A Culturally Specific End-of-life Communication Skills Training

Effects of a Culturally Specific End-of-life Communication Skills Training for Chinese Oncology Nurses

The goal of this clinical trial is to evaluate the effectiveness of culturally specific end-of-life communication skills training (CST) among Chinese oncology nurses. The main question it aims to answer is: What is the effectiveness of culturally specific end-of-life CST among Chinese oncology nurses? Participants will receive an 8-week communication skills training. Researchers will compare the intervention group and the wait-list group to see if skills, self-efficacy, and outcome expectancy beliefs will be improved.

Objectives: The study aims to evaluate the effectiveness of culturally specific end-of-life CST among Chinese oncology nurses. Design and participants: It is designed as a single-blind, pre-post randomized controlled trial (RCT). Registered nurses who work with advanced cancer patients in hospital settings will be recruited. The participants will be randomly assigned to either the intervention group (IG) or the control group (CG). The IG will receive the end-of-life CST between the two measurement points, and the CG will be a waitlist group and receive the training after the end of data collection. Data analysis: Demographic information about the participants will be summarised in descriptive statistics. Independent t-tests and chi-square tests are used to investigate the comparability of groups in terms of the demographics generated by randomization. The primary and secondary outcome variables will be examined using covariate-adjusted linear mixed models. This approach enables the consideration of missing data. For non-repeated continuous measurements, ordinary linear regression and logistic models will be adopted. The intention-to-treat (ITT) analysis and post hoc analyses of contaminated data will be performed. Expected results: Nurses' skills, self-efficacy, and outcome expectancy beliefs will improve after the CST.

The IG will receive the end-of-life CST between the two measurement points, and the CG will be a waitlist group and receive the training after the end of data collection.

Training methods include lectures, video demonstrations, and simulation in small groups (4-5 trainees per group with multidisciplinary roles). Written and audiovisual learning materials will be offered. Each session will be 150 minutes, including lectures and video demonstration (90 min/session) and simulation and feedback (60 min/session). One session will be conducted in two weeks. Totally there will be four sessions completed in 8 weeks.

Measured by Nurses' Clinic Communication Competency Scale, a 58-item self-reported scale which measures six dimensions. A 5-point Likert scale from (1) very poor to (5) very good is used. Higher scores mean a better outcome.

Measured by Hospice Care Self-efficacy Scale on nurses, a 12 items with a 5-point Likert scale from (1) very diffident to (5) very confident. Higher scores mean a better outcome.

Measured by The Communication Outcomes Questionnaire, a 23-item self-report questionnaire with a 9-point Likert scale from 1 = very likely and 9 = very unlikely. Higher scores mean a worse outcome.

Inclusion Criteria: Registered nurses who work with advanced cancer patients in hospital settings Consent to participate in the study Exclusion Criteria: Nurses working temporarily in the two hospitals as scholars or trainees from other hospitals Specialized nurses in palliative care