Page 247 - EJMO-9-3

Eurasian Journal of Medicine

and Oncology

ORIGINAL RESEARCH ARTICLE
Perception of advance health-care directives

among nursing students in oncology
and palliative care settings: An Italian
pre–post study

Diego Lopane 1,2† , Sara Morales Palomares 3† , Alessandra Dacomi 1 ,
Daniela Cattani 1 , Simone Cosmai 2 , Chiara Provasoli 1 , Sarah Scollo 2 ,
Mauro Parozzi 4 , Giovanni Cangelosi * , Stefano Mancin 1 ,
5
Emanuela Morenghi 1,2‡ , and Beatrice Mazzoleni 2‡
1 Scientific Institute for Research, Hospitalization and Healthcare, Humanitas Research Hospital,
Milan, Milano, Italy
2 Department of Biomedical Sciences, Faculty of Nursing, Humanitas University, Milan, Milano, Italy
3 Department of Pharmacy, Health and Nutritional Sciences, Faculty of Health Sciences, University
of Calabria, Rende, Cosenza, Italy
4 Department of Medicine and Surgery, Faculty of Medicine and Surgery, University of Parma,
Parma, Parma, Italy
5 Department of Experimental Medicine and Public Health, School of Pharmacy, University of
Camerino, Macerata, Macerata, Italy
† These authors contributed equally
to this work. (This article belongs to the Special Issue: Nursing Care in Cancer)
‡ These authors contributed equally
as senior authors. Abstract
*Corresponding author: Introduction: Advance health-care directives (AHDs) empower individuals to express
Giovanni Cangelosi
(giovanni01.cangelosi@unicam.it) treatment preferences in anticipation of future incapacity and play a crucial role in
ensuring patient-centered end-of-life care. However, nursing students often report
Citation: Lopane D, Palomares SM, limited training and discomfort when addressing these issues.
Dacomi A, et al. Perception of
advance health-care directives Objective: This study aims to assess the impact of an oncology palliative care module
among nursing students in oncology on nursing students’ knowledge and perceptions of AHDs.
and palliative care settings: An Methods: In a pre–post observational design, 39 3 -year nursing students completed
rd
Italian pre–post study. Eurasian J questionnaires immediately before (pre-test) and after (post-test) a 75-h oncology palliative
Med Oncol. 2025;9(3):239-249. care module that included lectures, case discussions, and active learning methods.
doi: 10.36922/EJMO025250263
Sociodemographic and attitudinal data were analyzed using descriptive statistics.
Received: June 18, 2025 Results: After the module, students showed an increased preference for refusing non-
1st revised: July 15, 2025 beneficial treatments (from 63.6% to 71.4%) and reported heightened awareness of the
need for proactive communication regarding therapies and pain management. While
2nd revised: July 21, 2025 willingness to donate organs remained high (94.9% vs. 92.3%), students exhibited
Accepted: July 23, 2025 increased caution regarding the involvement of minors in end-of-life discussions.
Openness to spiritual support also rose, alongside slight increases in preferences
Published online: August 14, 2025 for cremation and body donation. Although these changes did not reach statistical
Copyright: © 2025 Author(s). significance, the consistency index indicated generally stable ethical orientations, with
This is an Open-Access article emerging trends toward deeper reflection and heightened awareness.
distributed under the terms of the Conclusion: Although no statistically significant differences were observed, the
Creative Commons Attribution
License, permitting distribution, educational intervention on AHDs appeared to influence certain perceptions and
and reproduction in any medium, attitudes among nursing students toward end-of-life decisions. Integrating structured
provided the original work is AHD training into nursing curricula may enhance students’ awareness and ability to
properly cited. support patient self-determination in clinical practice.
Publisher’s Note: AccScience
Publishing remains neutral with Keywords: Advance health-care directives; Nursing education; Patient self-
regard to jurisdictional claims in
published maps and institutional determination; Clinical ethics; End-of-life care
affiliations.

Volume 9 Issue 3 (2025) 239 doi: 10.36922/EJMO025250263