Palliative terminal care virtual training for inexperienced nurses on emotional and spiritual capability

Abstract

Over recent decades, the quality of death and dying has received much attention in society. Many patients with terminal cancers or admitted to intensive care/acute units are in need of care for the end of their life (Susan, 2015). With this need rising up, palliative care service is gradually developed mainly as the setting of hospice or home care. However, some patients who are terminally ill are in a situation in need of hospital medical settings to manage their symptoms (Cotogni, 2018). Therefore, in-hospital palliative terminal care becomes important for those patients/families in terms of guaranteeing the quality of life in their last days or hours. Currently, most western hospitals, including Maasstad Hospital, implement palliative terminal care with the integrative model (Metaxa, 2019) which needs general medical professionals, especially nurses, to provide palliative care as a part of routine practice combined with a consultative palliative care team, which is a reported as a challenging work for nurses (Bratianu, 2015) (Johansson, 2011). The project aims to investigate how to support nurses in the Oncology Department of Maasstad Hospital to be able to provide palliative care to patients. Through a series of literature research and interviews from historical (trend), cultural, user and context, and technology aspects to understand and explore the context, the design opportunity, supporting junior nurses with palliative care on-site learning, is unearthed. Insights gained from supplementary research helps the project further define the design goal: to create virtual training of palliative care for inexperienced nurses on emotional and spiritual capabilities, where nurses gradually become mentally prepared to provide palliative terminal care for dying patients and families, to ensure nurses’ mental well-being while being able to provide emotional and spiritual care to patients and families with quality. A VR demo is built for nurses to evaluate the concept. Due to the Covid-19 situation with limited access to nurses, the evaluation result is not quantitative which means further user tests and evaluation need to be considered. The final design is perceived by the nurse as to be promising to provide the inexperienced nurses or even other medical professionals with a safe environment to learn to cope with their own feelings, explore and make mistakes, and be eventually more comfortable and confident to look after dying patients and their family members. However, since the design mainly focuses on the training program structure and the experience journey, more opportunities and details of the interaction design still need to be developed and tested if the application is expected to be launched. The recommendations regarding these details and opportunities are provided as the end of this project.