Evaluating the impact of COMFORT communication training on nurses self-reported communication confidence: conversations in deprescribing and the COMFORT model

Effective communication is essential in nursing and is especially salient in hospice and palliative care to foster collaboration and improve patient outcomes. Nevertheless, many nurses face challenges handling difficult conversations, including the topic of discontinuing potentially inappropriate medications. In this study, I aimed to evaluate the effectiveness of an education session based on the COMFORT model in enhancing nurses’ self-reported communication confidence with deprescribing conversations in the context of end-of-life care. This study employed a pre- and post-intervention survey design with a convenience sample of 38 community-based nurses. To evaluate self-reported communication confidence when communicating with patients and caregivers specifically during conversations related to deprescribing, participants completed the Self-Efficacy Questionnaire (SE-12) including five extension questions already associated with the questionnaire [1]. The intervention was a 1.5-hour continuing education session focused on the COMFORT model, which featured a simulated conversation on deprescribing. Of 74 eligible nurses, 38 enrolled in the study (51.4%). Prior to the intervention, 45% had completed prior communication skills training, and 71% engaged in deprescribing conversations at least monthly. Following the COMFORT educational session, self-reported communication confidence scores increased significantly across all 17 items ( p < .001), such as confidence communicating difficult news to patients and relatives (M = 7.61 vs. M = 8.97, p < .001). Post-intervention confidence positively correlated with perceived usefulness of the COMFORT model (r s = 0.458, p = .004). Overall model acceptability was high, with participants rating the framework usefulness at least 7 out of 10 on a researcher designed Likert scale (M = 9.34, SD = 0.82). Findings suggest that COMFORT model training effectively improves nurses’ self-reported communication confidence, supporting its potential to enhance conversations about deprescribing in end-of-life care. The COMFORT model was also well received as an educational framework.