Palliative care stay room - designing, testing and evaluating a gamified social intervention to enhance palliative care awareness.

INTRODUCTION: The message of palliative care can be promoted using creative thinking and gamification. It can be an innovative strategy to promote changes in behaviour, promote thinking, and work on skills such as empathy. AIM: Design, test and evaluate a gamified social intervention to enhance palliative care awareness among young university students from non-health background. METHODS: Participatory action research study with mixed methods, Design Thinking and using the Public Engagement strategy. Forty-three undergraduate students participated in a Palliative Care Stay Room and completed the Test of Cognitive and Affective Empathy (TECA) before and after the game. At the end of the game, a ten-minute debriefing was held with the participants, which was concluded with an open conversation. The content analysis was done independently and the sum of the scores of each dimension was compared before and after the activity. FINDINGS: The Stay Room improved the participants' knowledge and new perspectives about palliative care. Before the game, their views focused on the end of life and after the game on their values, highlighting the dedication of the healthcare professionals who do not treat death but the life until death. After de game, participants (N = 43: female = 23; male = 20; x̄ 19.6 years old) presented higher values in perspective adoption (intellectual ability to put oneself in the other's place) p = 0.046 and in emotional understanding (ability to recognize emotional states) p = 0.018, and had high scores on empathic joy (p = 0.08). CONCLUSION: Gamification can be used in teaching and transmitting positive attitudes. Palliative Care and can help young university students to think positively about care issues.

The relationship competencies guiding tool: A development, content validation and implementation study.

AIM: The aims of this paper are (1) to present the results of the development, content validation and implementation study of the Relationship Competencies Guiding Tool; (2) to provide examples of how each item in the tool is reflected in clinical narratives written by nurses and justify the corresponding scores after the evaluation; (3) to present how the language and content of the narratives are interpreted with the tool and to describe an exemplar; and (4) to present barriers to and facilitators of the application of the tool. BACKGROUND: From a person-centered care approach, the fostering of authentic relationships with patients is key to achieving therapeutic benefits. Therefore, it is essential to help nurses establish meaningful relationships with patients and help them acquire these abilities. Clinical narratives can be used as a way to promote reflective practice and professional competency development among nurses. A tool to evaluate the knowledge, skills, attitudes and values necessary for developing authentic encounters with patients through clinical narratives was developed, validated and implemented. DESIGN: An instrument-development study comprised of three steps: (1) conceptualization; (2) item generation and content validity; and (3) implementation of the tool and linguistic evaluation. METHODS: This study was conducted in three major steps. Step one entailed conceptualization. Step two included the generation of items and content validation. In step three, the tool was used to independently evaluate 25 narratives. One of these narratives was also linguistically analysed to provide a comprehensive view of the interpretative strategies deployed by evaluators. RESULTS: The Relationship Competencies Guiding Tool was developed, validated and implemented. It could help nurses work on nursing relationship-based professional competencies, guided the evaluators in the process of assigning scores to the corresponding items and helped the researchers identify certain barriers and facilitators before and during the narrative evaluation process. CONCLUSIONS: The tool has been shown to be clear, relevant and conceptually and linguistically suitable for evaluating clinical narratives. The Relationship Competencies Guiding Tool could be applied to interpret how nurses reflect professional competencies in a clinical narrative as a preliminary step in the construction of a measurement tool. TWEETABLE ABSTRACT: From a person-centered relationship-based care approach, clinical narratives can be used to promote professional competencies between nurses. The Relationship Competencies Guiding Tool may help evaluate the knowledge, skills, attitudes and values necessary for developing authentic encounters with persons/families, as reflected by nurses' clinical narratives.

Interdisciplinary discussions on palliative care among university students in Spain: giving voice to the social debate.

BACKGROUND: University students are the future professionals who will influence society. It is thus essential to improve students' understanding of palliative care (PC), especially those in the non-health field, to generate and encourage propitious opinions about PC. This study describes the perceptions of PC among university students from different disciplines. METHOD: Qualitative exploratory study using virtual focus groups (FGs) and design thinking (DT) approach. An intentional sample of students from various disciplines, universities and cities from Spain were selected. Numerous researchers from different fields were involved in the discussion of the final thematic analysis. RESULTS: Four themes and seven subthemes were found: i) Students have an ambiguous understanding about PC; ii) PC is not a common issue for non-health students; ii) Students see PC as an important and necessary field; iii) Students build counter-narratives against PC myths, demonstrating PC brings key benefits into people's lives; iv) PC is a synonym of death. CONCLUSION: Despite the fact that students do not know much about PC, the topic easily arouses reflection and positive discussion. Through the conversations they find positive values and arguments against misunderstand- ing. Students from different disciplines could be the target of innovative educational initia- tives and the social debate on PC.

Cross-sectional survey of the wish to die among palliative patients in Spain: one phenomenon, different experiences.

OBJECTIVE: Cultural backgrounds and values have a decisive impact on the phenomenon of the wish to die (WTD), and examination of this in Mediterranean countries is in its early stages. The objectives of this study were to establish the prevalence of WTD and to characterise this phenomenon in our cultural context. METHODS: A cross-sectional study with consecutive advanced inpatients was conducted. Data about WTD (Assessing Frequency & Extent of Desire to Die (AFFED) interview) and anxiety and depression (Edmonton Symptom Assessment System-revised (ESAS-r)) were collected through two face-to-face clinical encounters. Data were analysed with descriptive statistics, χ2 and analysis of variance. RESULTS: 201 patients participated and 165 (82%) completed both interviews. Prevalence of WTD was 18% (36/201) in the first interview and 16% (26/165) in the second interview (p=0.25). After the first interview, no changes in depression (p=0.60) or anxiety (p=0.90) were detected. The AFFED shows different experiences within WTD: 11% of patients reported a sporadic experience, while 7% described a persistent experience. Thinking about hastening death (HD) appeared in 8 (22%) out of 36 patients with WTD: 5 (14%) out of 36 patients considered this hypothetically but would never take action, while 3 (8%) out of 36 patients had a more structured idea about HD. In this study, no relation was detected between HD and frequency of the appearance of WTD (p=0.12). CONCLUSIONS: One in five patients had WTD. Our findings suggest the existence of different experiences within the same phenomenon, defined according to frequency of appearance and intention to hasten death. A linguistically grounded model is proposed, differentiating the experiences of the 'wish' or 'desire' to die, with or without HD ideation.

Quantifying the speech-gesture relation with massive multimodal datasets: Informativity in time expressions.

The development of large-scale corpora has led to a quantum leap in our understanding of speech in recent years. By contrast, the analysis of massive datasets has so far had a limited impact on the study of gesture and other visual communicative behaviors. We utilized the UCLA-Red Hen Lab multi-billion-word repository of video recordings, all of them showing communicative behavior that was not elicited in a lab, to quantify speech-gesture co-occurrence frequency for a subset of linguistic expressions in American English. First, we objectively establish a systematic relationship in the high degree of co-occurrence between gesture and speech in our subset of expressions, which consists of temporal phrases. Second, we show that there is a systematic alignment between the informativity of co-speech gestures and that of the verbal expressions with which they co-occur. By exposing deep, systematic relations between the modalities of gesture and speech, our results pave the way for the data-driven integration of multimodal behavior into our understanding of human communication.

What does the media say about palliative care? A descriptive study of news coverage in written media in Spain.

INTRODUCTION: The goal of palliative care (PC) is to improve the quality of life of terminal stage patients and their families. The subject frequently appears in the mass-media and this helps create a socially accepted identity. The aim of this study is to describe and analyse PC related news items appeared in the Spanish written media. METHODOLOGY: A descriptive cross-sectional study was designed. Considering diffusion, scope and the range in editorial policy criteria, four printed newspapers (PN) were selected, together with four exclusively digital media sources (DM). Through Mynews, a newspaper content depository, and the search tool for each DM website, articles published between 2009 and 2014 which included the terms "palliative care" and "palliative medicine" were sought. A questionnaire was created to characterise each article identified and a descriptive analysis was undertaken. RESULTS: A total of 627 articles were identified, of which 359 (57%) were published in PN (42% in the printed editions -PE- 16% in their online editions -OE-) and 268 (43%) in DM. In general, they appeared mainly in sections concerning Health (23%), Culture and Society (18%) and General/Home News (15%). In PE, just 2% were found in the Health section and nearly 70% in Culture and Society and General/Home News. Most of the articles were informative in nature and contained socio-political messages (90%). Statements by PC professionals were found in 35% of the articles and by politicians in 32%. The most frequent content was related to facing end of life (74%) and patient quality of life (70%). CONCLUSIONS: The Spanish written media reflects the socio-political interest aroused by PC. Nevertheless, messages circulating about PC do not describe professional practice, or the contribution of the same for patients. Content more in line with the clinical practice might help contribute to the development of this new area of medicine.

Visibilidad de los sanitarios durante la crisis del Covid-19: estudio de fuentes y temáticas en los informativos de televisión / Visibilidade dos profissionais de saúde durante a crise Covid-19: estudo de fontes e temas em notícias de televisão / Visibility of healthcare workers in the Covid-19 crisis: a study of sources and topics in television news broadcasts

Esta investigación analiza la cobertura mediática de la crisis del Covid-19 en España, y el papel que en ella ha tenido la comunicación sobre salud y sobre los profesionales sanitarios. Se estudia el tratamiento recibido por las fuentes y temas sanitarios en los informativos de Radiotelevisión Española (RTVE) emitidos entre el 31 diciembre 2019 y el 8 junio 2020. Para ello, se realiza un análisis de contenido cuantitativo de 452 noticias de 21 informativos. Los resultados muestran que los debates de política y los propios políticos ocupan más espacio como tema y fuentes, respectivamente, en los informativos analizados, por delante de la salud y de los profesionales sanitarios. El estudio confirma, por tanto, la falta de visibilidad de los profesionales de salud en la cobertura informativa televisiva en España sobre el Covid-19. (AU)

Esta pesquisa analisa a cobertura mediática da crise do Covid-19 na Espanha e o papel que a comunicação sobre a saúde e os profissionais de saúde nela tiveram. É estudado o tratamento recebido pelas fontes e questões de saúde nos telejornais da Radiotelevisión (RTVE) da Espanha, transmitidos entre 31 de dezembro de 2019 e 8 de junho de 2020. Para isso, é realizada uma análise quantitativa do conteúdo de 452 notícias de um total de 21 telejornais. Os resultados mostram que os debates sobre políticas e os próprios políticos ocupam mais espaço como tema e fontes, respectivamente, nos noticiários analisados, à frente dos profissionais de saúde e dos profissionais de saúde. O estudo, portanto, confirma a falta de visibilidade dos profissionais de saúde na cobertura noticiosa da televisão na Espanha sobre o Covid-19. (AU)

This study is an analysis on the Spanish media coverage of the Covid-19 crisis and the role of information on health and healthcare professionals within it. We studied the treatment given to healthcare sources and topics in news broadcasts released by Radiotelevisión Española (RTVE) between December 31, 2019, and June 8, 2020. To this end, we conducted a quantitative content analysis on 452 news items from 21 news broadcasts. The results showed that debates on political issues were the main topics and politicians were the main sources, in the broadcasts analyzed, ahead of health issues and healthcare professionals. Our study thus confirms the lack of visibility of healthcare professionals in the television news coverage of the Covid-19 crisis in Spain. (AU)