention

          Background By 2013 Palliative Care will become a mandatory examination subject in the medical curriculum in Germany. There is a pressing need for effective and well-designed curricula and assessment methods. Debates are on going as how Undergraduate Palliative Care Education (UPCE) should be taught and how knowledge and skills should be assessed. It is evident by this time that the development process of early curricula in the US and UK has led to a plethora of diverse curricula which seem to be partly ineffective in improving the care for the seriously ill and dying offered by newly qualified doctors, as is demonstrated in controlled evaluations. The goals of this study were to demonstrate an evidence-based approach towards developing UPCE curricula and investigate the change in medical students’ self-perceived readiness to deal with palliative care patients and their families. Methods To evaluate the effects of the UPCE curriculum we chose a prospective, controlled, quasi-experimental, pre, retrospective-pre, post study design. A total of n = 37 3rd and 4th –year medical students were assigned to the intervention group (n = 15; 4th -year) and to the control group (n = 22; 3rd-year). Resting on the self-efficacy concept of Bandura the measurement was conducted by a refined test-battery based on two independent measurements (the revised Collet-Lester-Fear-of-Death-Scale and the instrument of the “Program in Palliative Care Education and Practice” at Harvard Medical School) including 68 items altogether in a five-point Likert-scale. These items were designed to test elementary skills in caring for the dying and their relatives as perceived by medical undergraduates. Datasets from both groups were analysed by paired and independent two-sample t-test. The TREND statement for reporting non-randomized evaluations was applied for reporting on this quasi-experimental study. Results Three constructs showed statistically significant differences comparing the intervention group before and after. Willingness to accompany a dying patient increased from 21.40 to 37.30 (p < .001). Self-estimation of competence in communication with dying patients and their relatives increased from 12.00 to 23.60 (p = .001). Finally, self-estimation of knowledge and skills in Palliative Care increased from 8.30 to 13.20 (p = .001). Conclusions This study is a small but systematic step towards rigorous curricular development in palliative care. Our manualised curriculum is available for scrutiny and scientific feedback to support an open and constructive process of best-practice comparison in palliative care.
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            Chronic childhood disorders: prevalence and impact.

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              Knowledge and attitude of final - year medical students in Germany towards palliative care - an interinstitutional questionnaire-based study

              Background To care for terminally ill and dying patients requires a thorough medical education, encompassing skills, knowledge, and attitudes in the field of palliative care. Undergraduate medical students in Germany will receive mandatory teaching in palliative care in the near future driven by recent changes in the Medical Licensure Act. Before new curricula can be implemented, the knowledge of medical students with respect to palliative care, their confidence to handle palliative care situations correctly, their therapeutic attitude, and their subjective assessment about previous teaching practices have to be better understood. Method We designed a composite, three-step questionnaire (self estimation of confidence, knowledge questions, and opinion on the actual and future medical curriculum) conducted online of final - year medical students at two universities in Germany. Results From a total of 318 enrolled students, 101 responded and described limited confidence in dealing with specific palliative care issues, except for pain therapy. With regard to questions examining their knowledge base in palliative care, only one third of the students (33%) answered more than half of the questions correctly. Only a small percentage of students stated they had gained sufficient knowledge and experience in palliative care during their studies, and the vast majority supported the introduction of palliative care as a mandatory part of the undergraduate curriculum. Conclusion This study identifies medical students' limited confidence and knowledge base in palliative care in 2 German universities, and underlines the importance of providing a mandatory palliative care curriculum.
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                Author and article information

                Journal
                eg
                Enfermería Global
                Enferm. glob.
                Universidad de Murcia (Murcia, Murcia, Spain )
                1695-6141
                2020
                : 19
                : 59
                : 322-344
                Affiliations
                [2] Valencia orgnameUniversitat Jaume I orgdiv1Unidad Predepartamental de Enfermería Spain afolch@ 123456uji.es
                [3] orgnameHospital Universitario General de Castellón orgdiv1Unidad de Oncohematología España
                [1] orgnameConsorcio Hospitalario Provincial de Castellón orgdiv1Unidad de Hospitalización Oncológica España
                Article
                S1695-61412020000300322 S1695-6141(20)01905900322
                10.6018/eglobal.402691
                04025327-ed53-40cc-ab1e-57eab7a1f908

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 International License.

                History
                : 18 February 2020
                : 11 November 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 24, Pages: 23
                Product

                SciELO Spain

                Categories
                Originales

                Estudiantes de Enfermería,Nursing Students,Cuidados Paliativos,Educación,Palliative Care,Education,Atención de Enfermería,Nursing Care

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