Abstract:

Objective To explore the effect of using Heart to Heart cards in the Palliative Care course for undergraduate nursing students. Methods From September 2023 to October 2023，the Heart to Heart card was utilized in experimental teaching activities of death education and communication with end-stage patient needs for 46 third-year nursing undergraduate students taking an elective Palliative Care course. After the teaching，participants’ evaluation were collected through Heart to Heart Café and semi-structured interviews were conducted with 8 conveniently selected students to understand their experiences and feelings. Results A total of 138 Heart to Heart cards were selected by the 46 participants，of which 39（28.3%） focused on physical needs，39（28.3%） on psychological needs，17（12.3%） on interpersonal needs，and 43（31.2%） on spiritual needs. Most of the participants（95.7%） thought that the experience of playing the Heart to Heart cards was very meaningful；40（87.0%） participants thought that it was easier to discuss death using the Heart to Heart cards；40（87.0%） participants would discuss advance care plans with their relatives and doctors；42（91.3%） participants would complete their own advance care plans；38（82.6%） participants would encourage family and friends to complete their advance care plans；and 41（89.1%） participants would recommend the Heart to Heart cards to others. Through the analysis of interview data，three main themes and seven sub-themes were extracted，namely：1） the Heart to Heart Café talk activities were both interesting and challenging；2） the Heart to Heart cards aided in breaking the taboo around discussing death and enhancing understanding of palliative care；3） looking forward to a deeper integration of the Heart to Heart cards into various situations. Conclusion The use of Heart to Heart cards in palliative care courses can promote nursing students’ discussions on death and dying topics，deepen their understanding of the connotation of palliative care，and help them overcome the taboo surrounding death while finding meaning in life.

Key words: Education, Nursing, Hospice care, Baccalaureate, Heart to Heart cards