title: Improving family carers' experiences of support at the end of life by enhancing communication: an action research study.
abstract: BACKGROUND
  This paper builds on findings from phase one of a participatory action research study, which investigated support for family carers at the end of life in an acute hospital setting in Scotland, UK ( Dosser and Kennedy, 2012 ). The research presented here is the second phase of the participatory action research study, in which nursing staff from an acute hospital ward are involved in ongoing analysis of data and ideas guided by action cycles and reflection.
  
  
  METHODS
  Two key change initiatives are reported; improving nurses' communication skills and improving the environment for family carers of loved ones at the end of life within the acute hospital setting. To address these points, nurses were enrolled on a communications skills course, and a new room for family carers was integrated into the hospital.
  
  
  RESULTS
  Data were analysed from interviews and questionnaires with the nurses, and from insights gathered in a reflective diary taken by the researcher. The changes implemented improved the confidence of participants in communicating with carers as well as patients and colleagues.
  
  
  CONCLUSIONS
  The findings highlight practical strategies and communication issues that can potentially impact on the grief experience of family carers, such as having a safe space nearby to rest in private, away from the bedside.
authors.affiliation: School of Nursing, Midwifery and Social Care, Edinburgh Napier University, Sighthill Campus Sightill Court, Edinburgh, Scotland, UK.
authors.forename: Isabel
authors.initials: I
authors.lastname: Dosser
authors.forename: Catriona
authors.initials: C
authors.lastname: Kennedy
mesh_terms: D017028:Caregivers / Q000523:psychology*; D003142:Communication; D005190:Family / Q000523:psychology*; D006302:Health Services Research; D006801:Humans; D012606:Scotland; D013727:Terminal Care
keywords: Action research; Bereavement; Communication; End of life; Family carers; Support