Nurses' attitudes toward death and caring for dying patients.

Division of Nursing, Indiana University Northwest, Gary, USA.
Oncology nursing forum (Impact Factor: 2.39). 26(10):1683-7.
Source: PubMed

ABSTRACT To examine possible relationships among the demographic variables of nurses and their attitudes toward death and caring for dying patients.
A private hospital and Visiting Nurses Association office in an ethnically diverse metropolitan area in the Midwest.
403 nurses, predominantly female (90%) and Caucasian (70%), with a mean age of 41.8 years.
Participants completed the Frommelt Attitude Toward Care of the Dying Scale, the Death Attitude Profile-Revised (DAP-R), and a demographic questionnaire.
Attitudes toward death and caring for dying people.
DAP-R scores were related to sex, religious affiliation, and current contact with terminally ill patients. Frommelt scale scores (e.g., showing acceptance of death) were positively related to current contact with dying patients, negatively correlated with two DAP-R subscales (Fear of Death and Death Avoidance), and positively correlated with two other DAP-R subscales (Approach Acceptance and Neutral Acceptance).
Nurses' attitudes toward death and their current contact with terminally ill patients were predictive of their attitudes toward caring for terminally ill patients.
Professionals who are responsible for designing educational programs focused on nurses' attitudes toward caring for terminally ill patients may want to include an assessment of death attitudes and interventions aimed at decreasing negative attitudes and increasing positive attitudes toward death in such programs.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Besides personal and professional experiences, long term care providers' own attitudes toward death may affect the care given to dying residents. To assess beliefs, values, and attitudes toward death, dying, palliative, and interdisciplinary care in long term care workers and identify any differences between different job categories and places of work. Descriptive cross-sectional survey study. Five public long term care facilities. One thousand one hundred seventy volunteers, clinical managers, and all categories of residential long term care workers. An anonymous paper or electronic self-administered survey questionnaire consisting of 24 items, answered on a 4-point bipolar Likert scale. Between-group differences were compared with the analysis of variance test after adjustment for the multiple post-hoc comparisons. Healthcare workers had a relatively positive attitude toward more than one-half of the selected aspects of interdisciplinary practice and end-of-life palliative care for long-term residents. However, attitudes were more mixed about 10 other aspects and a higher percentage of respondents indicated negative attitudes toward them. Overall, there are significant differences between upper-level professionals and managers (registered nurses, physicians, rehabilitation staff, and clinical managers) vs the hands-on caregivers (nursing assistants, patient assistants, and volunteers) with regard to some aspects of the care of the dying. The results suggest that healthcare workers' attitudes need to be taken into account in long term care facilities. Patient assistants, volunteers, and nursing assistants seem most likely to above all benefit from training and support programs.
    Journal of the American Medical Directors Association 01/2014; · 5.30 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This is a randomised controlled pilot study using a mixed methods design. The overall aim was to test an educational intervention on existential issues and to describe surgical nurses' perceived attitudes towards caring for patients dying of cancer. Specific aims were to examine whether the educational intervention consisting of lectures and reflective discussions, affects nurses' perceived confidence in communication and to explore nurses' experiences and reflections on existential issues after participating in the intervention. Forty-two nurses from three surgical wards at one hospital were randomly assigned to an intervention or control group. Nurses in both groups completed a questionnaire at equivalent time intervals: at baseline before the educational intervention, directly after the intervention, and 3 and 6 months later. Eleven face-to-face interviews were conducted with nurses directly after the intervention and 6 months later. Significant short-term and long-term changes were reported. Main results concerned the significant long-term effects regarding nurses' increased confidence and decreased powerlessness in communication, and their increased feelings of value when caring for a dying patient. In addition, nurses described enhanced awareness and increased reflection. Results indicate that an understanding of the patient's situation, derived from enhanced awareness and increased reflection, precedes changes in attitudes towards communication.
    European Journal of Cancer Care 01/2014; · 1.31 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To explore nursing students' experiences of death and dying in clinical practice. The encounter with death constitutes one of the most stressful experiences reported by nursing students during their clinical training. In particular, it can be difficult for student nurses to cope with the patient's suffering, to provide postmortem care and to communicate with the patient and his/her family as death approaches. Although some research has been carried out in relation to this phenomenon, there remains a need to identify and understand the situations and experiences that are of most concern to students, those which may affect their ability to cope and, therefore, interfere with the care they are able to offer to the dying patient and his/her family. Qualitative descriptive and hermeneutic study. Semi-structured interviews (n = 12) were conducted with nursing students. Data were collected in 2012-2013. Transcripts were analysed using Colaizzi's seven-step procedure. The analysis identified five themes: impact, training in end-of-life care, ethical issues, coping and learning/growth/healing connections. The central theme was the enormous impact the encounter with death had, while the other themes were a response to and/or modulators of this impact. An explanatory model was derived on the basis of the relationship between all these emergent themes. It is essential to understand nursing students' experience of death so as to minimise its impact. The explanatory model described here could be a useful tool for the design of training programmes on end-of-life care. Adequate training of this kind would help to ensure that future nurses offer high-quality care to patients and their families, minimising the impact of death and preventing emotional fatigue.
    Journal of Clinical Nursing 04/2014; · 1.32 Impact Factor