title: Including personal development in palliative care education to address death anxiety.
abstract: BACKGROUND
  Death anxiety may interfere with health care workers' (HCW) relationship with patients and their families.
  
  
  OBJECTIVE
  Evaluate an intervention to address death anxiety and improve HCW skills dealing with patients/families in palliative and end-of-life care.
  
  
  METHODS
  Quasi-experimental mixed methods approach with a pre-test/post-test design.
  
  
  METHODS
  208 HCWs receiving the intervention and working in end-of-life care, in and out of palliative care units, were invited to answer quantitative and qualitative questionnaires. In the end, 150 returned with quantitative answers and of these, 94 with qualitative answers as well. Additionally, out of the 150 participants, 26 were recruited for interview.
  
  
  RESULTS
  Pre-and post-test results revealed a significant reduction in levels of death anxiety, an increase in existential wellbeing, and a significant improvement in HCWs' perception of the quality of their helping relationship skills with patients/families. Content analysis provided an understanding of the difficulties experienced by the HCWs and the positive impact of the intervention.
  
  
  CONCLUSIONS
  An intervention to address death anxiety and help relationship skills can reduce the use of avoidance mechanisms and improve HCW self-perceived psycho-existential support to patients/families.
authors.affiliation: PhD (Psychologist) AMARA-Associação pela Dignidade na Vida e na Morte, Lisbon, Portugal.
authors.forename: Carol Gouveia
authors.initials: CG
authors.lastname: Melo
authors.affiliation: Professor of Applied Health Research, Director of the Integrated Care Research Unit, University of Kent, Canterbury, UK.
authors.forename: Jenny
authors.initials: J
authors.lastname: Billings
mesh_terms: D001007:Anxiety; D004509:Education, Nursing, Continuing / Q000941:ethics; D006801:Humans; D010166:Palliative Care; D011795:Surveys and Questionnaires; D013727:Terminal Care
keywords: Burnout; Death anxiety; Professional education