title: Training intervention for health care staff in the provision of existential support to patients with cancer: a randomized, controlled study.
abstract: BACKGROUND
  When a patient receives a cancer diagnosis, existential issues become more compelling. Throughout the illness trajectory, patients with cancer are cared for in oncology wards, by home care teams or in hospices. Nurses working with these patients are sometimes aware of the patients' existential needs but do not feel confident when discussing these issues.
  
  
  OBJECTIVE
  To determine the effects of a training intervention, where the focus is on existential issues and nurses' perceived confidence in communication and their attitude toward caring for dying patients.
  
  
  METHODS
  This was a randomized, controlled trial with a training intervention comprising theoretical training in existential issues combined with individual and group reflection. In total, 102 nurses in oncology and hospice wards and in palliative home care teams were randomized to a training or non-training group. Primary outcomes, confidence in communication, and attitude toward the care of dying patients were measured at baseline, immediately after the training, and five to six months later.
  
  
  RESULTS
  Confidence in communication improved significantly in the training group from baseline (before the training) to both the first and second follow-up, that is, immediately after the training and five months later. The attitude toward caring for the dying did not improve in the training group.
  
  
  CONCLUSIONS
  This study shows that short-term training with reflection improves the confidence of health care staff when communicating, which is important for health care managers with limited resources. Further studies are needed to explore how patients experience the communication skills of health care staff after such training.
authors.affiliation: Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Electronic address: ingela.henoch@gu.se.
authors.forename: Ingela
authors.initials: I
authors.lastname: Henoch
authors.forename: Ella
authors.initials: E
authors.lastname: Danielson
authors.forename: Susann
authors.initials: S
authors.lastname: Strang
authors.forename: Maria
authors.initials: M
authors.lastname: Browall
authors.forename: Christina
authors.initials: C
authors.lastname: Melin-Johansson
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D004506:Education, Nursing / Q000379:methods / Q000706:statistics & numerical data; D005086:Existentialism / Q000523:psychology*; D005260:Female; D064946:Hospice and Palliative Care Nursing / Q000193:education* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality / Q000451:nursing* / Q000523:psychology*; D009723:Nurse-Patient Relations; D009859:Oncology Nursing / Q000193:education* / Q000706:statistics & numerical data; D010353:Patient Education as Topic / Q000706:statistics & numerical data*; D015995:Prevalence; D012944:Social Support; D029181:Spirituality; D013548:Sweden / Q000453:epidemiology; D016896:Treatment Outcome; D055815:Young Adult
keywords: Existential support; education; nurse; palliative care; training