Table 1 The content of the educational sessions

Module 1

Nursing Care at the End of Life

The main concepts with regard to dying patients, the structure of providing end-of-life palliative care, providing appropriate physical and psychological space for supportive care, the role and position of nurses in the palliative care team, diagnosing a life-threatening disease and transition from the treatment stage to the palliative stage, the necessity of providing end-of-life palliative care from a human rights perspective, and gaining public satisfaction

Module 2

Pain Management

General methods of pain management, physiological, psychological and cultural/ social variables affecting pain

Module 3

Symptom Management

Managing and treating patients’ symptoms, determining the main symptoms and concerns of patients, listening actively to what patients say and paying attention to their values and beliefs, the impact of symptoms on life and physical and motor functions, and factors that aggravate or alleviate these symptoms

Module 4

Ethical/Legal Issues

Ethical/legal issues in caring for dying patients by taking into account precise cultural considerations including how to deal with a dying patient and his or her family, talking about imminent death, knowing about reasons for providing post-mortem care, continuing medical treatment, decisions as to having cardiopulmonary resuscitation, consideration of patient’s autonomy in treatment decisions, attempting to reconcile with the beliefs of the patient and his/her family, conflict resolution approaches, consideration of ethics in retelling information about diseases and death, providing spiritual care, and giving hope and comfort to the patient and his/her family

Module 5

Cultural Considerations

Evaluation of cultural and spiritual issues as a necessity for adequate communication and providing appropriate cultural care

Module 6

Communication

The need to establish effective communication in palliative care, providing support centered on the patient and his/her family, knowing the physiological, psychological, environmental and cultural barriers to communication, and making efforts to remove these barriers

Module 7

Grief, Loss, Bereavement

Discussing death, grief and bereavement after death based on cultural differences including the ways to cope with the end-of-life crisis, nursing care of the dying patient, expected physiological changes at the time of death, post-mortem care, and helping the family in adapting to the loss of life

Module 8

Achieving Quality Care at the End of Life

Focusing on care at the very time of death and emphasizing the need to be prepared and ensuring the best care while experiencing this critical incident

Module 9

Preparation and Care for the Time of Death

Identifying basic human needs at the end of life by recognizing the values, beliefs and preferences of patients, and raising knowledge of "good death"—patients’ preferences for having a good death. Finally, in addition to providing a conclusion on the material presented in the previous sessions and summarizing the topics, as is practiced in the official courses held at the End-of-Life Nursing Care Association, a case study related to end-of-life palliative care was discussed and the participants shared their own opinions. The researcher discussed each of the topics after each presentation at the end of each session. The participants exchanged their views based on their experiences in caring for dying patients