Web-Based End-of-Life and Post-Mortem Care Education for Nursing Students

Официальное название

The Effect of Web-Based End-of-Life and Post-Mortem Care Education on Nursing Students' Post-Mortem Self-Efficacy, Death Literacy, and Attitudes Toward the Principles of a Dignified Death: A Randomized Controlled Trial

Обзор

This study aims to evaluate the effect of a web-based end-of-life and post-mortem care education program on nursing students' post-mortem self-efficacy, death literacy, and attitudes toward the principles of a dignified death. Participants will receive educational content through an online learning platform, and the effectiveness of the program will be assessed using validated questionnaires administered before and after the intervention. The findings are expected to support the development of accessible, sustainable, and effective digital education programs that enhance nursing students' knowledge, skills, and attitudes related to end-of-life and post-mortem care.

Подробное описание

This study is designed as a single-blind, parallel-group randomized controlled trial to evaluate the effectiveness of a web-based end-of-life and post-mortem care education program developed for undergraduate nursing students. The educational intervention has been developed as part of a doctoral dissertation and is based on current scientific evidence, international recommendations, and the End-of-Life Nursing Education Consortium (ELNEC) curriculum.

The intervention consists of eight structured online learning modules covering the fundamental concepts of end-of-life care, symptom management, recognition of the dying process, principles of a dignified death, post-mortem care practices, family support, spiritual care, and case-based learning. Each module is designed to be completed within approximately 10-15 minutes and includes narrated presentations, visual materials, flowcharts, decision trees, animations, and case-based learning activities. The educational videos will be delivered through a dedicated web-based learning platform that allows participants to access the content regardless of time and location. The platform will ensure sequential completion of the modules; participants will not be able to fast-forward videos or proceed to the next module without completing the current one.

Participants randomized to the intervention group will receive the web-based educational program through the online learning platform over a two-month period. Participants randomized to the control group will participate in three face-to-face case discussion sessions covering end-of-life and post-mortem care as specified in the study protocol. To minimize contamination between the study groups, participants in the control group will not have access to the web-based educational platform during the intervention period. After completion of data collection, the web-based educational materials will also be made available to participants in the control group.

Before implementation, the educational materials will undergo expert review to establish content validity. Subsequently, a pilot study will be conducted with nursing graduates to evaluate the usability of the web platform and the comprehensibility of the educational content. Feedback obtained during the pilot phase will be incorporated into the final version of the educational program before participant recruitment begins.

Participants will be allocated to the study groups using a computer-generated randomization procedure conducted by an independent researcher who is not involved in the implementation of the study. To ensure comparability between groups, randomization will be performed while considering participants' grade point averages. Because the educational intervention will be delivered by the principal investigator, investigator blinding will not be feasible. However, participants will not be informed of their group allocation, and the researchers responsible for outcome assessment, data coding, and statistical analyses will remain blinded to group assignment. The study will be conducted and reported in accordance with the CONSORT 2025 Statement: Updated Guideline for Reporting Randomized Trials.

The web-based education platform has been specifically designed for this study to provide flexible access to educational materials while enabling standardized delivery of the intervention. The platform includes secure individual user accounts, participant progress monitoring, reminder functions, and restricted access limited to enrolled participants. These features are intended to improve participant adherence and ensure consistent implementation of the educational intervention throughout the study.

Вмешательства

• Поведенческое Web-Based End-of-Life and Post-Mortem Care Education
  Participants assigned to the experimental group will receive a web-based educational program consisting of eight structured online modules covering end-of-life and post-mortem care. The program is delivered through a dedicated web-based learning platform and includes narrated presentations, visual materials, case-based learning activities, and interactive educational resources. The intervention is designed to be completed over a two-month period, with sequential access to the modules to ensure c
• Поведенческое Face-to-Face Case Discussion Sessions
  Participants assigned to the control group will participate in three face-to-face case discussion sessions focusing on end-of-life and post-mortem care according to the study protocol. During the intervention period, participants in the control group will not have access to the web-based educational platform. After completion of data collection, access to the web-based educational materials will be provided.

Первичные конечные точки

• Post-Mortem Self-Efficacy [Срок оценки: Baseline, immediately after completion of the 2-month intervention (approximately 2 months), and 2-month follow-up (approximately 4 months from baseline).]

Вторичные конечные точки (2)

• Death Literacy [Срок оценки: Baseline, immediately after completion of the 2-month intervention (approximately 2 months), and 2-month follow-up (approximately 4 months from baseline).]
• Attitudes Toward the Principles of a Dignified Death [Срок оценки: Baseline, immediately after completion of the 2-month intervention (approximately 2 months), and 2-month follow-up (approximately 4 months from baseline).]

Критерии участия

Критерии включения

• Fourth-year undergraduate nursing students enrolled at the Faculty of Health Sciences, Necmettin Erbakan University, during the 2026-2027 Spring semester.
• Successful completion of the Fundamentals of Nursing, Medical Nursing, and Psychiatric and Mental Health Nursing courses.
• Access to an internet-enabled device.
• Willingness to participate and provide informed consent.

Критерии исключения

• Failure to complete at least one educational module.
• Failure to complete the baseline, post-intervention, or follow-up assessments.
• Withdrawal from the study at any time.

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Да

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Двойное слепое

Основная цель

Другое

Центры проведения

Turkey (Türkiye) · 1 центр

• Seydişehir Kamil Akkanat Faculty of Health Sciences, Necmettin Erbakan University — Konya

Публикации

• Webster, T., Fial, A., Moore, P., Rajaram, S., Shope, R., & Davies, D. (2021). Building a robust e-learning module scorecard: The Nebraska e-learning scorecard (NEscore). Innovations in Health Sciences Education Journal. https://doi.org/10.32873/unmc.dc.ihsej.0001
• Yoong SQ, Wang W, Seah ACW, Kumar N, Gan JON, Schmidt LT, Lin Y, Zhang H. Nursing students' experiences with patient death and palliative and end-of-life care: A systematic review and meta-synthesis. Nurse Educ Pract. 2023 May;69:103625. doi: 10.1016/j.nepr.2023.103625. Epub 2023 Mar 28. PMID 37004470
• Xu GR, Yu WY. Mediating effect of meaning in life on death anxiety and attitude toward palliative care among undergraduate nursing students. BMC Palliat Care. 2024 Jun 5;23(1):139. doi: 10.1186/s12904-024-01472-w. PMID 38840188
• Wang W, Wu C, Bai D, Chen H, Cai M, Gao J, Hou C. A meta-analysis of nursing students' knowledge and attitudes about end-of-life care. Nurse Educ Today. 2022 Dec;119:105570. doi: 10.1016/j.nedt.2022.105570. Epub 2022 Sep 23. PMID 36182790
• Wang A, Nan F, Jin LS, Jin H. A SWOT Analysis of Death Literacy Education in Nursing: Implications for Hospice and Palliative Care in China. J Multidiscip Healthc. 2025 Nov 27;18:7749-7756. doi: 10.2147/JMDH.S559188. eCollection 2025. PMID 41334159
• Vanderspank-Wright B, Efstathiou N, Vandyk AD. Critical care nurses' experiences of withdrawal of treatment: A systematic review of qualitative evidence. Int J Nurs Stud. 2018 Jan;77:15-26. doi: 10.1016/j.ijnurstu.2017.09.012. Epub 2017 Sep 28. PMID 29024808
• Uzen Cura S. Nursing Students' Spiritual Orientations and Their Attitudes Toward the Principles of Dying with Dignity: A Sample from Turkey. J Relig Health. 2021 Feb;60(1):221-231. doi: 10.1007/s10943-020-01029-0. PMID 32418151
• Ustundag S, Durgu N, Cekic Y, Unver G. Visual perceptions of a good death: A mixed-methods study on the perceptions of nursing students in Turkey toward a good death. Nurse Educ Pract. 2025 Feb;83:104289. doi: 10.1016/j.nepr.2025.104289. Epub 2025 Feb 9. PMID 39951904

Идентификаторы

NCT: NCT07737028 · 2026/1406

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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