Article

Nurses' characteristics and their attitudes toward death and caring for dying patients in a public hospital in Jordan

October 2013
Health Science Journal 7(4):384-394

Authors:

Background: Nurses are expected to care for death and many patients at their end-of-life (EOL) stage. Care of death and the dying provoke many undesired emotions and attitudes that reflect on the quality of patients' care. However, there are many factors that can affect nurses' attitudes towards caring for death and dying patients, such as nurses' demographics (age, gender, nursing experience, and others). Which deserve carefully designed studies. Yet, limited Jordanian studies addressing these factors are available Aim: The present study aims to assess how Jordanian nurses providing care for terminal ill patients feel about death and caring for dying patients and to examine any relationships between their attitudes and certain nursing characteristics. Methods: A descriptive quantitative design was utilized to accomplish the purpose of this study. A total of 155 nurses were recruited to participate in the study. The nurses' attitudes toward caring for dying patients were measured using the Frommelt Attitude toward Care of the Dying (FATCOD) scale. The nurses' attitudes toward death were measured using the Death Attitude Profile-Revised (DAP-R) scale. The t-test and F-test were computed to examine the relationships between nurses' attitudes toward care of dying and death and demographic factors. Results: The present study showed that statistical significant association was existed among age (P=.048;P=.049) and nursing experience (P=.000; P=.000) with nurses' attitudes toward death and caring for terminal ill patients, and the total scores on the FATCOD and DAP-R respectively. It also showed a significant correlation between nurses' attitudes toward death and caring for dying patients (P=.002). Conclusion: Based on the obtained results, older registered nurses with more experience tended to have more positive attitudes toward death and caring for dying patients. Therefore, understanding the effect of nurses' factors that are associated with their attitudes toward care of dying and death can guide hospital and health care agencies to devel.

Assessment of Oncology Nurses’ and Physicians’ Attitudes Toward Death and End-of-Life Care, Along With Contributing Factors: A Cross-Sectional Study

Article

Full-text available

Feb 2025
OMEGA-J DEATH DYING

Background: Providing care for terminally ill patients presents a complex challenge for nurses and physicians, often leading to psychological concerns and significant physical and emotional distress for patients, their families, and healthcare providers. The intricacies of managing end-of-life care can evoke a range of feelings, including fear, anxiety, and sadness, which can affect the quality of care delivered. Understanding these dynamics is essential for improving the support systems for both healthcare professionals and patients during this critical time. Aim: This study aimed to evaluate the attitudes toward death and end-of-life care among nurses and physicians and to investigate whether these attitudes are influenced by specific demographic characteristics, including gender, years of experience, previous education on death and dying, previous experience in dealing with terminally ill persons, previous experience with loss, present experience with loss, and the influence of religious beliefs. By examining these attitudes, the research seeks to identify potential areas for intervention and education that could enhance the overall approach to end-of-life care in oncology settings. Method: A total of 200 oncology nurses and physicians were recruited through a non-probability convenience sampling method from a specialized oncology hospital in Jordan. Participants were asked to complete a comprehensive questionnaire that included a demographic data sheet and Frommelt’s Attitude Toward Care of the Dying - B scale. This scale is designed to measure attitudes toward caring for dying patients, providing valuable insights into the perspectives of healthcare professionals in this challenging field. Results: The findings indicated that the majority of nurses and physicians held a positive attitude toward death (FATCOD = 106.31), suggesting a general comfort with the concept of death and the process of dying. Additionally, statistically significant correlations were found between attitudes toward death and demographic factors, specifically, female nurses had significantly higher scores on the FATCOD scale compared to male nurses ( p = .003); participants with prior experience caring for terminally ill patients had more positive attitudes ( p = .047); increased years of professional experience were associated with higher scores ( p < .001); participants who received education on death and dying had significantly better attitudes ( p < .001); personal experiences with loss correlated with more positive attitudes ( p = .001); and those whose religious beliefs strongly influenced their attitudes scored higher ( p < .001). These associations highlight the multifaceted nature of attitudes toward death and the various influences that shape them. Conclusion: The findings of this study indicate that end-of-life care can induce a range of emotions that significantly impact the attitudes of nurses and physicians toward caring for patients at the end of life. As well as it was also found that healthcare professionals with more clinical experience in caring for terminally ill patients generally exhibited more positive attitudes toward death. Additionally, education on death and personal religious beliefs were identified as key factors influencing these attitudes. These insights suggest the need for enhanced educational initiatives and support systems to prepare healthcare providers for the emotional challenges of end-of-life care, ultimately improving patient experiences during this critical time.

Perspective towards End-of-Life Care among Nurses Working in BPKIHS: A Cross-Sectional Study

Article

Full-text available

Dec 2021

Background: End-of-life care (EOLC) is the term used to describe the support and medical care given to dying patients and their families during the time surrounding death. It has a direct impact on the attitude of nurses towards the care of dying. We aimed to assess the perspective towards end-of-life care and its association with different socio-demographic variables among the nurses working in B.P. Koirala Institute of Health Sciences (BPKIHS). Methods: This cross-sectional study was carried out among 136 nurses working in the selected settings of BPKIHS. Simple random sampling was used to select staff nurses and purposive sampling to select senior staff nurses and senior Auxiliary Nurse Midwifes. Frommelt Attitude towards Care of the Dying (FATCOD-B) scale was used to assess the nurses' perspective towards care of dying. Data were analyzed using SPSS version 17.0. Descriptive statistics were used for describing sample characteristics. The Chi-square test was used to show the association between level of attitude and socio-demographic variables. Results: Almost two-third (64%) of the nurses had a fair attitude, 36% had a good attitude. The socio-demographic characteristics i.e.; marital status, ward/unit, level of education, designation, total duration of work, experience of caring for dying, and training on end-of-life care were significantly associated with the nurses' attitude towards care of dying. Conclusion: Overall, nurses had a fair attitude towards the care of dying; none had a poor attitude.

Nurses’ Attitudes Towards Death and Its Relationship With Anxiety Levels

Article

Jan 2022

This study examined nurses’ attitudes towards death, anxiety levels, and socio-demographic characteristics affecting their attitudes towards death. Three hundred and eighty-four nurses participated in the study. A questionnaire form, the Death Attitude Profile-Revised (DAP-R), and the Penn State Worry Questionnaire were applied to the nurses. Nurses’ attitudes towards death were positive and their level of fear of death was low. Approach acceptance was high in younger ones; the escape acceptance score was higher in single ones. The neutral acceptance score was higher in those who received training on death. A statistically significant positive correlation was found between nurses' anxiety level and escape acceptance score. There was a statistically significant positive correlation between the length of working years of nurses and the escape acceptance and approach acceptance. Nurses should be prepared for and supported on death with in-service training. It will be useful to provide these training programs to nursing students during their education process.

Attitudes of Oncology Nurses Towards Care of Dying Patients and the Principles of Dying with Dignity and Their Views on Good Death

Article

Full-text available

Dec 2021

This study investigated oncology nurses' attitudes toward caring for dying patients, their principles of dying with dignity, and their views on good death. This descriptive study included 257 oncology nurses working at two university hospitals, an educational research hospital and a state hospital in Turkey. Data were collected using the descriptive characteristics information form, the Frommelt Attitudes toward Care of the Dying scale, the Assessment Scale of Attitudes toward the Principles of Dying with Dignity, and the Good Death Scale. The nurses obtained mean scores of 99.53 ± 7.76 on the Frommelt Attitudes toward Care of the Dying scale, 26.84 ± 12.45 on the Assessment Scale of Attitudes toward the Principles of Dying with Dignity, and 57.23 ± 7.48 on the Good Death Scale. The nurses' personal and professional characteristics influenced their attitudes toward caring for dying patients, the principles of dying with dignity, and their views on good death.

Enhancing Perception of the Nurses toward End-of-Life Concept by Conducting Educational Program in Mosul Teaching Hospitals-Iraq

Article

Full-text available

Aug 2021

Death is a predictable end part of the lifecycle. It may result from the relentless progression of chronic disease. Even nurses who routinely care for critically ill or dying patients may have difficulty accepting death. Many healthcare professionals have become so focused on preventing disease or treating illnesses that they are more likely to view death as an individual or professional failure than an inevitable end to the human experience. The study's objective is to enhance the critical care nurses' perception toward the End-of-Life concept by conducting an educational program. A quantitative "quasi-experimental study design" is carried out by conducting a pre-test and a post-test for both the experimental and control group to determine the effect of the educational program to enhancing critical care nurses' perception of the EOL concept from January 24, 2020, to February 4, 2021, in Mosul Teaching Hospitals. The study participants consisted of (60) CCNs, who are divided into two groups: (30) nurses in the experimental group and (30) nurses in the control group. All nurses in the experimental group had enhanced scores from (78.2±6.9) 52.1% in the pre-test to (121.23±0.4) 80.8% in the post-test after implemented the educational program, demonstrating the growth of (28.7%) of the percentage score.

Nurses’ Attitude Toward Caring for Dying Patients in a Nigerian Teaching Hospital

Article

Full-text available

Mar 2021

Introduction Death and the dying experience are common phenomena in all clinical settings. Death and the dying presents physical and emotional strain on the dying patient, his relations and professional caregivers. Objective The study therefore assessed the sociodemographic determinants of nurses’ attitudes towards death and caring for dying patient. Method A cross–sectional design was used to study 213 randomly selected nurses, working in one of the tier one teaching hospital in Nigeria. Attitude towards death and the dying was collected with Frommelt Attitude Care of the Dying and Death Attitude Profit–Revised questionnaire. The data collected was analysed with SPSS version 20 and inferential analyses were considered statistically significant at p < 0.05. Results The study revealed that most of the nurses had negative attitudes toward the concept of death (76.5%) and caring for dying patient (68%). Furthermore, a chi-square test revealed significant associations between the nurses’ years of working experience (χ ² = 24.57, p <.00) and current unit of practice (χ ² = 21.464; p = .002) and their attitude towards caring for the dying patient. Also, nurses’ age (χ ² = 13.77, p = .032), professional qualifications (χ ² = 13.774, p = .008), and current ward of practice (χ ² = 16.505, p = .011) were significantly associated with their attitudes to death. Furthermore, the study observed a significant association between nurses’ attitudes to death and caring for the dying patient (χ ² = 11.26, p < 0.01). Conclusion This study concluded that nurses had negative attitudes towards death and dying and therefore prescribes, as part of continuing professional development strategy, the need for requisite positive value – laden, ethnoreligious specific education regarding end of life care.

Sikap Perawat terhadap Persiapan Kematian pada Pasien Kanker Stadium Lanjut

Article

Full-text available

May 2020

Pasien kanker stadium lanjut atau tahap terminal secara umum mengalami kesulitan dalam penyembuhannya dan berakhir dengan kematian. Peran perawat sangat diperlukan dalam mempersiapkan kematian yang damai bagi pasien dengan kondisi ini dan keluarganya melalui perawatan menjelang ajal (end-of-life care). Sudut pandang terhadap kesiapan perawat dalam merawat pasien menjelang ajal dapat dijelaskan melalui sikapnya. Sikap perawat dapat mempengaruhi emosi dan perilaku perawat dalam merawat pasien terminal dan keluarganya. Penelitian ini bertujuan untuk mendeskripsikan sikap perawat terhadap persiapan kematian padapasien kanker stadium lanjut. Jenis penelitian ini adalah kuantitatif noneksperimental deskriptif survei. Teknik pengambilan sampel yang digunakan dalam penelitian ini adalah total sampling dengan jumlah sampel sebanyak 145 orang responden. Data penelitian ini dikumpulkan menggunakan kuesioner The Frommelt Attitude Toward Care of the Dying Scale (FATCOD). Hasil penelitian ini menunjukkan 76 orang dari 145 perawat (52,4%) memiliki sikap positif terhadap persiapan kematian yang damai bagi pasien kanker stadium lanjut. Hasil analisis lebih lanjut menunjukkan kedua domain sikap perawat mayoritas positif yakni 53,8% perawat memiliki sikap positif terhadap persiapan kematian bagi pasien kanker tahap terminal dan 57,2% perawat memiliki sikap positif terhadap persiapankeluarga menghadapi kematian pasien kanker stadium lanjut. Intervensi keperawatan bagi pasien kanker stadium lanjut menjelang ajal dan keluarga perlu ditingkatkan. Sangat penting untuk perawat berkomunikasi dengan pasien dan keluarga mereka dalam membahas tentang masalah akhir kehidupan untuk meningkatkan kualitas hidupnya dan mempersiapkan kematian yang damai sertaberkualitas.Patients with advanced cancer are generally difficult to be healed and end up in death. Nurses' roles are needed in preparing the patient's death through end-of-life care. The nurses' viewpoint of readiness in caring for a dying patient can be explained through their attitudes. Nurses' attitudes will affect the nurses' emotions and actions while conducting end-of-life care for dying patients and their families. This study aims to determine the nurses' attitudes toward death preparation in advanced cancer patients at RSUP Dr. Kariadi Semarang. The type of this researchis descriptive quantitative non-experimental. The sampling technique used was total sampling with a sample of 145 respondents. Data was collected by using The Frommelt Attitude Toward Care of the Dying Scale (FATCOD) questionnaire. The results showed 76 of 145 nurses (52.4%) had positive attitudes toward death preparation. The result of the analysis of two domains showed 53.8% of nurses had positive attitudes toward death preparation in advanced cancer patients and also 57.2% of nurses had positive attitudes toward death preparation in families of advanced cancer patients. Nurse interventions are still needed to improve communication with patients and their families in discussing about end-of-life issues for improving the quality of life and good death.

Attitudes of Jordanian Nurses Toward Caring for Dying Patients

Article

Full-text available

Mar 2024
OMEGA-J DEATH DYING

Hospital nurses are expected to care for dying patients. Such care provokes many undesired emotions and attitudes that affect the quality of care. This study aims to assess the attitudes of Jordanian nurses toward caring for dying patients in addition to examining the relationship between nurses’ attitudes toward caring for dying patients and their selected characteristics. A quantitative descriptive cross-sectional research design was used to recruit a total of 290 Jordanian nurses from two hospitals in Jordan. The findings of this study revealed a significant correlation between nurses’ attitudes toward caring for dying patients and receiving educational courses on palliative care (p = .008). Also, the study found a correlation between nurses’ attitudes toward caring for dying patients and prior experience attending death cases (p = .004). The attitudes nurses have toward caring for dying patients are affected by educational courses, which make these attitudes adjustable toward the positive.

Death Anxiety and Accosiated Factors Among Oncology Nurses and Physicians

Article

May 2023
OMEGA-J DEATH DYING

Background: Providing care for dying patients is a stress-inducing, complicated, as well as essential responsibility for health care providers. Furthermore, end-of-life care is associated with intense personal emotions such as grief, anxiety, depression, frustration, and guilt. Moreover, caring for terminally ill patients is a challenging task that confronts physicians and nurses with the psychological concerns of dealing with death, which is accompanied by a high level of physical and psychological discomfort. Objective: This study was aimed to measure the level of death anxiety among oncology nurses and physicians and to determine the associated factors that influence their level of death anxiety. Method: A cross-sectional descriptive design was used to guide this study, a non-probability convenience sampling method was used to recruit 200 oncology nurses and physicians from one specialized cancer center in Jordan. Data were collected using an electronic self-reported questionnaire include demographic data sheet and Collett-Lester fear of death scale, as well as all participants were invited via email for voluntary participation in this study. Result: The results revealed that the oncology nurses and physicians exhibited a moderate levels of death anxiety (CLDFODS = 91.07), furthermore, the result showed that female nurses and physicians exhibited a higher level of anxiety than male. Further, there were statistically significant differences in nurses’ and physicians’ level of death anxiety according to years of experience, receiving previous education on death and dying, and religious beliefs. On the other hand, there is no statistically significant differences in nurses’ and physicians’ level of death anxiety based on present or previous experience with loss of someone close to them. Conclusion: Jordanian oncology Nurses and physicians exhibited a moderate levels of death anxiety and fear of death, therefore, they have to address the inevitability of mortality since they are caring for dying patients frequently. They have to understand and acknowledge their thoughts regarding death and dying, as well as their death anxiety level before interacting with dying patients.

The effect of status and frequency of confronting death in emergency nurses on atti- tude towards death

Article

Full-text available

Oct 2021

Perception and attitude towards death is influenced from various factors such as religion, culture, social value judgments, beliefs and traditions. People may develop negative or positive attitude towards death according to the experiences they live about death of individuals in their environment. In this study, mean score of Attitude to Death Scale was determined as 123, mean score of “Neutral Acceptance and Approach Acceptance” among sub-dimensions of scale is 68, mean score of sub-dimension of “Escape Acceptance” is 20.235.98, mean score of sub-dimension of “Fear and Avoidance of Death” is 35.9810.06. It was determined that score of Attitude to Death Scale does not differ according to socio-demographic or occupational characteristics such as age, education, marital status, receiving education during or after occupational education yet; mean score of nurses who have experienced the loss of a close relative recently was higher than those who have not.

Sikap Perawat Terhadap Pasien Menjelang Ajal Dan Sikap Terhadap Kematian

Article

Dec 2020

Merawat pasien menjelang ajal merupakan pengalaman yang kurang menyenangkan bagi perawat karena bisa menimbulkan rasa takut, cemas, sedih dan frustasi. Tujuan dari penelitian ini adalah mengetahui hubungan antara sikap perawat pasien menjelang ajal dan sikap terhadap kematian. Metode yang digunakan dalam penelitian ini adalah deskriptif korelasi dengan menggunakan tehnik convinence sampling kepada 95 perawat yang bekerja di Rumah Sakit Advent Bandung. Pengumpulan data dilakukan pada bulan Oktober - November 2019. Untuk mengukur sikap perawat terhadap pasien menjelang ajal digunakan kuesioner Frommelt’s Attitude Toward Care of the Dying (FATCOD) scale. Sedangkan untuk mengukur sikap perawat terhadap kematian digunakan kuesioner Death Attittudes Profile-Revised (DAP-R). Hasil penelitian ini menunjukkan bahwa sebagian besar perawat memiliki sikap yang negatif terhadap pasien menjelang ajal (dying attitude) yaitu 83% dan 81.1% menunjukkan sikap yang negatif terhadap kematian (death attitude). Hasil uji-t dan uji-F menunjukkan bahwa unit kerja dan pelatihan paliatif mempunyai hubungan yang positif terhadap perawatan menjelang ajal dengan nilai sig< 0.05. Oleh karena itu penulis menyarankan agar perawat diberikan pelatihan tentang perawatan paliatif agar dapat meningkatkan sikap yang positif dalam merawat pasien menjelang ajal dan sikap terhadap kematian. Kata kunci: kematian; menjelang ajal; sikap perawatNURSE’S BEHAVIOR TOWARD DEATH AND DYING PATIENT ABSTRACT Caring for a dying patient is an unpleasant experience because nurses can feel frightened, anxiety, sadness, and frustration. The purpose of this study was to determine the correlation between nurse’s behavior towards death and dying patient. Data collection was conducted from October - November 2019 to 95 nurses at Adven Hospital of Bandung using a convenience sampling technique and descriptive correlation method using Frommelt's Attitude toward Care of the Dying (FATCOD) scale and Death Attitudes Profile-Revised (DAP-R) questionnaire. The results of this study indicate that the majority (87.4 %) of nurses have a negative dying attitude, and 81.1 % of nurses have a negative death attitude. F-test and t-test show that the work unit and palliative training have a significant correlation (sig <0.05) to nurses’ dying attitude. Therefore the authors suggest that nurses need to take palliative training to enhance nurses' positive dying attitudes and death attitudes. Keyword: death; dying; nurse attitude

The Relationship Between Death and Do Not Resuscitation Attitudes Among Intensive Care Nurses

Article

Sep 2020
OMEGA-J DEATH DYING

This study aimed to determine the relationship between death and DNR attitudes among ICNs. This descriptive-analytical study was performed on 156 ICNs in 2018. All nurses were enrolled in the study; data collection instruments included Death Attitude Profile-Revised (DAP-R) and the DNR attitude questionnaires. The mean scores of DAP-R and DNR items were 150.89/ ± 23.59 and 91.82 ± 11.41, respectively. There was a significant relationship between death attitude and DNR attitude Famong ICNs. All dimensions of DAP-R significantly predicted attitude toward DNR (P < 0.05). Among those, "neutral acceptance" (1.17 [95% CI (0.68--1.65)] was the strongest predictor and "death avoidance" was the weakest predictor (0.36 [95% CI (0.09--0.62)]. There was a significant relationship between the ICNs' work experience and attitude toward DNR (p = 0.03). The findings can be used in formulation of the national guideline for DNR order.

Factors Relating to Nurses’ End-of-Life Care

Article

Full-text available

Jan 2020

Stepping out of the comfort zone: Perceptions and attitudes of Saudi early childhood teachers to death educationالخروج من منطقة الراحة: وجهات نظر معلمات الطفولة المبكرة واتجاهاتهم نحو علم الموت: -

Article

Mar 2025

Objectives: Early education about death is essential to raise children’s level of awareness and acceptance of death. The present study aimed to explore Early Childhood (EC) teachers’ perceptions and attitudes to the integration of the concept of death and dying in early years educational settings. Method: This study is based on descriptive design and two scales; a modified death profile scale and teachers’ perceptions of teaching children about the concept of death scale were distributed to female EC teachers (n = 617) who were selected randomly from EC schools in Riyadh, Saudi Arabia. Results: The results revealed that there is a significant relationship between teachers’ qualifications and their attitudes to death education. Although teachers had positive perceptions and adequate knowledge about death, they did not view death education as beneficial for children. Teachers believed the topic should first be addressed at home before being introduced in school. Most teachers were self-educated about the subject of death and dying. Conclusion: These results provide new direction toward supporting children to understand the concept of death, to increase their preparation and learning about real life experience, which promotes their wellbeing.

Nurse's Obstacles In Delivering End Of Life Care

Article

Dec 2022

Background: Death can occur in any situation at any time, and each hospital setting has different difficulties in providing high-quality end-of-life care. The hospital's Islamic culture might offer new experiences to nurses when providing EOLC and be related to the challenges they face. This study identified the difficulties nurses encounter when providing end-of-life care in an Islamic-based hospital. Methods: A descriptive cross-sectional survey was applied to this study. A questionnaire that was adapted from the Nursing Survey Questionnaire Regarding End-of-Life Care on Medical-Surgical Units was used to collect the data. The translation and back-translation processes were carried out in the Indonesian version. All questionnaire items were declared valid with a validity value range of 0.820 to 0.950 (r table = 0.312), and the reliability test results obtained an alpha coefficient value of 0.977 (very reliable). The consecutive sampling method was applied. The data were analyzed using univariate analysis. At an Islamic hospital in Semarang, 97 surgical and medical nurses in total participated in the survey. Results: The findings indicate that the three main obstacles to nurses delivering end-of-life care are knowledge gaps (x = 2.53), a lack of education or training (x = 2.34), and health professionals’ avoidance of dying patients (x = 2.30). Other major impediments include a lack of family acceptance and uncooperative family attitudes. Conclusion: Nurses and family factors are the biggest obstacles for nurses in caring for dying patients.

Stepping Out of the Comfort Zone: Saudi Early Childhood Teachers' Perceptions and Attitudes towards Death Education

Article

Full-text available

Jan 2025

Sabha Hakim Allehyani

Objectives: Early education about death is essential to raise children’s level of awareness and acceptance of death. The present study aimed to explore Early Childhood (EC) teachers’ perceptions and attitudes to the integration of the concept of death and dying in early years educational settings. Method: This study is based on descriptive design and two scales a modified Death Profile Scale, and teachers’ perceptions of teaching children about the concept of the Death Scale were administered to female EC teachers (n = 617) who were selected randomly from EC Schools in Riyadh, Saudi Arabia. Results: The results revealed that there is a significant relationship between teachers’ qualifications and their attitudes to death education. Although teachers had positive perceptions and adequate knowledge about death, they did not view death education as beneficial for children. Teachers believed the topic should first be addressed at home before being introduced in school. Most teachers were self-educated about the subject of death and dying. Conclusion: These results provide new direction toward supporting children to understand the concept of death, to increase their preparation and learning about real life experience, which promotes their wellbeing. Keywords: Attitudes, concept of death, children, teachers, professional training.

The Attitude of Nurses of PHC Organizations to the Care of Dying Patients: A Cross-Sectional Study

Article

Full-text available

Dec 2023

Patients with incurable progressive diseases and conditions suffer from complex symptoms, requiring continuous nursing care, which, in turn, can be associated with emotional burnout of nurses in the workplace. Analysis of the available world and local literature in most cases shows us the negative attitude of nurses to palliative care, lack of understanding of its principles, lack of adequate emotional support for nurses caring for incurable patients and their families from the health care organizers. In Kazakhstan, little attention is paid to improving the attitude of nurses to the care of the dying, which could help to increase the preparedness of nurses to meet the growing needs of patients for quality care at the end of life. It should be noted the important role of nurses in ensuring universal access to palliative care, especially at the primary health care. The purpose of this study: To determine the attitude of nurses working in PHC towards caring for dying patients. Methods. An observational descriptive cross-sectional study was conducted among 565 nurses working in PHC in the city of Astana. The survey was conducted between January and December 2022 using a specialized questionnaire (The Frommelt Attitudes Towards Care of the Dying (FATCOD)). Results. The average score for all FATCOD respondents was 94.5 points. A third of the nurses surveyed (34%) have a negative attitude towards caring for dying patients, and only 6.7% of respondents have a positive attitude towards it. The majority of nurses (59.3%) showed a neutral attitude to the care of dying patients. The overall average score of the FATCOD test is usually higher for those nurses who have higher work experience, age, level of education, and have attended palliative care training in the past. However, no significant differences were found between gender and attitude to the care of dying patients (p=0.164). Conclusions. The results show that nurses have a neutral or negative attitude towards caring for dying patients. The level of education, extensive work experience, age and training in palliative care can change the attitude of nurses to caring for dying patients in a positive way.

Nurses' Level of Preparedness to Provide Palliative Care and Its Relationship With Their Evidence-based Practice

Article

Full-text available

May 2024

Background: Nursing practice must include palliative care (PC) as an essential component. The main obstacles to quality PC are nurses' lack of knowledge, negative attitudes, and gaps in evidence-based practice (EBP). Accordingly, the present study aims to evaluate nurses' knowledge of PC, their attitude towards caring for dying patients, and its relationship with EBP (knowledge/skills, attitude, and performance) in primary health care (PHC) organizations in Astana City, Kazakhstan. Methods: The data were collected through a cross-sectional study design from 565 nurses working in primary health care organizations in Astana, Kazakhstan, from January 2022 to March 2023. The subjects were recruited by convenience sampling. The study data were collected using an online questionnaire with four parts: Demographic and professional characteristics, the palliative care quiz for nurses (PCQN), the Frommelt attitudes towards care of the dying (FATCOD), and the evidence-based practice questionnaire (EBPQ). The independent t-test, a one-way ANOVA, and Kendall tau rank correlation coefficient were employed to analyze data. Hierarchical multiple regression was also developed to identify variables influencing nurses' PC knowledge. SPSS software, version 24, was used for data analysis. The significance level was set at 0.05. Results: The nurses' PC knowledge level was low (mean score=9.06±2.93). Most nurses (93%) had a neutral or negative attitude towards caring for dying patients (mean score=94.50±12.41). The obtained score (4.39±1.05) on the EBPQ indicated a moderate level of competence in EBP. Work experience (β=0.534; P=0.000) and competencies in EBP (β=0.136, P=0.001) were associated with knowledge of PC. The aspect of knowledge/skills in EBP had the most significant impact on nurses' competence level in the PC field (β=0.122, P=0.005). Conclusion: An insufficient level of nurses' knowledge about PC and a neutral or negative attitude towards caring for dying patients were revealed. The results also indicated that much attention and resources should be directed to improving nurses' knowledge level in the field of EBP because this aspect significantly affects the level of knowledge on PC.

Attitude Toward Death and Associated Factors Among Nurses And Physicians: A cross-sectional study

Preprint

Full-text available

Apr 2024

Background: Caring for terminally ill patients is a complicated task that challenges nurses and physicians with the psychological concerns and associated with a high level of physical and psychological discomfort among family, patients, and health care professionals. Aim: the aim of this study was to assess nurses’ and physicians’ attitudes towards death and end-of-life care, as well as to examine the correlations between nurses’ and physicians’ attitudes toward caring for dying patients and theirdemographic characteristics. Method: A total of 200 oncology nurses and physicians were recruited using a non-probability convenience sample from Jordanian specialized oncology hospital. All participants were invited to complete the questionnaire, which consisted of the demographic data sheet and Frommelt’s Attitude toward Care of the Dying -B scale. Result: The majority of nurses and physicians have a positive attitude toward death (FATCOD=106.31). Furthermore, there are statistically significant associations between nurses’ and physicians’ gender, previous experience with terminally ill patients, years of working experience, previous education on death and dying, previous experience with loss, religious beliefs and attitude toward end-of-life care and death. Conclusion: End-of-life Care can provoke a wide range of inconvenient attitudes and feelings, which have a significant impact on the end-of-life care. Based on the study finding, more positive attitudes toward death were found among physicians and nurses with longer clinical experience in caring for terminally ill patients. Furthermore, death education and religious beliefs significantly influence the death attitude of nurses and physicians.

THE RELATIONSHIP BETWEEN FEAR OF DEATH AND MEANING OF LIFE IN NURSING STUDENTS AND NURSES CARING FOR TERMINAL PATIENTS

Article

Full-text available

Feb 2024

IThis study aims to determine the relationship between fear of death and the meaning of life in nursing students and nurses caring for terminally ill patients. The study was conducted in a cross-sectional and relationship-seeking research design. The research was conducted between March 15 and June 30, 2023. 123 nurses and 139 nursing students working with terminal-stage patients at a university hospital participated in the study. The study was conducted with a total of 262 participants. The Personal Information Form was collected using the Fear of Death Scale (DAS) and the Meaning of Life Scale (MLQ). The relationship between fear of death and the meaning of life in nursing students and nurses caring for terminally ill patients was determined to be 31.74 (7.13) years old on average for the nurses participating in the study and 22.71 (1.66) years for the nursing students. 61% of nurses and 66.2% of nursing students were women. It was determined that 56.1% of the nurses had undergraduate degrees and 77.7% of the students were third-year students. According to the Student t-test analysis, a significant difference was detected between the groups in terms of the total score of the DAS, and the DAS scores of the nursing students were statistically significantly higher. According to the Pearson correlation analysis, a weak negative relationship was detected between the total scores of the nurses' DAS and MLQ, while no significant difference was found between the scale scores of the nursing students. In this study, the Cronbach's alpha coefficient of the Death Anxiety Scale (DAS) was found to be 0.96 and the Meaning of Life Scale (MLQ) was 0.68. It can be said that there is no relationship between the fear of death and the meaning of life in nursing students who care for terminal patients, but there is a relationship between the fear of death and the meaning of life in nurses.

Отношение медицинских сестер организаций ПМСП к уходу за умирающими пациентами: поперечное исследование

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Jan 2024

Резюме Пациенты с неизлечимыми прогрессирующими заболеваниями и состояниями страдают от сложных симптомов, требуя непрерывного сестринского ухода, который, в свою очередь, может быть сопряжен с эмоциональным выгоранием медицинских сестер на рабочем месте. Анализ доступной мировой и отечественной литературы в большинстве случаев демонстрирует нам негативное отношение медицинских сестер к паллиативной помощи, непонимание ее принципов, отсутствие адекватной эмоциональной поддержки медицинских сестер, ухаживающих за инкурабельными пациентами и их семьями со стороны организаторов здравоохранения. В Казахстане мало внимания уделяется тому, чтоб улучшить отношение медицинских сестер к уходу за умирающими, что могло бы способствовать повышению готовности медицинских сестер удовлетворять растущие потребности пациентов к качественному уходу в конце жизни. Необходимо отметить важную роль медицинских сестер в обеспечении всеобщего доступа к паллиативной помощи, особенно на этапе ПМСП. Цель исследования: определить отношение медицинских сестер, работающих в организациях ПМСП, к уходу за умирающими пациентами. Методы. Было проведено обсервационное описательное поперечное исследование среди 565 медицинских сестер, работающих в организациях ПМСП по городу Астана. Опрос был проведен в период с января по декабрь 2022 года с применением специализированного опросника (The Frommelt Attitudes Towards Care of the Dying (FATCOD). Результаты. Средний балл для всех респондентов по опроснику FATCOD составил 94,5 баллов. Треть опрошенных медицинских сестер (34%) негативно относятся к уходу за умирающими пациентами, и всего 6,7% респондентов относятся к ней положительно. Большинство медицинских сестер (59,3%) проявили нейтральное отношение к уходу за умирающими пациентами. Общий средний балл теста FATCOD обычно выше у тех медицинских сестер, которые имеют более высокий опыт работы, возраст, уровень образования, а также в прошлом посещали обучение по паллиативной помощи. Однако, не было обнаружено существенных различий между полом и отношением к уходу за умирающими пациентами (р=0,164). Выводы. Результаты показывают, что медицинские сестры имеют нейтральное или негативное отношение к уходу за умирающими пациентами. Уровень образования, большой опыт работы, возраст и прохождение обучения по паллиативной помощи могут поменять отношение медицинских сестер к уходу за умирающими пациентами в положительную сторону. Ключевые слова: паллиативная помощь, сестринское дело, медицинская сестра, отношение, знания, FATCOD.

Nurses’ knowledge, attitudes and practices towards palliative care provided to patients diagnosed with cancer

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Oct 2023
PLOS ONE

Aim and objectives This study aimed to explore the levels of knowledge, attitudes, and practices toward palliative care (PC) among nurses working with patients diagnosed with cancer in Jordan. Background PC is a growing specialty in healthcare and nursing in Jordan with an increased need to expand its scope, develop policies to govern it, and increase the awareness of its importance especially for patients diagnosed with cancer. Design Cross sectional design was used in the current study. Methods Using an online self-report questionnaire data was collected from 228 nurses working at four hospitals in Amman. The four hospitals were from three different healthcare sectors: one public, one educational, and two private hospitals. A convenience sampling method was employed. Results Results showed a low level of PC knowledge (M = 8.8), a moderate level of attitudes (M = 80.9) toward dying patients, and a moderate level of PC practices (M = 52.7). Differences in PC knowledge, attitudes, and practices were found in regard to nurses’ gender, level of education, PC training, years of experience, and working sector. Significant correlations were found between PC practices with both PC knowledge and attitudes toward dying patients. No significant relationship between PC knowledge and attitudes toward dying patients. Conclusion Low level of PC knowledge and moderate level of attitudes toward dying patients. Differences in PC knowledge, attitudes, and practices were found in regard to some participants’ demographics.

Factors associated with death anxiety and nurses’ preparedness to care for the dying patients with COVID-19

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Jun 2023
CURR PSYCHOL

Death is the most traumatic life experience among humans. Nurses' caring for dying patients increases their death anxiety, especially during pandemics. This study examined factors associated with nurses' death anxiety and preparedness to care for dying patients diagnosed with COVID-19 in Jordan. A cross-sectional correlation study recruited 400 nurses from six hospitals with specialized COVID-19 units in Jordan. Nurses have moderate levels of death anxiety and preparedness to care for the dying. Furthermore, the result revealed statistically significant differences in death anxiety levels and nurses’ readiness to care for dying patients according to their demographic and professional characteristics. As nurses’ death anxiety is negatively associated with their preparedness to care for dying patients, implementing adequate assessment of nurses' death anxiety to encourage early intervention through counseling and organizing training programs to improve their preparedness to care for the dying is highly recommended.

First death experiences of newly graduated nurses: A qualitative phenomenological study

Article

Jun 2023

Newly graduated nurses typically face death for the first time during the transition to their professional careers. This encounter can cause nurses to experience compelling emotions and make it difficult for them to manage and cope with the process of adaptation to the profession and the death process of the patient. This study aims to retrospectively examine and reveal the first death experiences of newly graduated nurses (N = 15) using a retrospective phenomenological method. Analysis of the responses of the newly graduated nurses revealed three themes: first encounter with death, nothing is like before, and support need. Newly graduated nurses realized that their first death experiences change their perspectives on life and profession and that nursing touches human life.

Factors Affecting Death Attitudes among Nursing Staff Working in Tertiary Hospitals

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Full-text available

Mar 2023

Introduction: Clinical nurses very often confront death and dying mostly in caring for patients at the end-of-life. Their death attitudes and their involvement in the dying process is a multifactorial and personal process. Aim: To investigate the death attitudes of nursing staff working in tertiary hospitals and the factors affecting them. Material and Method: A descriptive study was conducted with a convenience sample of 210 nurses and assistant nurses, employed in two large oncology hospitals and in one general hospital in Attica, Greece. Data collection was performed between June to October 2020. Participants completed a demographic questionnaire and the Greek version of the Death Attitude Profile-Revised (DAP-R) questionnaire. Results. The mean±SD age of the participants was 43±9.9 years and 86.7% of them were women, with mainly Greek nationality (97.1%). Among them 38.6% worked in oncology hospitals, 61.4% worked in a large general hospital, 64.3% had higher education, 84.6% had experienced a loss of a loved one and 54.2% had not received help/guidance for the management of end-of-life stage patients. The frequency of participants' experience of death was associated negatively with the attitudes of "fear of death" (p=0.003) and "death avoidance" (p=0.001). Receiving help/guidance for the management of dying patients was negatively correlated with the "death avoidance" attitude (p=0.31). The loss of a loved one was found to be correlated with the attitude "approach acceptance" (p=0.031) and "death avoidance" (p=0.036). Finally, it was found that there was no significant correlation in death attitudes between participants' workplace (oncology and general hospital) as well as their other occupational and demographic characteristics, with the exception of the Greek nationality which was found to correlate with a reduced attitude "neutral acceptance"(p=0.034). Conclusions: The frequency of the experience of nursing staff with death and dying patients as well as receiving help and guidance, on an empirical or cognitive level, seems to weaken their negative death attitudes. Therefore, it is suggested that educational and support programs for nurses and health professionals, are needed to provide knowledge for the management of death, the dying process and the management of families, and this could also shape nurses’s personal attitudes toward death.

Diálogo visual sobre as implicações do trabalho com a morte e o corpo sem vida

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Jan 2022

Com o objetivo de utilizar a arte para promover reflexões sobre as implicações do trabalho com a morte, este estudo teórico reflexivo de natureza qualitativa apoiou-se na tecnologia educativa para uma mostra cultural, para a produção dos dados para análise, pautando-se no referencial de Paulo Freire. O corpus de análise foi constituído por imagens paradas e em movimento, selecionadas intencionalmente, utilizando recursos de busca do Google. A análise crítica dos autores, sustentada nas produções científicas utilizadas, possibilitou uma formulação discursiva sobre as implicações do trabalho com a morte, evidenciando tabus, estigmas, desvalorização social e não reconhecimento, associados ao manuseio do cadáver. A mostra cultural temática é uma tecnologia educacional que promove uma reflexão sobre fenômenos da vida e potencializa uma compreensão crítica sobre os sentidos do trabalho de profissionais que lidam com a morte.

Hubungan Karakteristik Individu dengan Perilaku Proaktif Perawat dalam Melaksanakan Handover

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Jan 2022

Karakteristik individu seperti jenis kelamin, umur, tingkat pendidikan, dan masa kerja merupakan variabel yangdapat mempengaruhi kinerja perawat, termasuk sikap proaktif perawat dalam melaksanakan handover. Artikel inibertujuan untuk mengetahui hubungan karakteristik perawat yang terdiri dari jenis kelamin, umur, tingkatpendidikan, dan masa kerja dengan perilaku proaktif perawat di ruang rawat intensif dalam melaksanakanhandover di RSUD Zainal Abidin Provinsi Aceh. Penelitian ini menggunakan metode kuantitatif model deskriptifdengan desain cross sectional study. Sampel penelitian adalah seluruh perawat yang bertugas di ruang intensifyang berjumlah 124 orang. Pengumpulan data dilakukan secara online dengan bantuan aplikasi google formkemudian dianalisis menggunakan uji Spearman Rank dengan bantuan aplikasi SPSS. Berdasarkan hasilpenelitianditemukan bahwa perawat yang bekerja di ruang rawat intensif RSU Zainal Abidin mayoritas berjenis kelaminperempuan (68.5%) berumur 31-40 tahun (60.5%), berpendidikan Sarjana (53.2%), masa kerja 0- 5 tahun (40.3%),dan memiliki kategori perilaku proaktif tinggi dengan persentase 80.6%. Kemudian, berdasarkan hasil pengujianyang dilakukan ditemukan bahwa variabel umur dan masa kerja perawat tidak berhubungan dengan perilakuproaktif perawat dalam melakukan handover. Sedangkan variabel pendidikan dan jenis kelamin memilikihubungan yang signifikan dengan perilaku proaktif perawat dalammelaksanakan handover di ruang rawat intensifRSU Zainal Abidin Aceh.

Analysis of Nurses’ Attitudes toward Patient Death

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Full-text available

Oct 2022
Int J Environ Res Publ Health

(1) The aim of the study was to analyze nurses’ attitudes toward a patient’s death, taking into account the emotions they experience and the general perception of death. (2) The study involved 516 nurses from the West Pomeranian Voivodeship in Poland. The research was carried out using the diagnostic survey method using The Death Attitudes Profile Revisited (DAP-R-PL), the Scale of Fear and Fascination with Death, and a demographic questionnaire. (3) Research has shown that nurses accept the phenomenon of death as a natural process of human life; however, they adopt the attitude of fear of death. Most of the respondents experienced: sadness (73.4%), helplessness (58.5%), and regret (43.6%) due to the patient’s death. (4) Both age, sex, marital status, and place of residence significantly influenced the attitudes of nurses toward the patient’s death. Therefore, it is important to provide psychological support or special education in the case of dealing with the fear of death.

Attitudes of Jordanian Nursing Students Toward Death: A Cross-Sectional Study

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Jun 2022

Background: Although death is significantly increasing and most death cases take place in hospitals. However, nursing students are not well prepared to care for patients who are near death. Aim: This study aims to assess the attitudes of Jordanian nursing students towards death in addition to examine the relationship between nursing students’ attitudes towards death and their selected characteristics. Design: A quantitative descriptive cross-sectional research design was used. Method: 551 nursing students from two universities in Jordan participated, Death Attitude Profile–Revised (DAP-R) tool and a demographic questionnaire that was developed by the researcher, which included (type of university, age, studying year, attending educational courses and attending death situation) were used. Results: Jordanian nursing students most reported attitude was neutral acceptance, additionally type of university using independent t test showed a correlation with escape acceptance with p value = 0.02, using ANOVA test for both age and studying year showed that age had a correlation with death avoidance and escape acceptance with p value = 0.03, 0.004 respectively, studying year had a correlation with fear of death, death avoidance and escape acceptance with p value = 0.02, 0.001,0.01 respectively and attending death had a correlation with death avoidance with p value = 0.011. However, attending educational courses was analyzed using t test and the result revealed no correlation with any of the death attitude dimension. Conclusion: The attitudes nursing students have towards death affect how they care for dying and end of life patients, these findings demonstrate the importance of understanding students stress when they deal with death, furthermore emphasize the importance of integrating palliative educational courses into nursing curriculum.

Undergraduate nursing students’ attitudes towards the care of dying patients

Article

May 2022

Background and objectives: A holistic approach to care is essential as nurses must aim to address all aspects of a patient to provide the best quality and most personalized care. Regardless of nursing units or patients’ situations, dying is inevitable, and nursing students may need to provide care for the dying patient during pre-licensure preparation. Studies show nursing students are ill prepared to provide this care. This study aims to understand nursing students’ attitudes towards and perceived emotional preparation to care for dying patients at an undergraduate baccalaureate program in the northeast.Methods: The study utilized a mixed methods approach of analyzing the electronic survey distributed via Qualtrics to all nursing students in an undergraduate nursing program at a mid-size public university in northern New Jersey. The study utilized the Frommelt’s Attitudes Toward Care of Dying Scale with results analyzed through one-way ANOVA testing and regression tests utilizing SPSS software. Thematic analysis was used to analyze the answers to the open-ended questions.Results and conclusion: Sixty (N = 60) students completed the survey. Data analysis revealed a significant relationship between students with previous death experience and education through regression testing (p < .05). Themes included feeling unprepared and afraid of patient death and desiring to contribute positively to the dying patients’ experience. Results of this study may be used to encourage further discussion on the emotional aspects of nursing care for dying patients. Strategies can be implemented in undergraduate programs to enhance students’ emotional abilities to provide care during these distressing circumstances.

Actitudes y ansiedad ante la muerte en personas mayores pertenecientes a 2 culturas diferentes: España y Egipto

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Mar 2022

Background and objective There are multiple variables that influence fear of death, as well as attitudes towards it, including age, religiosity, emotional and cultural aspects. Due to the proximity to death, the study of attitudes and death-related anxiety and the variables that influence it in the elderly population is of great relevance. The aim of the present study was to compare the levels of death anxiety, fear of death, attitudes towards death and associated emotional aspects (anxiety and depression) in older adults from two different cultures, Western and Arab. Materials and Method A total of 91 people over 60 years old took part and were divided into two groups, one of people born in Spain (n=46) and the other of people born in Egypt (n=45). In an individualized assessment, participants completed the DAS, PRAM and the anxiety and depression subscales of the SCL-90-R questionnaires. Results Statistically significant differences between groups were observed in fear of death, acceptance and emotional aspects. Predictors of anxiety and fear of death were different for each group. Conclusion The results show the importance of taking into account cultural, religious and emotional aspects in the evaluation of fear and attitudes towards death in the elderly population.

Nursing students' attitudes toward death and stigma toward individuals who attempt suicide

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Full-text available

Dec 2021

Purpose: This study was conducted to assess the stigmatizing attitudes of nursing students toward individuals who had made suicide attempts as well as these students' attitudes toward death. Design and methods: The universe of this descriptive and cross-sectional study consisted of 650 students studying in the fall semester of the 2017-18 academic year. No sample selection was made and a total of 560 students who agreed to participate in the study were reached. The Stigma of Suicide Scale (SOSS) and the Death Attitude Profile-Revised (DAP-R) were used as data collection tools. Findings: We found that the students had a moderately positive attitude toward death and, in terms of the DAP-R, they exhibited more Neutral Acceptance and Approach Acceptance. It was determined that the stigma against suicide decreased when positive attitudes toward death increased. Practice implications: To reduce stigmatizing attitudes toward suicide, it is important to ensure that students learn about both death and suicide earlier during their education, to design forms of training that aim to eliminate negative beliefs and attitudes toward suicide attempts and to ensure that this training is sustainable.

Nursing students’ attitudes towards death and caring for dying patients

Article

Full-text available

Nov 2021

Aim To examine the attitudes of undergraduate Jordanian nursing students towards death and caring for dying patients. Design A cross-sectional correlational design. Methods The Frommelt Attitude Toward Care of the Dying and Death Attitude Profile-Revised scales were used in this study with a convenience sample of 555 students from nursing schools in Jordan. Results Nursing students had positive attitudes towards death (M = 153.7, SD = 21.5) and a positive attitude towards caring for dying patients (M = 98.1, SD = 9.2). Fear of death, escape acceptance and death avoidance were significant negative predictors, while neutral acceptance, higher academic level and female gender were significant positive predictors of caring for dying patients (F = 4.5). Conclusion Nursing students had positive attitudes towards caring for dying patients that was influenced by university type, academic level and gender. Nursing education must further focus on death, dying and end-of-life care across the core courses of nursing curricula, theory and practicum.

Design and Validation of the INCUE Questionnaire: Assessment of Primary Healthcare Nurses' Basic Training Needs in Palliative Care

Article

Full-text available

Oct 2021
Int J Environ Res Publ Health

Many instruments have been created to measure knowledge and attitudes in palliative care. However, not only is it important to acquire knowledge, but also that this knowledge should reach patients and their relatives through application in clinical practice. This study aimed to develop and psychometrically test the INCUE questionnaire (Investigación Cuidados Enfermeros/Investigation into Nurses' Care Understanding of End-of-Life) to assess the basic training needs of primary or home healthcare nurses in palliative care. A questionnaire was developed based on the classical theory of tests and factor analysis models. Initially, 18 experts developed 67 items in two blocks and determined content validity by two rounds of expert panels. Exploratory factor analysis and reliability testing were conducted with a non-probabilistic sample of 370 nurses. Some items were observed to have very low homogeneity indices or presented convergence problems and were eliminated. Questionnaire reliability was 0.700 in the theoretical block (KR20 Index) and 0.941 in the practical block (Cronbach's alpha). The model converges and shows an adequate fit, specifically CFI = 0.977, TLI = 0.977 and RMSEA = 0.05. The correlation between the two factors in the model is ρ = 0.63. The questionnaire objectively evaluates primary or home healthcare nurses' knowledge of palliative care and its practical application, thereby facilitating more efficient training plans.

Hemşirelik ve Ölümü Konuşabilmek Üzerine Bir Derleme

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Mar 2020

Ölüm, yaşayan tüm organizmaların paylaştığı evrensel bir ger-çektir. Ölümün doğasını tartışmak, üzüntü ve yoksunluk duygusunu kontrol etmek oldukça güçtür. Hemşireler, ölümü yaklaşan birey ve ailesinin ölüm korkusunun ele alınması, ölüme hazırlanması ve ölümün kabul edilmesinde önemli rol oynamaktadırlar. Hem bireyin hem de ailenin üzüntü ve yoksunluk duygularını anlayarak, empati kurarak yardım etmek, hemşirenin sorumluluğundadır. En zor olan ise bunu başarabilmektir. Yapılan çalışmalarda, hemşirelerin ölümden sonra hasta yakınlarına destek olmada yetersiz hissettikleri, ölüm yaklaştıkça hastaya bakım vermekten korktukları, ölüm ile ilgili iletişim kurmak-tan kaçındıkları, ölüm olgusuyla ağlayarak baş ettikleri ve yalnız kaldıklarında ölümle ilgili kötü düşüncelere yoğunlaştıkları belirlenmiştir. Bu doğrultuda hemşirelerin, ölüm sürecinde birey ve yakınları ile ölümü konuşmaktan kaçtıkları, ölümü yeterince konuşamadıkları ve sundukları bakımın da olumsuz etkilenebileceği söylenebilir. Ne diyeceğini bilemeyen hemşirenin, sadece hastanın yanında olup onu dinlemesinin de uygun bir iletişim olduğu söylenebilir. Özellikle terminal dönemdeki bireylere bakım veren hemşirelerin ölüme yüklediği anlam, deneyimleri ve tükenmişlik düzeyi gibi faktörlerin araştırılması, hemşirelerin kendi ölüm algılarına yönelik kişisel farkındalığın sağlanması, hizmet içi eğitim programlarıyla ölmekte olan hasta ve hasta yakını iletişim konusunda becerilerin artırılması, hemşirelerin ölümü konuş-maktan kaçmasını engelleyebilir.

The Relationship of Nurses' Attitudes Towards Caring for the Dying Patient with Their Ethical Sensitivity: Descriptive Study

Article

Jan 2021

Hemşirelik ve Ölümü Konuşabilmek Üzerine Bir Derleme A Review on Nursing and Being Able to Talk About Death

Article

Jun 2021

Ölüm, yaşayan tüm organizmaların paylaştığı evrensel bir gerçekliktir. İnsanoğlu ölümü bazen hiç beklenmedik zamanda-trafik kazası gibi sebeplerle-aniden, hazırlıksız bir şekilde, bazen de-kanser gibi-bir hastalığın tedavi edilememesiyle beklenen, kaçınılmaz bir son olarak deneyimleyebilmektedir. Ölüm süreci, hangi şekilde gerçekleşirse gerçekleşsin büyük bir acıyı içermekte; ölen kişi için hayatın yok oluşu, birlikte yaşadığı insanlar için de sevdikleri bir bireyin artık olmaması anlamına gelmektedir. 1,2 Çağımızda yaşanılan teknolojik ilerlemeler, sağ-lık sistemini de etkilemiş, geçmiş dönemlerde sıklıkla ev ortamında gerçekleşen ölümü, bireyin yaşam sü-resini uzatmak, terminal dönemde daha etkin bakım ÖZET Ölüm, yaşayan tüm organizmaların paylaştığı evrensel bir ger-çektir. Ölümün doğasını tartışmak, üzüntü ve yoksunluk duygusunu kontrol etmek oldukça güçtür. Hemşireler, ölümü yaklaşan birey ve ai-lesinin ölüm korkusunun ele alınması, ölüme hazırlanması ve ölümün kabul edilmesinde önemli rol oynamaktadırlar. Hem bireyin hem de ai-lenin üzüntü ve yoksunluk duygularını anlayarak, empati kurarak yar-dım etmek, hemşirenin sorumluluğundadır. En zor olan ise bunu başarabilmektir. Yapılan çalışmalarda, hemşirelerin ölümden sonra hasta yakınlarına destek olmada yetersiz hissettikleri, ölüm yaklaştıkça hastaya bakım vermekten korktukları, ölüm ile ilgili iletişim kurmak-tan kaçındıkları, ölüm olgusuyla ağlayarak baş ettikleri ve yalnız kaldıklarında ölümle ilgili kötü düşüncelere yoğunlaştıkları belirlenmiştir. Bu doğrultuda hemşirelerin, ölüm sürecinde birey ve yakınları ile ölümü konuşmaktan kaçtıkları, ölümü yeterince konuşamadıkları ve sundukları bakımın da olumsuz etkilenebileceği söylenebilir. Ne diye-ceğini bilemeyen hemşirenin, sadece hastanın yanında olup onu dinle-mesinin de uygun bir iletişim olduğu söylenebilir. Özellikle terminal dönemdeki bireylere bakım veren hemşirelerin ölüme yüklediği anlam, deneyimleri ve tükenmişlik düzeyi gibi faktörlerin araştırılması, hem-şirelerin kendi ölüm algılarına yönelik kişisel farkındalığın sağlanması, hizmet içi eğitim programlarıyla ölmekte olan hasta ve hasta yakını iletişim konusunda becerilerin artırılması, hemşirelerin ölümü konuş-maktan kaçmasını engelleyebilir. ABS TRACT Death is the most just universal truth shared by all living organisms. It is very difficult to discuss the nature of death and to control the feeling of sadness and deprivation. Nurses play an important role in addressing the fear of death of the individuals approaching death and their family, preparing for death and accepting death. It is the responsibility of the nurse to help by understanding and empathizing both the individual's and the family's feelings of sadness and deprivation. The most difficult is to achieve this. In the studies, it was determined that nurses felt insufficient to support their relatives after death, they were afraid to give care to the patient as death gets closer, they avoided communicating about death, they cope with the phenomenon of death by crying and they concentrated on bad thoughts about death when they were alone. It can be said accordingly that nurses avoid talking about death with the individual and their relatives during the death process, that they do not speak the death adequately and that the care they provided may be affected negatively. It can be said that it is an appropriate communication for the nurse, who does not know what to say, to listen to the patient only. Investigation of factors such as meaning of death, experience and burnout level attributed to death by nurses caring for individuals in terminal period, providing personal awareness of nurses' own perceptions of death, and increasing skills in dying patient and relative's communication with in-service training programs may prevent nurses from escaping death.

Correlates of End of Life Planning Across Life Span in Nairobi County, Kenya

Article

Full-text available

Feb 2021

Stephen Asatsa

End of life planning is an important process towards quality of dying for all, yet it remains skewed towards the terminally ill. Prior planning and preparation for one's own death has been shown to improve psychological well-being towards end of life. The continued conceptualization of end of life planning in terms of palliative care leaves out a large percentage of the general population which compromises the quality of dying. This study examined demographic factors and death attitudes as correlates of end of life planning in the general population in Nairobi, Kenya. The study adopted the correlational research design and targeted young adults, middle-aged adults, and seniors with a sample of 310 participants selected using multistage and stratified sampling techniques. Data was collected using the Death Attitude Profile-Revised and End of Life Pertinent Issues Questionnaire and analyzed using univariate analysis and Pearson correlation. The study found significant demographic differences in end of life planning in terms of age, religion, income levels and marital status. The findings further indicated significant correlation among various death attitudes and end of life planning domains. The results of this study imply that mental health practitioners need to address negative death attitudes in order to enhance end of life planning in the general population.

The Relationship Between Nurses’ Ethical Sensitivity Levels and Their Attitudes Toward Principles About Die with Dignity

Article

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Feb 2021
J RELIG HEALTH

This study was conducted to determine the relationship between nurses’ ethical sensitivity levels and their attitudes toward principles about die with dignity. The study was descriptive and correlational in design. The data were obtained from 226 nurses. The results of the correlation analysis conducted to determine whether there is a relationship between the nurses’ ethical sensitivity level and their attitudes toward principles about die with dignity are among the autonomy, meaning and relation showed a significant, negative and low-level relationship between. As a result of the research, it was found that there was a negatively, significant and low-level relationship between autonomy, meaning and relation and attitudes toward respectable principles of death.

Hospital Nurses’ Perception of Death and Self-Reported Performance of End-of-Life Care: Mediating Role of Attitude towards End-of-Life Care

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May 2020

Few studies have explored how nurses in acute care hospitals perceive and perform end-of-life care in Korea. Therefore, this study aimed to evaluate the influence of nurses’ perceptions of death on end-of-life care performance and analyze the mediating role of attitude towards end-of-life care among hospital nurses. This cross-sectional study included a total of 250 nurses who have had experience with end-of-life care from four general hospitals in Korea. We used the Korean validated tools with the View of Life and Death Scale, the Frommelt Attitudes Toward Care of the Dying (FATCOD) scale, and the performance of end-of-life care. Hierarchical linear regression and mediation analysis, applying the bootstrapping method. The results of hierarchical linear regression showed that nurses’ positive perceptions of death and attitude towards end-of-life care were significantly associated with their performance of end-of-life care. A mediation analysis further revealed that nurses’ attitude towards end-of-life care mediates the relationship between the perceptions of death and performance of end-of-life care. Our findings suggest that supportive and practical death educational programs should be designed, based on nurses’ professional experience and work environment, which will enable them to provide better end-of-life care.

The Relationship Between Euthanasia Attitude and Optimism Among Students: A Descriptive Study

Article

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Jun 2019

Factors associated with good death for end-of-life patients in the intensive care unit based on nurses' perspectives: A systematic review

Article

Feb 2025

Contributors to fatigue among nurses working in critical care units: A qualitative study

Article

Full-text available

May 2024
Nurs Crit Care

Background Fatigue is a growing concern among nurses who provide care to unstable and critically ill patients in critical care wards. It has various negative consequences for both nurses and patients. Aim To explore and describe contributors to fatigue among nurses working in critical care units. Study Design A qualitative content analysis. Results Participants were 21 nurses chosen using purposeful sampling. They were working in different critical care units at different hospitals in nine urban areas of Iran. Semi-structured interviews were used to collect data, and conventional content analysis was used to develop categories and subcategories. The analysis of data on the nurses' perspectives and experiences led to developing nine categories as contributors to fatigue: ‘compassion fatigue’, ‘extensive network of interactions’, ‘sound and alarm fatigue’, ‘psychological tensions’, ‘managerial and organizational tensions’, ‘lack of motivation and incentives’, ‘individual characteristics of nurses’, ‘physical and mental pressure’, and requirements of special care and situational complexity’. Conclusions Understanding the factors that influence the experience of fatigue among nurses working in critical care units is essential for maintaining a reliable and high-quality health care environment within health care facilities. Relevance to Clinical Practice The experience of fatigue by critical care nurses can increase the possibility of practice errors, reduce patient safety and quality of care, and enhance staff burnout and turnover. Proactive policies should be formulated to assess nurses' fatigue levels and implement strategies for effective fatigue management. This approach aims to enhance both patient safety and job satisfaction in the workplace.

A Descriptive Study to Assess the Knowledge and Attitude Towards Care of Dying Patients among Nursing Interns

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Mar 2021

Background of the Study: Death is inevitable for all living beings. Nurses play a vital role in care of dyingpatients and their family. Regardless whether the death occurs, in the community or hospital nurses spendslargest proportion of time during the care of dying patients. The nurses concern and support are valued bypatients as well as the relativesAim: To examine the nursing intern’s knowledge and attitude towards care of dying patient.Method and Materials: A quantitative research approach with non-experimental descriptive study wasadopted in this study. The stratified random sampling technique was used to select the subject for the study.Data collected from 100 subjects were analyzed by descriptive and inferential statistics using SPSS version22.Result: Among the selected subjects 83% had average knowledge, 69% had neutral attitude towards careof dying patients.Conclusion: In the present study by assessing the level of knowledge and attitude of Nursing interns towardscare of dying patients, it was found that 83% of Nursing interns had average knowledge and 69% of Nursinginterns had neutral attitude towards care of dying patients. This chapter enlightens the need of the researchstudy. The research reveals that there is no association between level of knowledge, level of attitude withselected demographic variables and there is no significant relationship between level of knowledge andattitude of Nursing interns towards care of dying patients.

Palliative Care Knowledge, Attitude, and Practice of Nursing Students at Colleges of Nursing, Praboromarajchanok Institute

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Dec 2020

Objectives: This descriptive study aimed to describe and to test the palliative care knowledge, attitude, and practice (KAP) of 3 rd year (junior) and 4 th year (senior) nursing students at the College of Nursing, Praboramarajchanok Institute. Methods: A regional cluster and proportional-to-size sampling technique was applied to select 299 junior and senior students from the College of Nursing, Praboromarajchanok Institute. Data were collected by questionnaires administered to students. The test reliability of the questionnaires measuring palliative care KAP among students was acceptable (Knowledge: Kuder-Richardson-20 (KR-20) statistic = 0.75; Attitude: Cronbach's alpha = 0.79; Practice: Cronbach's alpha = 0.93). MANOVA was used to test whether mean scores of knowledge, attitude, and practice of palliative care among nursing students was different based on variations in the amount of palliative care classes taken and prior experience providing palliative care. Results: 61 % of respondents were seniors. 61 % of the respondents never attended a class or training on palliative care previously. 62 % had prior experience delivering palliative care to patients. The students had low mean scores for knowledge about palliative care among both 3 rd year and 4 th year students. Nursing students had high mean scores for attitude for palliative care, which demonstrated having positive attitudes about delivering palliative care. 3 rd year and 4 th year students also had high mean scores for practice on delivering palliative care, showing that they had experience providing palliative care for a relatively high number of patients with a wide range of different illnesses and conditions. Moreover, mean score on knowledge, attitude, and practice on delivering palliative care of 4 th year students were higher than those of 3 rd year students deliver. Mean scores on knowledge, attitude, and practice on delivering palliative care among respondents who had previous experience with providing palliative care were higher than those who had no prior experience providing palliative care. The only statistically significant difference in mean knowledge score was among nursing students who have different levels of experience de on palliative care (F=5.73, df = 1, p=.018). Conclusions: Education, training, and experience on palliative care should be given to nursing students to increase their KAP on palliative care, particularly knowledge.

Attitudes and Experiences Towards Death of Healthcare Professionals Working in Neonatal Intensive Care Units

Article

Oct 2021
OMEGA-J DEATH DYING

Background: Death is an integral part of neonatal intensive care units' (NICUs) environment and little it is known about NICU's staff death concepts. Aim: To investigate attitudes and experiences towards death of healthcare professionals (HPs) working in NICUs. Design: Totally 131 participants from six hospitals were included in the study. Research instruments were a questionnaire designed by the authors and the scale Death Attitude Profile-Revised. Results: Gender, marital and educational status, frequent contact with end of life neonates and provision of neonatal end of life care during the research period correlated significantly with dimensions of DAP-R. Impact of NICU neonatal deaths on personal life correlated negatively with fear of death and positively with escape acceptance. Conclusion: Evaluating the interrelationships among personal characteristics, attitudes and experiences towards death among NICU HPs may increase our understanding concerning working with dying neonates and provide direction for educational intervention and continuing professional support.

When we Talk about Neutral Acceptance... and When We Talk About the Fear of Death of Others...

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Nov 2020

Critical Care Nurses’ Experiences of End-of-Life Care: A Qualitative Study

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Dec 2020

Background: Patients admitted to the intensive care unit (ICU) may face terminal illness situations, which may lead to death. In this case, the role of critical care nurses shifts from life-sustaining to end-of-life care (EOLC). Nurses’ involvement in EOLC varies between countries, even in one country due to differences in religion, culture, organization, laws, cases and patient quality. In Indonesia, research on EOLC in ICU has not been carried out. Purpose: This study aimed to explore the experiences of critical care nurses in providing EOLC. Methods: A qualitative study with a phenomenological approach was conducted. Ten critical care nurses having the experiences of caring for dying patients were recruited through a purposive sampling technique for in-depth interviews. Manual content analysis was used to identify themes. Results: The results of the study found five themes, including the challenge of communication with the family, support for the family, support for the patient, discussion and decision making, and nurses’ emotions. Conclusion: Most of EOLC provided by critical care nurses was focused on the family. They had some challenges in communication and decision making. Nurses need to get training and education about how to care for patients towards the end of life.

Nurses’ Opinions on Do-Not-Resuscitate Orders

Article

Oct 2020

The aim of this study was to determine nurses’ opinions on Do Not Resuscitate (DNR) orders. This is a descriptive study. A total of 1250 nurses participated in this study. The mean age of participants was 34.5 ± 7.7 years; 92.6% were women; 56.4% had bachelor’s degrees, and 28.8% were intensive care, oncology, or palliative care nurses. Most participants (94.3%) agreed that healthcare professionals involved in DNR decision-making processes should have ethical competence, while they were mostly undecided (43%) about the statement whether or not DNR should be legal. More than half the participants (60.2%) disagreed with the idea that DNR implementation causes an ethical dilemma. Participants’ opinions on DNR decisions significantly differed according to the number of years of employment and unit of duty. The results showed that most of the nurses had positive attitudes towards DNR orders despite it being illegal. Future studies are needed to better understand family members’ and decision makers’ perceptions of DNR orders for patients.

The attιtudes and behavιors of intensιve care unιt nurses towards end-of-lιfe care

Article

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Jul 2020

Introduction: The end-of-life period is a process in which anxiety of death is experienced intensely and there are positive and negative experiences for the nurse and the patient. Nurses' attitudes and behaviors about death affect the quality of care in the end-of-life process.Aim: The aim of the present study was to determine the attitudes and behaviors of intensive care unit nurses towards end-of-life care.Material and Method: The studied sample consisted from 216 nurses working in the intensive care units of three university hospitals. In the present study, the Nurse Identification Form and The Attitude and Behaviors of The Intensive Care Unit Nurses Towards The End-of-Life Care Scale were used as the data collection forms.Results: Statistically significant differences were found between attitudes subscale, behavior subscale, scale total mean scores and some variables such as the education level, the intensive care unit classification, knowledge for end-of-life care, the frequency of death in their unit. As a result of the correlation analysis, there were statistically significant positive correlations between attitudes subscale, behavior subscale, scale total mean scores, and some variables such as total working years as a nurse, total working years in the intensive care unit, age.Conclusions: The level of education, the intensive care unit classification, knowledgeabout end-of-life care, the frequency of death in their unit, age, total working years as a nurse, and total working year in the intensive care unit have relationship with the attitudes and behaviors of intensive care unit nurses towards end-of-life care.

How Death Anxiety Impacts Nurses’ Caring for Patients at the End of Life: A Review of Literature

Article

Full-text available

Jan 2013
Open Nurs J

Nurses are frequently exposed to dying patients and death in the course of their work. This experience makes individuals conscious of their own mortality, often giving rise to anxiety and unease. Nurses who have a strong anxiety about death may be less comfortable providing nursing care for patients at the end of their life. This paper explores the literature on death anxiety and nurses' attitudes to determine whether fear of death impacts on nurses' caring for dying patients. Fifteen quantitative studies published between 1990 and 2012 exploring nurses' own attitudes towards death were critically reviewed. Three key themes identified were: i). nurses' level of death anxiety; ii). death anxiety and attitudes towards caring for the dying, and iii). death education was necessary for such emotional work. Based on quantitative surveys using valid instruments, results suggested that the level of death anxiety of nurses working in hospitals in general, oncology, renal, hospice care or in community services was not high. Some studies showed an inverse association between nurses' attitude towards death and their attitude towards caring for dying patients. Younger nurses consistently reported stronger fear of death and more negative attitudes towards end-of-life patient care. Nurses need to be aware of their own beliefs. Studies from several countries showed that a worksite death education program could reduce death anxiety. This offers potential for improving nurses' caring for patients at the end of their life.

Hopeful Thinking and Level of Comfort Regarding Providing Pediatric Palliative Care: A Survey of Hospital Nurses

Article

Full-text available

Feb 2007
Pediatrics

The purpose of this work was to test the hypothesis that individual nurses' level of hope is associated with greater self-reported comfort and competence in providing palliative care. We conducted a Web-based cross-sectional survey at the Children's Hospital of Philadelphia, a large referral hospital, during the spring of 2005 with all of the employed nurses. The response rate was 44% (410 of 932 eligible nurses). The questions were adapted from published studies or written for this study regarding nurses' knowledge, attitudes, practices, and experiences regarding various aspects of palliative care. We used the Adult Dispositional Hope Scale. Respondents, asked to rate their degree of agreement (+2, strongly agree to -2, strongly disagree) with the statement that they were "comfortable working with dying children and their families," reported a mean score of 0.5. Regarding whether they "find it very difficult to talk about death and dying with children and families," the mean score was -0.1. Nurses specifically reported feeling most competent regarding pain management and least competent regarding talking with children and families about dying. After multivariable adjustment, greater number of years in nursing practice, more hours of palliative care education, and higher scores on the Hope Scale, each were significantly associated with higher levels of comfort working with dying children and the families, lower levels of difficulty talking about death and dying, and higher levels of palliative care competency. Nurses' level of hope is associated with their self-reported comfort and competence regarding palliative care.

Home care and hospice nurses' attitudes toward death and caring for the dying: Effects of palliative care education

Article

Jan 2005

Evaluation of a palliative care education intervention and reflective narratives of experience from 33 southern California home care and hospice nurses indicated that some attitudes toward death improved and, although attitudes toward care for dying patients did not change significantly, an overall slightly positive trend was noted.

Influence of nurses' characteristics and education on their attitudes towards death and dying: A review of literature

Article

Jan 2010

Apprehension Among Hospital Nurses Providing End-of-Life Care

Article

Mar 2007

Palliative care services in the US have quickly grown, challenging nurses to increase knowledge relating to end-of-life care. One area requiring investigation concerns nurses' attitudes in caring for the dying patient. Nurses (N = 151) representing seven hospital units were administered the Professional End-of-Life Care Attitude Scale. Data analysis quantified total, personal, and professional apprehension levels and identified differences by professional degree, gender, department, and personal experience. There were no differences in scores by education (P < .05). All units showed a high level of apprehension in caring for dying patients. Rehabilitation was highest (mean = 96, SD = 6.23); remaining units showed no differences. Male nurses were more apprehensive (mean = 95.5, SD = 3.32) than their female counterparts (mean = 91.60, SD = 6.37). Individuals with less nursing experience reported higher personal communication apprehension scores. Findings suggest the need for increased professional exposure and training for nurses who provide care to dying patients and their families. More research is needed to explore these findings.

Caring for Dying People: Attitudes Among Iranian and Swedish Nursing Students

Article

Sep 2010

To compare the attitudes of Iranian and Swedish nursing students toward caring for dying persons. Their attitudes were measured with the Frommelt's Attitude Toward Caring of the Dying and the Death Attitude Profile Revised. The results indicated that the participating Iranian students were more afraid of death and less likely to give care to dying persons than the Swedish participants. It is suggested that theoretical education should be individualized and culturally sensitive in order to positively influence the students' attitudes, and promote professional development.

Effect of Experience on Nurses?? Responses to Dying and Death in the Hospital Setting

Article

Jan 1980

Eleanor Palo. Stoller

To examine the impact of work experience on nurses' anticipated responses to situations involving dying and death in the hospital setting, 62 responses to a questionnaire were analyzed. Licensed practical nurses, it was found, had developed coping mechanisms to alleviate the uneasiness associated with unstructured interaction with dying patients. Among registered nurse respondents, however, uneasiness associated with such interaction was positively related to nursing experience. Experience was not significant in predicting responses of either RNs or LPNs to statements describing the event of death, proximity to a dead body, or provision of nursing care to dying patients.

A comparative study of death anxiety in hospice and emergency nurses

Article

Nov 1998

This paper describes a preliminary cross-sectional study which aimed to compare levels of death anxiety and coping responses in palliative care and accident and emergency (A & E) nurses. Forty-three nurses (23 from palliative care and 20 from A & E) were recruited from a district general hospital and nearby hospice. Both sites had the same mean annual death rate of 150 patients. Death anxiety was measured by the Death Attitude Profile-Revised Questionnaire and coping responses were elicited by a semi-structured interview. As hypothesized, hospice nurses had lower death anxiety and they were more likely to recall both good and difficult experiences related to patient care. Unlike the hospice nurses, a subgroup (20%) of A & E nurses reported that they were unable to discuss problems with colleagues. The study has implications for the development of institutional support for staff to enable nurses to provide good quality care for dying patients and bereaved people.

Nurses’ attitudes to terminally ill patients

Article

Jun 2001

The care of terminally ill patients is a challenge for nurses that has raised special interest in recent years. Several studies have shown a stereotyped negative attitude in nurses towards terminally ill patients. However, all have used methods with several limitations. The aim of the study presented in this paper was to identify the nurses' attitude to the terminally ill patient in Catalonia, Spain, and the relationship of this attitude to different socio-demographic data (type of centre, shift, years of experience, age and sex) by means of a new quantitative method based on the free word-association test. One hundred and seventy-five nurses working in 18 hospitals and hospices in Catalonia, Spain were included in the study. Data were analysed by the Associative Semantic Field Differential method by means of the computer programme CONTEXT and a quantitative evaluation of the degree of attitudes positivity was obtained. The study revealed a general slight negative trend in attitudes towards the terminally ill patient. A more positive attitude was observed in older caregivers and in women. The positivity in attitude decreased from morning to night shift. No differences were observed between nurses working in hospitals and those working in hospices. We conclude that nursing attitudes can be analysed by methods such as that used in this study. Attempts can be made to modify this attitude in caregivers by means of training programmes and stimulating awareness of an adequate professional approach.

The Experiences of the Registered Nurse Caring for the Person Dying of Cancer in a Nursing Home

Article

Nov 2000
Collegian

Susan Irvine

This paper reports on research that set out to identify and describe the experiences of the registered nurse caring for the resident dying of cancer in a nursing home. The research method used was a qualitative single case study involving five registered nurses in one nursing home. Thematic analysis of data from unstructured interviews and reflective journals was used to explicate the nurses' experiences. Four major themes were extracted from the data. These themes were the exclusivity of the relationships, difficulties in the management of pain, the expectations of the registered nurse and the impact of caring. The nurses' experiences were loving, fascinating, compelling and rich. The overarching experience of the nurses came from the relationship they formed with the residents. A crucial finding in this study was that these registered nurses valued the elderly resident and developed meaningful relationships with them. All aspects of the relationships were unique and profound. However, the emotional involvement with the resident, multiple death losses, confrontation of personal losses, limited workplace support such as counselling, potentially places these registered nurses at emotional risk from burnout and complicated bereavement. The implications of these findings for nursing practice, education and research are discussed.

Frommelt K . Attitudes toward care of the terminally ill: an educational intervention. Am J Hosp Palliat Care. 20:(1): 13-22

Article

Jan 2003

Katherine H. Murray Frommelt

This quasiexperimental study examined the effect of an educational program on attitudes toward caring for terminally ill persons and their families. Participants were 115 undergraduate students: intervention group, N = 49; control group, N = 66. Pre- and post-intervention measurements were done with the Frommelt Attitude Toward Care of the Dying Scale (FATCOD, Form B). Students in the intervention group participated in a semester-long (15-week, 45-hour) educational program. Demographic variables, including age, gender, religion, major area of study, influence of religious beliefs, profession, previous education, and past or present experience with loss were evaluated. Statistical analyses (t-test, ANOVA, ANCOVA, and APVs) indicated a significant positive change in the attitude scores of the intervention group and no significant change in the attitude scores of the control group.

Communication skills training in cancer care: Where are we and where are we going?

Article

Aug 2005

This review gives an overview of recent developments in the field of communication skills training programs designed for cancer health care professionals. The Web of Knowledge was searched for empirical papers published between January 2002 and February 2005. Twenty-two papers were included in the review describing 13 different studies. Four studies were randomised trials using a pretest-posttest comparison design. As regards participant-based outcomes, studies showed improvements in terms of participant satisfaction with course, reported improvements in communication skills, increased knowledge and confidence, and changes in attitudes and beliefs. Results in terms of participants' level of stress and burnout were inconsistent across studies. Improvements were observed as regards the use of taught skills following training. Three studies using an utterance-by-utterance analysis system reported improvements in physicians' use of assessment skills or supportive skills. One study observed improvements in terms of decision-making skills. No change was observed as regards physicians' detection of patient distress. As regards patient-based outcomes, only two of four studies reported improvements in terms of patient satisfaction with and perception of interviews. Results of this review confirm the usefulness of learner-centred, skills-focused, and practise-oriented communication skills training programs organised in small groups of a maximum 6 participants and lasting at least 20 hours. Such communication skills training programs may therefore be recommended to health care professionals treating cancer patients and their families.

The Influence of End-of-Life Education on Attitudes of Nursing Students

Article

Feb 2008

Palliative care is an important aspect of nursing when comfort and quality of life are the patient goals. The End-of-Life Nursing Education Consortium (ELNEC) developed a comprehensive program of teaching care of the dying to nurses and nursing students. This pretest-posttest study evaluated the influence of the integration of the ELNEC curriculum into a baccalaureate nursing program on students' attitudes toward care of the dying. The Frommelt Attitudes toward Care of the Dying Scale for nurses (FATCOD) was administered to traditional and accelerated baccalaureate students before and after exposure to a nursing curriculum that integrated essential ELNEC elements. Multiple regression analyses indicated that no previous experience with death and an age of 18-22 accounted for the most variance in attitude change. The findings suggest that integrating the ELNEC curriculum throughout a baccalaureate program positively affects the attitudes of nursing students toward the care of patients who are dying.

Nurses' characteristics and their attitudes toward death and caring for dying patients in a public hospital in Jordan

Abstract

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