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将预先护理计划纳入临终教育:护理专业学生对预先医疗指示和“五个愿望”任务的反思。

Integrating Advance Care Planning into End-of-Life Education: Nursing Students' Reflections on Advance Health Care Directive and Five Wishes Assignments.

作者信息

Doan Therese, Brennan Sumiyo

机构信息

School of Nursing, San Francisco State University, San Francisco, CA 94132, USA.

Institute for Gerontology, J.F. Oberlin University, Tokyo 3758, Japan.

出版信息

Nurs Rep. 2025 Jul 28;15(8):270. doi: 10.3390/nursrep15080270.

Abstract

: End-of-life care is a vital part of nursing education that has been overlooked until recent years. Advance care planning should be incorporated into the prelicensure nursing curriculum to build student nurses' confidence in aiding patients and families with their preferred future care plans. Advance care planning tools, such as the Advance Health Care Directive (AHCD) and Five Wishes, provide experiential learning opportunities that bridge theoretical knowledge with real-world patient advocacy. In this study, students were asked to complete either the AHCD or Five Wishes document as though planning for their own end-of-life care, encouraging personal reflection and professional insight. Embedding these assignments into nursing education strengthens students' confidence in facilitating end-of-life discussions. This study applied Kolb's experiential learning theory, including concrete experience, reflective observation, abstract conceptualization, and active experimentation, to explore student nurses' perspectives on the Advance Health Care Directive and Five Wishes assignments, as well as their understanding of end-of-life care. : This study used an exploratory-descriptive qualitative design featuring one open-ended question to collect students' views on the assignments. : The final sample comprised 67 prelicensure student nurses from Bachelor of Science and Entry-Level Master's programs. The Advance Health Care Directive and/or Five Wishes assignment enhanced students' understanding of end-of-life decision-making. : It is essential to complete the assignment and immerse oneself in an end-of-life situation to grasp patients' perspectives and concerns regarding when to engage in difficult conversations with their patients.

摘要

临终关怀是护理教育的重要组成部分,直到近年来才被忽视。预先护理计划应纳入护理执照前课程,以增强学生护士在协助患者及其家属制定他们所希望的未来护理计划方面的信心。预先护理计划工具,如《预先医疗护理指示》(AHCD)和《五个愿望》,提供了将理论知识与现实世界中的患者权益倡导联系起来的体验式学习机会。在本研究中,要求学生完成AHCD或《五个愿望》文件,就好像是在为自己的临终护理做规划,以鼓励个人反思和专业洞察力。将这些作业融入护理教育可增强学生在促进临终讨论方面的信心。本研究应用了科尔布的体验式学习理论,包括具体体验、反思观察、抽象概念化和主动实验,以探讨学生护士对《预先医疗护理指示》和《五个愿望》作业的看法,以及他们对临终关怀的理解。本研究采用探索性描述性定性设计,以一个开放式问题收集学生对这些作业的看法。最终样本包括来自理学学士和入门级硕士项目的67名护理执照前学生护士。《预先医疗护理指示》和/或《五个愿望》作业增强了学生对临终决策的理解。完成作业并沉浸在临终情境中对于理解患者在何时与他们的患者进行艰难对话方面的观点和担忧至关重要。

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