title: Development of an existential support training program for healthcare professionals.
abstract: OBJECTIVE
  Our aim was to describe the developmental process of a training program for nurses to communicate existential issues with severely ill patients.
  
  
  METHODS
  The Medical Research Council (MRC) framework for the development and evaluation of complex interventions was used to develop a training program for nurses to communicate about existential issues with their patients. The steps in the framework were employed to describe the development of the training intervention, and the development, feasibility and piloting, evaluation, and implementation phases. The development and feasibility phases are described in the Methods section. The evaluation and implementation phases are described in the Results section.
  
  
  RESULTS
  In the evaluation phase, the effectiveness of the intervention was shown as nurses' confidence in communication increased after training. The understanding of the change process was considered to be that the nurses could describe their way of communicating in terms of prerequisites, process, and content. Some efforts have been made to implement the training intervention, but these require further elaboration.
  
  
  CONCLUSIONS
  Existential and spiritual issues are very important to severely ill patients, and healthcare professionals need to be attentive to such questions. It is important that professionals be properly prepared when patients need this communication. An evidence-based training intervention could provide such preparation. Healthcare staff were able to identify situations where existential issues were apparent, and they reported that their confidence in communication about existential issues increased after attending a short-term training program that included reflection. In order to design a program that should be permanently implemented, more knowledge is needed of patients' perceptions of the quality of the healthcare staff's existential support.
authors.affiliation: University of Gothenburg,The Sahlgrenska Academy,Institute of Health and Care Sciences,Gothenburg,Sweden.
authors.forename: Ingela
authors.initials: I
authors.lastname: Henoch
authors.affiliation: University of Gothenburg,The Sahlgrenska Academy,Institute of Health and Care Sciences,Gothenburg,Sweden.
authors.forename: Susann
authors.initials: S
authors.lastname: Strang
authors.affiliation: Karolinska Institute,Department of Neurobiology,Care Science and Society,Division of Nursing,Solna,Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Browall
authors.affiliation: University of Gothenburg,The Sahlgrenska Academy,Institute of Health and Care Sciences,Gothenburg,Sweden.
authors.forename: Ella
authors.initials: E
authors.lastname: Danielson
authors.affiliation: University of Gothenburg,The Sahlgrenska Academy,Institute of Health and Care Sciences,Gothenburg,Sweden.
authors.forename: Christina
authors.initials: C
authors.lastname: Melin-Johansson
mesh_terms: D001291:Attitude of Health Personnel; D003142:Communication; D004493:Education / Q000379:methods*; D005086:Existentialism / Q000523:psychology*; D017144:Focus Groups; D006282:Health Personnel / Q000193:education*; D006801:Humans; D009723:Nurse-Patient Relations; D010166:Palliative Care / Q000379:methods* / Q000523:psychology; D029181:Spirituality
keywords: Education; Existential; Medical Research Council framework; Nurses; Spirituality; Training