Background: While serious illness communication is an important aspect of nursing care, it is recognized as an area of practice for which nursing students are not adequately prepared. Communication tools such as the Serious Illness Conversation Guide (SICG) may help address these gaps in knowledge and skill. Aim: The aim of this study is to explore undergraduate nursing students’ experiences engaging in serious illness communication and their perceptions about participation in a SICG workshop that aimed to improve such communication. Methods: A qualitative descriptive approach was used. One-on-one, semi-structured interviews were conducted with eight undergraduate nursing students at McMaster University who had attended SICG training. Critical incident technique was used to elicit participant accounts of engaging in serious illness communication at their professional practice placements. Data were analyzed using qualitative techniques. Participants were surveyed to assess perceptions of the SICG workshop. Findings: Three themes related to undergraduate nursing students’ experiences engaging in serious illness communication after receiving SICG training were: a) serious illness communication is challenging to enact, b) finding moral and ethical ground, and c) fitting into the culture of the professional practice setting. Three themes related to nursing students’ perceptions of the SICG workshop were: a) applicability of SICG training to practice, b) strengths of SICG training, and c) limited opportunities to develop competence. Conclusions: Nursing students are challenged by serious illness communication in their practice. Findings support the integration of educational resources aimed to better prepare them for critical communication knowledge and skills on entry-to-practice. / Thesis / Master of Science in Nursing (MSN)

Being affected by a serious or life-threatening illness implies an existentially changed situation that is accompanied by a number of questions about the illness itself, consequences of the illness in an everyday context and implications for the future. The purpose of this dissertation is to examine people’s meaning-making when they are affected by a serious illness and to determine how the illness acquires meaning in the context of their lives. The dissertation thus deals with what can be referred to as existential meaning-making. A hermeneutical approach was adopted, drawing more specifically on Paul Ricoeur’s narrative theory that emphasises the importance of different dimensions of time and memory in the understanding of narratives. An empirical study was carried out of illness narratives collected in research interviews with six women who had been diagnosed with serious illnesses, such as cancer, stroke and heart attack. The analysis reveals that the discovery of the illness and the period following was characterized by chaos and a lack of time perspective, feelings of lack of freedom and thoughts about death, but also feelings of responsibility towards the family. Experiences of the health services were also important in accounts of this early period, particularly wishes for more empathic encounters with the professionals. In the women’s accounts of the long term living with the illness, death continues to emerge as a back drop to their everyday experiences of the illness, but gradually more as confronting the problem of death rather than giving up life. Over time, relationships to significant others and the importance of everyday life also constitute increasingly important themes. In their expectations for the future, the women account for some experiences that have been important in creating a sense of hope and heightened vitality, and thus a new ‘wholeness’, such as being close to nature as well as their religious or spiritual experiences. These results are discussed in terms of how memories of significant events or places play an important role in existential meaning-making, and also how reflections on these memories can be seen as a process of existential ‘learning’.

The thesis focuses on the Risk Life Insurance of the Czech insurance market offering coverage just for serious health risks without any investment or savings component. Assessment of the Risk Life Insurance offer is based on the findings of the general and special insurance conditions as well as on the gained draft insurance contracts worked on the model setting. The aim of the thesis is the analysis of the main coverage which is in all cases the life insurance along with the offer of the complementary insurance for case of death, disability, cancer or severe diseases. The emphasis is on the scope of risks coverage and the insurance conditions which are considered to be an insurance event.