Palliative and Supportive Services, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia.
Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia.
Omega (Westport). 2020 Jun;81(2):242-271. doi: 10.1177/0030222818765813. Epub 2018 Mar 26.
A Massive Open Online Course, Dying2Learn, was designed to foster community death conversations and strengthen community awareness of palliative care and death as a normal process. This exploratory study used a pre-post prospective design to determine if participation in Dying2Learn and exposure to online conversations about death and dying resulted in any significant influence on death competence in 134 participants who completed the Coping-with-Death-Scale both at the beginning and end of the course in 2016. Death competence refers to a range of attitudes and capabilities people have for dealing with death. Results at the end of the course indicated that engagement in Dying2Learn led to significant improvements in death competence scores over time (medium-to-large effect size). The positive impact was greater for those who completed more of the course, and effectiveness did not depend on sociodemographic characteristics. In conclusion, this study found that an online learning platform in the form of a Massive Open Online Course could engage community members in meaningful social discussion about death and dying, and that exposure to these conversations was beneficial for all participants regardless of previous exposure to death. Further exploration is required to determine whether this change in death competence will have an impact on participant's behavior in the community regarding death conversations and preparedness.
一门名为“大规模开放在线课程（Dying2Learn）”的课程旨在促进社区内关于死亡的对话，并增强社区对姑息治疗和死亡作为正常过程的认识。本探索性研究采用了前后瞻性设计，以确定在 2016 年，134 名参与者在课程开始和结束时都完成了“应对死亡量表”后，是否会因参与 Dying2Learn 并接触关于死亡和临终的在线对话而对死亡能力产生任何重大影响。死亡能力是指人们在处理死亡时所具有的一系列态度和能力。课程结束时的结果表明，随着时间的推移，参与 Dying2Learn 导致死亡能力得分显著提高（中到大的效应大小）。对于那些完成更多课程的人来说，积极影响更大，而且效果并不取决于社会人口特征。总之，这项研究发现，大规模开放在线课程形式的在线学习平台可以使社区成员参与关于死亡和临终的有意义的社会讨论，并且所有参与者都可以从这些对话中受益，而不论他们以前是否接触过死亡。需要进一步探索，以确定这种死亡能力的变化是否会对参与者在社区中关于死亡对话和准备的行为产生影响。
