Teaching principles of Managing Cancer and Living Meaningfully (CALM) to oncology nurses: A feasibility study of an intervention to improve professional empathy in oncology nurses

The goal of this feasibility study is to evaluate the effects of a newly developed training for oncology nurses based on Managing Cancer and Living Meaningfully (CALM) psychotherapy. The study goals are to assess the feasibility of the training program and the effects of the training program on the nurses professional empathy, attitudes and self-efficacy when it comes to taking care of patients with advanced cancer.  

The CALM-Nurses training was developed by collaborators at the Netherlands Cancer Institute (NKI) and University College London. The introductory CALM course will consist of 2-3 e-learning modules to teach the most important theoretical aspects of CALM, including the framework of the four domains and the importance to provide reflective space for patients. It will include case vignettes to practice with these concepts and reflective exercises. Intertwined with the e-learnings there will be two face-to-face 3-hour group meetings with a CALM-N trainer, to elaborate on the theory, reflect on their own practice and attitudes, and to practice CALM related skills with an actor. During these face-to-face sessions, the CALM–N trainer will use video material from CALM therapy sessions to translate theory to practice. Attitudes about caring for patients with advanced cancer, and talking about death and dying will also be discussed. We will offer the training as two subsequent courses, to allow nurses to be trained, while having enough nurses on the ward at the same time.

The study will include 40 oncology nurses, who will receive CALM-N training. They are recruited from medical and surgical oncology wards in the NKI. Nurses who do not want to participate in the study are also allowed to follow the training. Questionnaires are collected before the start of the training. The primary endpoint for outcome measures and the focus group is one month-post-training. The secondary endpoint is 3 months post-training, to assess sustained or late effects.

The number of participants is a convenience sample, allowing two subsequent groups of 20 nurses to be trained. With an estimated 75% adherence to the curriculum and the study, we can collect pre-post data for 30 nurses to assess acceptability, perceived benefit, and preliminary effects of the intervention as well as the feasibility to conduct a randomized trial.



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