Perceptions and experiences of onco-haematology professionals in relation to advance care planning: a qualitative study.

PURPOSE: The objective of this study is to identify the beliefs, values, perceptions, and experiences of medical oncology, radiation oncology, and clinical haematology professionals about the advance care planning process. METHODS: Qualitative exploratory study. There were four focus groups with 14 nurses and 12 physicians (eight medical oncology, one radiation oncology, three haematology). A reflexive thematic analysis of the data obtained was performed. RESULTS: We identified 20 thematic categories, which we grouped into four themes: lack of knowledge about advance care planning; perception of the advance care planning process: knowledge acquired from practice; barriers and facilitators for the implementation of advance care planning; and communication as a key aspect of advance care planning. CONCLUSIONS: The participants valued advance care planning as an early intervention tool that promotes autonomy. They perceived difficulties in approaching planning due to lack of knowledge, training, and time. They identified the therapeutic relationship with the person, the participation of the person's loved ones, teamwork, and communication skills as essential to ensuring the quality of the process. Finally, they recognised that palliative care professionals provide added value in supporting planning processes.

Primary Care Professionals' Self-Efficacy Surrounding Advance Care Planning and Its Link to Sociodemographics, Background and Perceptions: A Cross-Sectional Study.

Primary care (PC) professionals have been considered the most appropriate practitioners for leading Advance care planning (ACP) processes with advanced chronic patients. AIM: To explore how PC doctors' and nurses' self-efficacy surrounding ACP is linked to their sociodemographic characteristics, background and perceptions of ACP practices. METHODS: A cross-sectional study was performed. Sociodemographics, background and perceptions about ACP in practice were collected using an online survey. The Advance Care Planning Self-Efficacy Spanish (ACP-SEs) scale was used for the self-efficacy measurement. STATISTICAL ANALYSIS: Bivariate, multivariate and backward stepwise logistic regression analyses were performed to identify variables independently related to a higher score on the ACP-SEs. RESULTS: N = 465 participants, 70.04% doctors, 81.47% female. The participants had a mean age of 46.45 years and 66.16% had spent >15 years in their current practice. The logistic regression model showed that scoring ≤ 75 on the ACP-SEs was related to a higher score on feeling sufficiently trained, having participated in ACP processes, perceiving that ACP facilitates knowledge of preferences and values, and perceiving that ACP improves patients' quality of life. CONCLUSION: Professionals with previous background and those who have a positive perception of ACP are more likely to feel able to carry out ACP processes with patients.

Spanish Cross-Cultural Adaptation and Psychometric Properties of the Advance Care Planning Self-Efficacy: A Cross-Sectional Study.

Background: Perceived self-efficacy in advance care planning (ACP) is frequently used to measure the impact of ACP programs for professionals responsible for advanced chronic patients. A validated ACP Self-Efficacy (ACP-SE) scale is not currently available in Spanish. Objective: To culturally adapt and validate Baughman's ACP-SE scale into Spanish (ACP-SEs). Methodology/Design: An instrumental study was performed in two phases: (1) cultural adaptation of the ACP-SE scale and (2) psychometric properties measurement. Setting/Participants: The survey was sent to 5785 professionals: physicians, nurses, psychologists, and social workers, members of scientific associations in the areas of primary care, geriatrics, and palliative care in Catalonia, Spain. Results: Five hundred thirty-eight questionnaires were obtained, respondents were physicians (69.0%) and nurses (28.4%) and mean age was 47 years (standard deviation [SD] = 10.1). Most were women (79.6%), 68% had >15 years of professional experience, and 80.7% worked in primary care. Internal consistency was high (Cronbach's alpha = 0.95) and showed a unidimensional structure explaining 56.2% of total variance. Mean score was 67.37 (SD = 16.1). Variables associated with greater self-efficacy were previous training (t = -3.23, df = 273.76, p = 0.001), previous participation in ACP processes (t = -6.23, df = 521, p < 0.001), and membership in geriatric or palliative care scientific association (p < 0.001). ACP-SEs positively correlated to other compared scales. Conclusion: The ACP-SE scale demonstrates adequate psychometric properties. This is the first self-efficacy scale for ACP in Spanish. It should facilitate a better understanding of implementation processes related to ACP programs for professionals involved in caring for patients with advanced diseases.

Innovative teaching strategies in palliative care: Reading of a phenomenological text on the experience of living with advanced cancer.

BACKGROUND: Pedagogical strategies in palliative care are diverse and mainly aimed to understand patients with advanced disease and improving their care. Phenomenological texts are stories intended to evoke lived experiences and help understand complex situations. AIM: To determine what thoughts, experiences and feelings nursing students have when reading a phenomenological text about the experience of a person living with advanced cancer. DESIGN AND METHOD: A descriptive qualitative study with palliative care students of the nursing degree at two university centres. The students reflected on a phenomenological text. A thematic analysis of the 14 reflections was performed. The reflections were analysed inductively and independently, and periodic sessions were held to discuss the identified categories and topics. RESULTS: The students' writings showed that reading the phenomenological text caused them to reflect and feel moved and challenged. The impact on the students is grouped into three categories: the experience of the corporeality of patients with advanced disease makes students aware of the importance of the body; the disease as an individual transformative process challenges students; and the experiences of people with advanced cancer make students aware of the importance of how they care for patients and their families. CONCLUSION: The reading of a phenomenological text on the experience of living with advanced cancer may be a teaching method that can generate experiences that promote reflective and experiential learning in nursing students. It seems to be a useful tool for teaching in subjects focusing on person-centred care.

Development and implementation of an advance care planning program in Catalonia, Spain.

OBJECTIVE: Implementation of an advance care planning (ACP) program for people with advanced chronic conditions is a complex process. The aims of this paper are to describe (1) the development of the ACP program in Catalonia, Spain, for patients with advanced chronic conditions and complex needs and (2) the preliminary results of the implementation of this program in health and social services. METHOD: The ACP program was developed and implemented in a four-stage process as follows: (1) design and organization of the project; (2) selection of the professionals to carry out the project; (3) creation of four working groups to develop the conceptual model, guidelines, training program, and perform a qualitative evaluation; and (4) project implementation. RESULT: The following deliverables were completed: (1) conceptual framework document; (2) practical guidelines for the application of the ACP; (3) online training course (3,763 healthcare professionals completed the online course, with an overall satisfaction rating of 8.4 on a 10-point scale); and (4) additional training activities (conferences, short courses, and seminars) in between 2015 and 2017. SIGNIFICANCE OF RESULTS: This project was led by the Catalan Ministry of Health. The strengths of the project development include the contribution of a wide range of professionals from the entire region, approval by the Catalan Bioethics Committee and the Social Services Ethics Committee, and the ongoing validation by members of the community. A standardized online training course was offered to all primary care professionals and included as a quality indicator for continuing education for those professionals in the period 2016-2020. The main outcome of this project is the establishment of a pragmatic ACP throughout the region and training of the health and social care professionals involved in the care of advanced chronic patients.

Otra manera de enseñar enfermería clínica: el arte como vehículo formador / Another way to teach clinical nursing: Art as a learning methodology

En los estudios de enfermería se reconoce la existencia de problemas que están provocando un bajo rendimiento académico a nivel internacional, así como un aumento de absentismo y abandono de la titulación. Diversos estudios han utilizado el arte como estrategia de enseñanza, demostrando un aumento en el aprendizaje y en la motivación de los estudiantes. El objetivo de este estudio es evaluar una experiencia docente que incluye el arte como vehículo formador en el aprendizaje de la fisiopatología y cuidados enfermeros de la piel. Para ello se realiza un diseño mixto, con una primera fase cualitativa exploratoria preliminar y una segunda fase cuantitativa para evaluar la intervención definitiva. Los principales resultados muestran que el aprendizaje de los contenidos en los que se ha utilizado el arte como metodología docente han sido mejor asimilados, y los estudiantes se han mostrado altamente satisfechos con esta metodología; respecto al pensamiento creativo, la escala EDICOS ha mostrado una alta consistencia en todas las dimensiones, y no se han obtenido diferencias significativas en relación con el género. Los estudiantes expresan que la observación e interpretación del arte les ha permitido una aproximación a la realidad y una reflexión sobre los cuidados enfermeros

Several nursing studies recognise the existence of problems that are caused by a low academic performance at international level, as well as an increase in absenteeism and abandonment of the degree. Most of these studies have used art as an instrument of learning, demonstrating an increase in student knowledge and motivation. The objective of this study is to evaluate a teaching experience that includes Arts-Based-Learning of the pathophysiology and nursing care of the skin. A two-phase mixed design was used to evaluate the (definitive) intervention. In the first phase, the qualitative performance was explored, and in the second phase, the quantitative performance was evaluated. RESULTS: showed a better assimilation of learning contents for those students for whom art has been used as a teaching methodology. A high level of satisfaction among students was also observed with this methodology. Regarding creative thinking, the EDICOS scale showed a high consistency in all dimensions. However, no significant gender-related differences were found. Students expressed that the observation and interpretation of art have provided them with an outline of the current situation, and a reflection of nursing care

Correction: An International Consensus Definition of the Wish to Hasten Death and Its Related Factors.

[This corrects the article DOI: 10.1371/journal.pone.0146184.].

Spanish Adaptation of the Frommelt Attitude Toward Care of the Dying Scale (FATCOD-S) in Nursing Undergraduates.

The Frommelt Attitude Toward Care of the Dying Scale (FATCOD) is designed to assess the attitudes of professionals and trainees toward caring for the dying patient and their family members. In this study the main aim is to adapt the FATCOD to a Spanish context (FATCOD-S). In addition, the relations between FATCOD-S, sociodemographic variables, emotional intelligence, and death attitudes have been analyzed. A sample of 669 Spanish nursing students from four Universities responded to a questionnaire. The exploratory factor analysis (EFA) concludes a structure composed of two significant factors. A confirmatory factor analysis (CFA) was carried out. The CFA supported a two-factor model. Students with past experience of death and those who had received training in palliative care scored significantly higher on both factors of the FATCOD-S ( p < 0.01). The FATCOD-S is an effective and valid tool for measuring the attitudes of Spanish nursing students toward caring for patients at the end of life.

A comparison of medical students', residents' and tutors' attitudes towards communication skills learning.

BACKGROUND: The consensus about the importance of communication skills in patient-care does not guarantee that students and faculty perceive the usefulness of these skills. This study evaluated and compared medical students', residents' and tutors' attitudes towards learning communication skills, and examined the association with gender and year of residency. METHODS: We conducted a cross-sectional survey with 492 participants (282 second-year students, 131 residents and 79 tutors). They completed the Communication Skills Attitude Scale (CSAS) and demographic/educational information. RESULTS: In general, participants showed positive attitudes towards learning communication skills. Medical students, residents and tutors did not differ on the Positive Attitudes Scale (CSAS-PAS). Residents scored higher than medical students on the Negative Attitudes Scale (CSAS-NAS) (P < 0.01). Females showed higher scores on the CSAS-PAS (P < 0.05) and lower scores on the CSAS-NAS (P < 0.01) than males in all subsamples. The effect sizes were medium. There were no significant differences according to year of residency. DISCUSSION: Medical students, residents and tutors consider training in communication skills an essential component for clinical practice and they agree about the need to learn these communication skills. Attention should be paid to measuring attitudes at all three levels of medical education in the design of communication skills courses.

An International Consensus Definition of the Wish to Hasten Death and Its Related Factors.

BACKGROUND: The desire for hastened death or wish to hasten death (WTHD) that is experienced by some patients with advanced illness is a complex phenomenon for which no widely accepted definition exists. This lack of a common conceptualization hinders understanding and cooperation between clinicians and researchers. The aim of this study was to develop an internationally agreed definition of the WTHD. METHODS: Following an exhaustive literature review, a modified nominal group process and an international, modified Delphi process were carried out. The nominal group served to produce a preliminary definition that was then subjected to a Delphi process in which 24 experts from 19 institutions from Europe, Canada and the USA participated. Delphi responses and comments were analysed using a pre-established strategy. FINDINGS: All 24 experts completed the three rounds of the Delphi process, and all the proposed statements achieved at least 79% agreement. Key concepts in the final definition include the WTHD as a reaction to suffering, the fact that such a wish is not always expressed spontaneously, and the need to distinguish the WTHD from the acceptance of impending death or from a wish to die naturally, although preferably soon. The proposed definition also makes reference to possible factors related to the WTHD. CONCLUSIONS: This international consensus definition of the WTHD should make it easier for clinicians and researchers to share their knowledge. This would foster an improved understanding of the phenomenon and help in developing strategies for early therapeutic intervention.

Death attitudes and positive coping in Spanish nursing undergraduates: a cross-sectional and correlational study.

AIMS AND OBJECTIVES: To analyse the relationship between death attitudes, emotional intelligence, resilience and self-esteem in a sample of nursing undergraduates. BACKGROUND: The death attitudes held by nursing students may influence the care they offer to end-of-life patients and their families. Emotional intelligence, resilience and self-esteem are important social and emotional competencies for coping positively with death and dying. DESIGN: Cross-sectional and correlational study. METHODS: Participants were 760 nursing undergraduates from four nursing schools in Spain. Data were collected in 2013-2014. The students responded anonymously to a self-report questionnaire that gathered socio-demographic data and which assessed the following aspects: fear of death (Collett-Lester Fear of Death Scale), death anxiety (Death Anxiety Inventory-Revised), perceived emotional intelligence (Trait Meta-Mood Scale, with its three dimensions: attention, clarity and repair), resilience (Brief Resilient Coping Scale) and self-esteem (Rosenberg Self-Esteem Scale). In addition to descriptive statistics, analyses of variance, mean differences, correlations and regression analyses were computed. RESULTS: Linear regression analysis indicated that attention to feelings, resilience and self-esteem are the significant predictors of death anxiety. CONCLUSIONS: The results show that death anxiety and fear of death are modulated by social and emotional competencies associated with positive coping. RELEVANCE TO CLINICAL PRACTICE: The training offered to future nurses should include not only scientific knowledge and technical skills but also strategies for developing social and emotional competencies. In this way, they will be better equipped to cope positively and constructively with the suffering and death they encounter at work, thus helping them to offer compassionate patient-centred care and minimising the distress they experience in the process.

Formación en habilidades comunicativas desde la perspectiva de residentes y tutores en medicina / Training in communication skills according to residents' and tutors' perspective in medicine

Introducción: En las últimas décadas se ha producido un cambio sustancial respecto a la consideración de las habilidades comunicativas en el currículo de medicina. Actualmente, se considera una competencia nuclear del profesional sanitario, susceptible de entrenamiento y mejora. Objetivo: Identificar el nivel de formación y las necesidades percibidas de médicos especialistas en formación (MEF) y tutores respecto al aprendizaje de habilidades comunicativas, como primer paso para diseñar programas efectivos adaptados al contexto actual. Sujetos y métodos: Participaron 131 residentes y 79 tutores, de 12 centros hospitalarios de Cataluña, que cumplimentaron vía online un cuestionario autoadministrado. Resultados: Un 74% de residentes y un 67% de los tutores habían recibido formación en habilidades comunicativas. Residentes y tutores coincidieron en la valoración del área en la que la formación es adecuada (entrevista clínica) y en las áreas susceptibles de mejora (manejo de emociones, gestión de situaciones difíciles y comunicación con familiares y cuidadores) durante el programa de MEF. Ambos manifestaron una alta predisposición a participar en futuros programas de formación. Conclusiones: Existen deficiencias en la formación en habilidades comunicativas de residentes y tutores de medicina. Uno de los retos es asegurar que los residentes, independientemente de la especialidad, adquieran un nivel óptimo de competencias comunicativas una vez finalizado el periodo de formación

Introduction: During last decades there has been a substantial change from the consideration of communication skills in the curriculum of medicine. Currently, it is considered a core competency of health professionals; it can be trained and improved. Aim: To identify the level of training and the perceived needs of residents and tutors about the learning of communication skills as a first step in designing effective programs adapted to the current context. Subjects and methods: Participants were 131 residents and 79 tutors, from 12 hospitals in Catalonia, who completed a self administered questionnaire via online. Results: 74% of residents and 67% of the tutors had received training in communication skills. Residents and tutors agreed on the valuation of the area in which the training was appropriate (clinical interview) and in areas for improvement (managing emotions, managing difficult situations, and communication with family and caregivers) during the training system of health care professionals. Both showed a high willingness to participate in future training programs. Conclusions: There are deficiencies in communication skills training of residents and tutors of Medicine. One of the challenges is to ensure that residents, regardless of specialty, acquire an optimal level of communicative competence upon completion of the training period

Perceived emotional intelligence in nursing: psychometric properties of the Trait Meta-Mood Scale.

AIMS AND OBJECTIVES: To examine the psychometric properties of the Trait Meta-Mood Scale in the nursing context and to determine the relationships between emotional intelligence, self-esteem, alexithymia and death anxiety. BACKGROUND: The Trait Meta-Mood Scale is one of the most widely used self-report measures for assessing perceived emotional intelligence. However, in the nursing context, no extensive analysis has been conducted to examine its psychometric properties. DESIGN: Cross-sectional and observational study. METHODS: A total of 1417 subjects participated in the study (1208 nursing students and 209 hospital nurses). The Trait Meta-Mood Scale, the Toronto Alexithymia Scale, the Rosenberg Self-Esteem Scale and the Death Anxiety Inventory were all applied to half of the sample (n = 707). A confirmatory factor analysis was carried out, and statistical analyses examined the internal consistency and test-retest reliability of the Trait Meta-Mood Scale, as well as its relationship with relevant variables. RESULTS: Confirmatory factor analysis confirmed the three dimensions of the original scale (Attention, Clarity and Repair). The instrument showed adequate internal consistency and temporal stability. Correlational results indicated that nurses with high scores on emotional Attention experience more death anxiety, report greater difficulties identifying feelings and have less self-esteem. By contrast, nurses with high levels of emotional Clarity and Repair showed less death anxiety and higher levels of self-esteem. CONCLUSIONS: The Trait Meta-Mood Scale is an effective, valid and reliable tool for measuring perceived emotional intelligence in the nursing context. Training programmes should seek to promote emotional abilities among nurses. RELEVANCE TO CLINICAL PRACTICE: Use of the Trait Meta-Mood Scale in the nursing context would provide information about nurses' perceived abilities to interpret and manage emotions when interacting with patients.

Associations between emotional intelligence, depression and suicide risk in nursing students.

BACKGROUND: The most important factor which predisposes young people to suicide is depression, although protective factors such as self-esteem, emotional adaptation and social support may reduce the probability of suicidal ideation and suicide attempts. Several studies have indicated an elevated risk of suicide for health-related professions. Little is known, however, about the relationship between perceived emotional intelligence and suicide risk among nursing students. OBJECTIVES: The main goals were to determine the prevalence of suicide risk in a sample of nursing students, to examine the relationship between suicide risk and perceived emotional intelligence, depression, trait anxiety and self-esteem, and to identify any gender differences in relation to these variables. METHOD: Cross-sectional study of nursing students (n=93) who completed self-report measures of perceived emotional intelligence (Trait Meta-Mood Scale, which evaluates three dimensions: emotional attention, clarity and repair), suicide risk (Plutchik Suicide Risk Scale), self-esteem (Rosenberg Self-esteem Scale), depression (Zung Self-Rating Depression Scale) and anxiety (Trait scale of the State-Trait Anxiety Inventory). RESULTS: Linear regression analysis confirmed that depression and emotional attention are significant predictors of suicidal ideation. Moreover, suicide risk showed a significant negative association with self-esteem and with emotional clarity and repair. Gender differences were only observed in relation to depression, on which women scored significantly higher. Overall, 14% of the students were considered to present a substantial suicide risk. CONCLUSIONS: The findings suggest that interventions to prevent suicidal ideation among nursing students should include strategies to detect mood disorders (especially depression) and to improve emotional coping skills. In line with previous research the results indicate that high scores on emotional attention are linked to heightened emotional susceptibility and an increased risk of suicide. The identification and prevention of factors associated with suicidal behaviour in nursing students should be regarded as a priority.

Death attitudes and emotional intelligence in nursing students.

The aims of this study were to analyze the relationships between death attitudes and perceived emotional intelligence in a sample of nursing students, and to determine whether there are differences between different academic years with regard to both emotional intelligence and death attitudes. The participants were 243 nursing students. They all responded voluntarily and anonymously to a questionnaire that assessed the following constructs: fear of death, death anxiety, death depression, death obsession, and emotional intelligence (attention, clarity, and mood repair). Students' scores on fear of death of others subscale (p < .05) decreased significantly across the 3 years of the nursing degree program and increased significantly on emotional clarity (p < .05), a dimension of emotional intelligence. The multiple linear regression analyses confirmed the predictive value of attention, clarity, and mood repair regarding levels of fear of death of others. The importance of including emotional skills training and death-education programs as part of professional nursing curricula are discussed.

Fear of death among nursing students

Objetivo. Evaluar, en una muestra de estudiantes de enfermería, el miedo ante la muerte propia y ajena y sus relaciones con diversas variables sociodemográficas: sexo, edad, curso académico, origen geográfico, estado civil y experiencias previas con la muerte. Método. Diseño observacional, descriptivo y transversal. Participaron 243 estudiantes de enfermería, que respondieron a un cuestionario que contenía las variables sociodemográficas y la forma española de la escala de miedo a la muerte de Collet-Lester (CLFDS). En el análisis estadístico se calcularon medias y desviaciones típicas, prueba t de Student, ANOVA y coeficientes de correlación de Pearson y Spearman. Resultados. Se obtuvieron correlaciones negativas entre la CLFDS y la edad. Las mujeres obtienen puntuaciones más altas en las cuatro subescalas de la CLFDS. La creencia y la práctica religiosa correlacionan negativamente con el miedo a la propia muerte. El contacto previo con la muerte correlaciona negativamente con tres de las subescalas de la CLFDS. Los sujetos solteros puntúan más alto en dos de las subescalas de la CLFDS. Según el curso académico se observa significación estadística en la subescala de miedo a la muerte de otros. Conclusiones. Para planificar la formación de los estudiantes de enfermería en competencias específicas para el acompañamiento al final de la vida, es muy importante conocer sus actitudes ante la muerte y sus variables relacionadas, así como los elementos que producen en ellos mayores reacciones de miedo y/o ansiedad, que pueden afectar a la calidad de los cuidados que proporcionen en su futuro ejercicio profesional (AU)

Objective. To assess, using a sample of nursing students, the fear of their own death and that of others and its relationship with several sociodemographic variables: gender, age, academic year, geographical origin, marital status and previous experiences with death. Methods. An observational, descriptive and cross-sectional study including 243 nursing students who completed a questionnaire containing the sociodemographic variables and the Spanish version of the Collet-Lester's Fear of Death Scale (CLFDS). Means and standard deviations, Student t test, ANOVA and Pearson and Spearman correlation coefficients, were calculated in the statistical analysis. Results. A negative correlation was obtained between the CLFDS and age. Women scored higher on the four subscales of the CLFDS. Religious belief and practice were negatively correlated with fear of own death. Previous experiences with death are negatively correlated with three subscales of the CLFDS. Single nursing students scored higher on two subscales of the CLFDS. Statistical significance with the academic year was observed in the subscale of fear of others’ death. Conclusions. To plan the training of nursing students based on specific competences on caring at the end of life, it is very important to understand the students’ attitudes toward death. It is also important to understand the related variables, as well as the elements that trigger more fear or anxiety in the students, which can affect the quality of care they provide in their future professional practice (AU)

[Fear of death among nursing students]. / Miedo a la muerte en estudiantes de enfermería.

OBJECTIVE: To assess, using a sample of nursing students, the fear of their own death and that of others and its relationship with several sociodemographic variables: gender, age, academic year, geographical origin, marital status and previous experiences with death. METHODS: An observational, descriptive and cross-sectional study including 243 nursing students who completed a questionnaire containing the sociodemographic variables and the Spanish version of the Collet-Lester's Fear of Death Scale (CLFDS). Means and standard deviations, Student t test, ANOVA and Pearson and Spearman correlation coefficients, were calculated in the statistical analysis. RESULTS: A negative correlation was obtained between the CLFDS and age. Women scored higher on the four subscales of the CLFDS. Religious belief and practice were negatively correlated with fear of own death. Previous experiences with death are negatively correlated with three subscales of the CLFDS. Single nursing students scored higher on two subscales of the CLFDS. Statistical significance with the academic year was observed in the subscale of fear of others' death. CONCLUSIONS: To plan the training of nursing students based on specific competences on caring at the end of life, it is very important to understand the students' attitudes toward death. It is also important to understand the related variables, as well as the elements that trigger more fear or anxiety in the students, which can affect the quality of care they provide in their future professional practice.

[Revision of the diagnostic label death anxiety]. / Revisión de la etiqueta diagnóstica ansiedad ante la muerte.

The inclusion of the diagnostic label of "death anxiety" by the North Americvan Nursing Diagnosis Association (NANDA) in the 2001-2002 taxonomy is justified by the interest in establishing the specific care required in terminal patients. Nevertheless, the definition of "death anxiety" does not delimit the concept precisely, since it does not clearly establish the difference between the terms "death anxiety" and "fear of death". Consequently, the need arose to design a project whose goal was to modify the nursing diagnostic label and defining characteristics proposed by the NANDA, as well as to formulate the related factors, which had not yet been developed. At the meeting of the Diagnostic Review Committee in February 2005, the NANDA considered the proposal, accepting both the modification of the definition of the diagnostic label and the inclusion of the related factors. The revision will be included in the 2007 NANDA taxonomy.

Revisión de la etiqueta diagnóstica ansiedad ante la muerte / Revision of the diagnostic label 'death anxiety'

La inclusión, por parte de la North American Nursing Diagnosis Association (NANDA) en la taxonomía 2001-2002, de la etiqueta ansiedad ante la muerte se justifica por el interés que supone la concreción de cuidados específicos dirigidos a personas en proceso de muerte. No obstante, la definición planteada no delimita el concepto de una manera precisa, ya que no establece con claridad la diferencia entre los términos de ansiedad ante la muerte y temor ante la muerte. Consecuentemente, se planteó la necesidad de diseñar un proyecto cuyo objetivo fuese la modificación de la etiqueta diagnóstica propuesta por NANDA, así como la formulación de los factores relacionados pendientes de desarrollar. En la reunión del Comité de Revisión de Diagnósticos de febrero de 2005, la NANDA sometió a consideración la propuesta realizada, aceptando tanto la modificación de la definición de la etiqueta diagnóstica como la inclusión de los factores relacionados, que serán incluidos en la taxonomía de 2007

The inclusion of the diagnostic label of "death anxiety" by the North Americvan Nursing Diagnosis Association (NANDA) in the 2001-2002 taxonomy is justified by the interest in establishing the specific care required in terminal patients. Nevertheless, the definition of "death anxiety" does not delimit the concept precisely, since it does not clearly establish the difference between the terms "death anxiety" and "fear of death". Consequently, the need arose to design a project whose goal was to modify the nursing diagnostic label and defining characteristics proposed by the NANDA, as well as to formulate the related factors, which had not yet been developed. At the meeting of the Diagnostic Review Committee in February 2005, the NANDA considered the proposal, accepting both the modification of the definition of the diagnostic label and the inclusion of the related factors. The revision will be included in the 2007 NANDA taxonomy

Efectos de un programa de educación emocional sobre la ansiedad ante la muerte en estudiantes de enfermería / Effects of an emotional education program on death anxiety in nursing students

Objetivos. Analizar el efecto de una intervención de educación emocional sobre la ansiedad ante la muerte, en estudiantes de enfermería que cursaron la asignatura de cuidados paliativos, así como las relaciones que hay entre la ansiedad ante la muerte y la inteligencia emocional. Método. Diseño transversal de medidas repetidas antes-después. Los estudiantes respondieron, al principio y al final de la asignatura, un cuestionario que contenía el inventario de ansiedad ante la muerte (DAI) y la escala de inteligencia emocional (TMMS). Las medidas obtenidas se compararon mediante el test de la t de Student para muestras apareadas y coeficientes de correlación de Pearson. Resultados. Aunque las puntuaciones posteriores a la intervención educativa fueron inferiores en el caso de la ansiedad ante la muerte y superiores en la inteligencia emocional, las diferencias fueron pequeñas y sin significación estadística. En las puntuaciones postest, la ansiedad ante la muerte correlaciona negativamente con los 3 factores de la inteligencia emocional, significativamente en el factor comprensión. Los resultados sugieren que cuando aumenta la comprensión del significado de la muerte y su asunción como un proceso natural, se produce una disminución de la ansiedad ante la muerte. Conclusiones. Los resultados apoyan los planteamientos de numerosos estudios acerca de que los profesionales de enfermería se sienten incómodos y muchas veces desbordados emocionalmente en el cuidado de los pacientes en situación terminal y sus familias, y necesitan formación específica que les permita elaborar estrategias de afrontamiento eficaces para superar la ansiedad que les supone el proceso

Objectives. To assess the effect of an emotional education intervention on death anxiety levels in nursing students who completed a course on palliative care and to analyze the association between death anxiety and emotional intelligence. Method. A cross-sectional, repeated-measures, before-after study was performed. The students completed a questionnaire containing the death anxiety inventory (DAI) and an emotional intelligence scale (Trait Meta-Mood Scale [TMMS]) at the beginning and end of the course. The scores obtained were compared using Student's t-test for paired samples and Pearson's correlation coefficients. Results. Although post-intervention scores were lower for death anxiety and higher for emotional intelligence, the differences were slight and non-significant. In post-test scores, death anxiety was negatively correlated with the three factors of emotional intelligence and was significantly correlated with the factor of comprehension. The results suggest that greater understanding of death and acceptance of death as a natural process lowers death anxiety levels. Conclusions. These results support the approach adopted by numerous studies showing that nursing professionals feel uncomfortable and very often emotionally overwhelmed when treating terminally ill patients and their families. Consequently, nurses should be provided with specific training that would allow them to develop effective strategies for coping with death anxiety