One Training Session Boosts Nurses’ Confidence in Difficult Deprescribing Talks

Nurses who completed a 1.5-hour communication training session based on the COMFORT model reported significantly greater confidence in holding difficult conversations about stopping potentially inappropriate medications at the end of life, according to a new study published in BMC Palliative Care.

The study, led by Angela Dobbie, used a pre- and post-intervention survey design with a convenience sample of 38 community-based nurses. Participants completed the Self-Efficacy Questionnaire (SE-12), which included five extension questions previously associated with the questionnaire, to measure their self-reported confidence when communicating with patients and caregivers specifically during deprescribing conversations.

The intervention was a single continuing education session focused on the COMFORT model, a communication framework for palliative care. The session featured a simulated conversation on deprescribing, giving nurses a structured example of how to approach the sensitive topic of discontinuing medications with patients and their relatives.

Of 74 eligible nurses, 38 enrolled in the study, an uptake rate of 51.4 percent. The cohort was experienced in the topic at hand: 71 percent reported engaging in deprescribing conversations at least monthly, and 45 percent had completed some form of communication skills training before the session.

Following the educational session, self-reported communication confidence scores increased significantly across all 17 questionnaire items, with p values below .001. One example item, confidence in communicating difficult news to patients and relatives, rose from a mean of 7.61 before the intervention to 8.97 afterward.

Post-intervention confidence was positively correlated with how useful participants perceived the COMFORT model to be, with a Spearman correlation of rs = 0.458 (p = .004). Nurses who found the framework more useful tended to report higher confidence after the training.

Acceptability of the model was high overall. Participants rated the framework’s usefulness on a researcher-designed Likert scale, and every rating was at least 7 out of 10, with a mean of 9.34 and a standard deviation of 0.82.

The author concludes that the findings suggest COMFORT model training effectively improves nurses’ self-reported communication confidence and supports its potential to enhance conversations about deprescribing in end-of-life care. The framework was also well received as an educational format.

Several caveats apply to these results. The study used a single-group pre- and post-intervention design without a control group, relied on a convenience sample, and measured self-reported confidence rather than observed communication behavior or patient outcomes. The reported improvements reflect participants’ own perceptions immediately surrounding the training, and the author notes the findings support the model’s potential rather than demonstrating clinical effects.

Subject of Research: The effect of COMFORT model communication training on nurses' self-reported confidence in deprescribing conversations in end-of-life care.

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

Article References: Dobbie, A. (2026). Evaluating the impact of COMFORT communication training on nurses self-reported communication confidence: conversations in deprescribing and the COMFORT model. BMC Palliative Care. https://doi.org/10.1186/s12904-026-02369-6

Image Credits: AI Generated

DOI: 10.1186/s12904-026-02369-6

Keywords: nurses, COMFORT model, communication training, deprescribing, palliative care, end-of-life care, communication confidence, self-efficacy, continuing education, hospice care, SE-12 questionnaire, Evaluating