Nursing students' attitudes towards death and caring for dying patients

Evaluation of the effect of death education based on the Peace of Mind Tea House: a randomized controlled trial of nursing trainees at Xiamen University, China

BACKGROUND

There are few studies on death education models for nursing students in China. It is of great significance to construct a model of nursing students' death education combined with clinical practice. This study aims to evaluate the effect of death education on nursing students based on the Peace of Mind Tea House.

METHODS

The randomized controlled trial commenced from February 7 to March 18, 2021,featuring a two-month intercession at a hospital situated in Xiamen, China. The research subjects were chosen using a convenient sampling approach with nursing students from the hospital's internship program. Ninety-two participants were enrolled, with 46 in each group. Thirteen participants were lost to follow-up, corresponding to 14% of the total study population. The samples were then allocated randomly into either the intervention group or the control group. In addition to their hospital internship, the intervention group participated in six death education courses that focused on cognitive, emotional, and motor skills as well as the "Peace of Mind Tea House" program. Control participants will undergo regular internships. Before and two weeks after the course, both groups were evaluated for death anxiety, attitude towards death, and the meaning of life to assess the intervention's effectiveness.

RESULTS

In the fear of death item of the Death Attitude Scale and the meaning of life section, the post-test score minus the pre-test score of the intervention group were 2.50 ± 3.90 (p = 0.011), and 8.90 ± 11.07 (p = 0.035), respectively. During the communication and sharing session of the reassurance card activity, 41 participants (95.3%) found the activity meaningful.

CONCLUSION

Our data analysis demonstrates that nursing students have accepted and acknowledged the Peace of Mind Tea House-based education on death, which positively impacted their attitudes towards deathand the meaning of life. The content of death education should be integrated with traditional culture, and a new model of death education should be constructed with the Heart to Heart cards as its core. This research presents proof of the efficacy of implementing appropriate death education for nursing students, and provides a successful intervention plan to alleviate their future death anxiety and develop a positive outlook on death.

TRIAL REGISTRATION

This study was approved by the Ethical Committee of Xiamen University School of Medicine (No. XDYX202304K21)(Date:18/01/2021). Written consent to participate was obtained from all the students.

Critical Care Experience Shapes Respiratory Therapists' Attitudes toward Death: A Survey Study

Respiratory therapists (RTs) frequently encounter death in their work with critically ill patients. Healthcare providers' attitudes toward death significantly affect their approach to caring for dying patients; however, there is a lack of knowledge on RTs' attitudes toward death. This study examines how the work environment and personal characteristics of RTs influence their attitudes toward death. Utilizing the Death Attitude Profile-Revised-Chinese questionnaire, a cross-sectional survey compared non-critical care RTs (non-CCRTs, N = 86) to critical care RTs (CCRTs, N = 85). Non-CCRTs displayed significantly lower scores in overall acceptance of death compared to CCRTs (p = 0.015) and a tendency to actively avoid thoughts about death (p = 0.005). CCRTs scored higher in "neutral acceptance" (p = 0.015), and non-CCRTs exhibited higher scores on items reflecting a negative attitude toward death. RTs with shorter professional tenures showed heightened fear of death and avoidance tendencies. Perception of life and death education correlated with higher "fear of death" and "death avoidance" scores (p = 0.001). The findings indicate that CCRTs demonstrate a more neutral acceptance of death. Additionally, experience, sex, mental health status, and life-death education exposure significantly influence RTs' attitudes toward death.

Attitudes toward Death among Health Care Professionals in the Balkan Region

Background and Objectives: Death is an unavoidable experience in any person's life and affects not only the dying person but also their caregivers. The dying process has been displaced from homes to health care facilities in the majority of cases. Facing death and dying has become an everyday life of health care professionals (HCP), especially in palliative care (PC) settings. This study aimed to investigate the death attitudes among HCPs in Serbia. Materials and Methods: The Serbian version of the Death Attitude Profile-Revised (DAP-RSp) was used as a measurement instrument. Results: The average age of the 180 included participants was 42.2 ± 9.9 years; the majority were females (70.0%), with more than 10 years of working experience (73.0%), physicians (70.0%) and those working in a non-oncological (non-ONC) field (57.78%). The mean total score of DAP-RSp was 124.80 ± 22.44. The highest mean score was observed in the neutral acceptance dimension (NA) (5.82 ± 0.90) and lowest in the Escape acceptance (EA) (2.57 ± 1.21). Higher negative death attitudes were reported among nurses compared to physicians (p = 0.002). Statistically significant differences were observed in the fear of death (FD) and death avoidance (DA) domains, favoring PC specialists and oncologists (p = 0.004; p = 0.015). Physicians working in Oncology (ONC) showed lower FD values (p = 0.001) compared to non-ONC departments. Conclusions: Attitudes toward death among HCPs are of great importance for the well-being of both HCPs and patients. Negative attitudes can lead to deficient care. The fear of death is highly represented among Serbian HCPs working in non-ONC fields, including both nurses and physicians. This study emphasizes the need for further research to comprehensively explore and understand HCPs' attitudes toward death. This research highlights the need for the development of an educational curriculum across all levels of medical education, aimed at overcoming the fear of death and enhancing coping strategies, which will improve the care for patients diagnosed with terminal illnesses.

Mediating effect of meaning in life on death anxiety and attitude toward palliative care among undergraduate nursing students

BACKGROUND

This study investigates the mediating effect of meaning in life between death anxiety and attitude toward palliative care among nursing students.

METHODS

We enrolled 363 undergraduate nursing students using a convenience sampling method as the respondents and conducted a survey using general information about nursing students, the Chinese version of the FATCOD-B Scale, the Chinese version of the Death Anxiety Scale, and the Chinese version of the Meaning in Life Questionnaire. The SPSS25.0 statistical software was used to analyze the mediating effect.

RESULTS

The mean total attitude score toward palliative care was (104.72 ± 10.62). Death anxiety had a significant negative predictive effect on the attitude toward palliative care (β = -0.520, P < 0.01). When the mediating variable of the presence of meaning in life was included, the negative predictive effect of death anxiety on attitude toward palliative care remained significant (β = -0.379, P = 0.036); the mediating effect (-0.141) accounted for 27.12% of the total impact (-0.520).

CONCLUSIONS

The presence of meaning in life mediates the relationship between death anxiety and attitude toward palliative care. This implies that nursing educators, through their role in educating nursing students about the meaning of life, can significantly influence the development of a positive attitude toward palliative care.

Effects of a Discourse Intervention on End-of-Life Knowledge and Attitudes of Bachelor of Science in Nursing Students

Several challenges exist to providing effective, formalized end-of-life education for undergraduate nursing students. The purpose of this study was to determine whether the addition of a discourse intervention to the End-of-Life Nursing Education Consortium Undergraduate Nursing Modules effectively improved junior-level prelicensure bachelor of science in nursing students' knowledge and attitudes toward end-of-life care. This quasi-experimental 2-group comparison, pretest/posttest design consisted of a sample of 135 enrolled in a medical-surgical nursing class. Applying Mezirow's transformational learning theory, a 2-hour discourse intervention that included a self-reflective journal, an unfolding case study focused on loss, and a discussion with question-and-answer session was implemented at the completion of the Undergraduate Nursing Modules for the intervention group. Knowledge and attitude toward end-of-life care were measured before and after the intervention with the Palliative Care Quiz for Nurses and the Frommelt Attitude Toward Care of the Dying. The findings indicated increased knowledge and positive attitude changes. This study supports the value of theory-based educational interventions, like a discourse intervention, to enhance effective pedagogy when addressing emotionally laden content such as end-of-life care. This study may have also given a glimpse of how a global pandemic may affect end-of-life knowledge and attitudes.

The Relationship between Attitudes toward Death and Emotional Intelligence, Personality, Resilience, and Justice Beliefs: A Cross-Sectional Study of Midwives in Greece

Midwifery practice inevitably includes miscarriages, stillbirths, and neonatal deaths. The aim of the present study was to investigate the relationship between attitudes toward death and emotional intelligence, personality, resilience, and justice beliefs among midwives in Greece. A descriptive cross-sectional study was conducted from 2020 to 2022 among 348 midwives employed in public hospitals, in regional health authorities, or as independent professionals. Research instruments included the Death Attitude Profile-Revised, the Connor-Davidson Resilience Scale, the Trait Emotional Intelligence Questionnaire-Short Form, the Eysenck Personality Questionnaire, and the Belief in a Just World scale. The results revealed that greater emotional intelligence was significantly associated with higher scores in the escape acceptance subscale. Midwives scored low on the neutral acceptance subscale (2.9 ± 0.8), with the highest score being recorded in the escape acceptance subscale (4.6 ± 1.0), which was significantly associated with greater emotional intelligence. Neuroticism was significantly associated with the death avoidance, approach acceptance, fear of death, and escape acceptance subscales. Finally, the subscale of distributive justice beliefs for self and others was significantly associated with the subscales of death avoidance and approach acceptance. These findings highlight the nuanced perspectives within the healthcare community. As we delve deeper into the complexities of end-of-life care, understanding these diverse attitudes is crucial for providing comprehensive and empathetic support to both patients and healthcare professionals.

Factors influencing death attitudes of medical students: a scoping review

Aim

To summarize factors influencing death attitudes of medical students, help identify intervention targets, and design precision interventions for improving death attitudes of medical students.

Methods

Web of Science, PubMed, Embase, OVID, China National Knowledge Infrastructure, and Wanfang databases were searched. Retrieval time was from January 2012 to September 2023. Studies on factors influencing death attitudes of medical students were included.

Results

Thirty-five studies were included in the final review. A total of 28 factors influencing death attitudes of medical students were summarized and divided into three categories comprising personal factors, social factors, and psychological factors. More than 15 studies confirmed that gender, religion, and discussing death with families were factors that influenced medical students' death attitudes.

Conclusion

Results indicate that there are many types of factors that influence death attitudes of medical students. It is necessary for universities to implement death education based individual characteristics and guide medical students to cultivate generally optimistic death attitudes and appropriate life values.

Nursing Students' Intention to Work in Hospice Care in the Future: A Cross-sectional Study

Studies reveal that nursing students rank hospice nursing among their least preferred career choices. The purpose of this study was to explore the association between nursing students' intention to work in hospice care in the future and their attitudes toward caring for dying patients, death anxiety, personal and/or professional experience of caring for dying patients, and type of nursing program studied. In this cross-sectional study, 200 nursing students completed an online survey based on the Frommelt Attitude Toward Care of the Dying Scale and the Turkish Death Anxiety Scale. Only 11% of the respondents were found to express interest in working in hospice care in the future. Studying in the accelerated program for nonnursing Bachelor of Arts graduates predicted a higher intention to work in hospice care in the future, than studying in the generic program (β = 0.27, P < .001). Completion of clinical experience in a medical ward predicted lower intention (β = -0.21, P < .01). These findings suggest that nursing students in the accelerated program for nonnursing Bachelor of Arts graduates should be provided with appropriate experience and support to maintain their interest in hospice nursing. Clinical experience in medical wards does not seem to be a good substitute for clinical experience in hospice care.

The effects of hospice care education on first-year undergraduate nursing students in mainland China: A mixed-methods study

BACKGROUND

With the rising number of people with end-stage chronic diseases, the demand for hospice care has increased dramatically. As the future health professionals for the implementation of hospice care, undergraduate nursing students in mainland China still lack knowledge and skills of hospice care, thus hospice care education plays a vital role in its development.

OBJECTIVES

To understand the effects of hospice care education on nursing students' death attitudes, end-of-life attitudes, humanistic care qualities, and their learning experiences.

DESIGN

This study used a mixed-methods design.

SETTING

A University of Chinese Medicine in mainland China.

PARTICIPANTS

The first-year undergraduate nursing students (n = 65).

METHODS

A mixed-methods study was conducted to evaluate the impact of a hospice care course from March to June 2021. The quantitative part included a quasi-experimental study designed with pre- and post-intervention measurements and the qualitative part included a descriptive qualitative study with semi-structured individual interviews.

RESULTS

The quantitative data revealed that after the course, nursing students experienced improvements in their death attitudes, end-of-life attitudes, and humanistic care qualities. Two categories were identified from the qualitative data. The category of "Gain from learning" included 4 themes (Confronting death and thinking about life; Understanding and agreeing with the idea of hospice care; Perceiving the humanistic spirit of medicine; Enhancing of the nursing discipline cognition and professional identity) and the category of "Course feedback" included 2 themes (Expressing recognition for the course arrangement; Making suggestions on the course optimization).

CONCLUSIONS

Hospice care education had a positive influence on nursing students. Students expressed satisfaction with the course arrangement. However, future hospice care courses should further optimize the curriculum designs by increasing the discussion of death-related topics, sharing more real clinical cases, recruiting students from different majors, and providing clinical practice, to provide high-quality nursing education for the development of hospice care.

Fear of Death in Colombian Nursing Students

Introduction: Death is a natural phenomenon inherent to the human condition and an inevitable consequence of life. As future professionals, nursing students should face the process of death and recognize their limitations, because emotional aspects can influence the quality of health care, especially in Spanish-speaking countries. This study aimed to quantify the level of fear of death among nursing students in a higher education institution in a region of Colombia. Methods: A quantitative correlational study including 258 university students selected by stratified sampling were administered the Collet-Lester Fear of Death Scale; the results were analyzed for the age, religion, marital status, number of children, and academic level of the respondents. Results: On average, the students were 22.9 years old; 83.3% of them were female, 75.6% were Catholic, 14.1% had at least one child, and 66.7% had experienced bereavement in the family. An association was found between the female gender and the fear of one's own death (p = .025). Conclusion: These findings differ from those reported in other Latin American countries where higher academic level and clinical experience are related to lower fear of death.

"It was the first time someone had died before my eyes…": A qualitative study on the first death experiences of nursing students

BACKGROUND

Accompanying a person at their death is a common experience in nurse education. In addition to all death experiences that are a meaningful part of the nursing profession, the first death experience is very important. However, there is limited understanding of nursing students' first death experiences.

OBJECTIVES

This study aimed to explore nursing students' experiences of the death of a person for the first time during clinical practice.

DESIGN

This study was conducted as a qualitative study using a phenomenological design.

PARTICIPANTS

A total of 17 nursing students participated in this study.

METHODS

Data were collected through online individual in-depth interviews and were analyzed using content analysis.

RESULTS

Four main themes and eleven sub-themes emerged. The themes were meaning of death (first death, a part of life), process management (death information, physical environment, bad news), after death (empty bed, questioning, death with dignity) and education (curriculum, support, professional perception).

CONCLUSIONS

While the first experience of death provides an opportunity for students to learn, this experience reveals various negative emotions and the need for support.

Status and predictors of medical students' knowledge and attitude towards palliative care in Jordan: a cross-sectional study

BACKGROUND

Palliative care focuses on the ability of medical students to use their expanded experiences and knowledge; however, basic medical education does not provide adequate knowledge and skills regarding palliative and end-of-life care. This study designed to examine knowledge related to palliative care and attitudes toward dying people among medical students in Jordan.

METHODS

Cross-sectional, descriptive design was used in this study. A total of 404 medical students were recruited using convenience sampling techniques from six medical programs. Data was collected using a self-administered questionnaire in relation to knowledge and attitudes regarding palliative care and dying persons using Palliative Care Assessment Knowledge (PCAK) and Frommelt Attitudes toward Care of the Dying Scale Form B (FATCOD-B).

RESULTS

Medical students have a moderate level of knowledge related to palliative care in (PCAK) part1 subscale about; pain managing (n = 156, 38.6 %), managing other palliative care symptoms (n = 164, 40.6 %), and in witnesses' family counseling and breaking bad news discussion (n = 178, 44.1 %). However, medical students have inadequate knowledge concerning the palliative care in part-2of the scale. Furthermore, students have positive attitudes towards caring for dying patients with mean score of 108.76 (SD = 8.05). The highest ranked attitude subscales were; Fairs/Malaise (M = 29.03, SD = 4.28), Communication (M = 21.39, SD = 2.51) and Relationship (M = 18.31, SD = 1.55). There was a significant difference in attitudes in relation to gender (t = -5.14, p < 0.001) with higher female mean score (M = 109.97) than males (M = 105.47). Also significant difference found among those who are exposed to Palliative Care and those who are not (t = -6.33, p < 0.001) with higher mean score of those exposed to palliative acre courses (M=298) than those who did not (M=106).

CONCLUSION

Improving knowledge and attitudes of medical students regarding palliative and end of life care should be highlighted to medical educators and medical schools need to incorporate palliative and end-of-life care into medical curricula across all levels.

Death education for undergraduate nursing students in the China Midwest region: An exploratory analysis

AIM

The purpose of this study was to comprehend the need for incorporating death education within the curriculum of undergraduate nursing students and to assess the factors that impact the desire for such education.

DESIGN

We enlisted undergraduate nursing students from several nursing colleges located in the central and west region of China. Undergraduate students who fulfilled the eligibility criteria between January and February 2021 were chosen to participate. Data were collected via an online platform called Questionnaire Star. The survey encompassed a general information questionnaire and a scale for assessing the need for education on the topic of death. Descriptive statistical analysis was performed using the SPSS 20.0 software, while multivariate stepwise regression was employed for more complex analysis. Statistical significance was indicated when the p-value was below 0.05, and high statistical significance was noted when the p-value fell below 0.01.

METHODS

We designed a descriptive quantitative approach to investigate the need for death education and its associated factors. The research involved 907 undergraduate nursing students from the central and west region of China. The data collection was done through the Questionnaire Star platform.

RESULTS

Following the collection of completed surveys, individuals displaying contradictory responses were omitted. Out of 911 surveys disseminated, 907 were successfully collected, resulting in a recovery rate of 99.6%. Among the participants, 769 identified as female, constituting 84.8% of the total, while 138 identified as male, making up 15.2%. The survey findings indicated that factors such as residency, parental educational history and exposure to hospice care education significantly impacted the need for death education among undergraduate nurses (p < 0.05).

CONCLUSIONS

Among students pursuing a nursing degree at the undergraduate level, there was a pronounced need for education related to the topic of death. Offering such education to these students is essential, as it helps cultivate a proper understanding of death. This, in turn, contributes to enhancing the overall quality of patient care throughout their life journey.

PATIENT OR PUBLIC CONTRIBUTION

A total of 907 nursing undergraduates from central and western China participated in the questionnaire.

Palliative care knowledge and attitudes toward end-of-life care among intensive care unit nurses in Jordan

BACKGROUND

There is a growing need for palliative care globally due to the rapid aging of the population and improvement in cancer survival rates. Adequate knowledge and a positive attitude are vital for palliative care nurses. The study's purpose was to examine nurses' knowledge and attitudes toward palliative care.

METHODS

A cross-sectional design with convenience sampling was used. The study included 182 intensive care unit (ICU) nurses from Jordanian hospitals in all sectors. Self-administered questionnaires were used to assess nurses' knowledge and attitudes toward palliative care. Descriptive statistics, analysis of variance, and the Kruskal-Wallis H test were used to analyze the data.

RESULTS

We measured nurses' knowledge using the Palliative Care Quiz for Nursing, and we measured nurses' attitudes using the Frommelt Attitude Toward Care of the Dying scale. The mean total knowledge and attitude scores were 8.88 (standard deviation [SD], 2.52) and 103.14 (SD, 12.31), respectively. The lowest level of knowledge was in psychosocial and spiritual care (mean, 0.51±0.70). The percentage of nurses with unfavorable attitudes was 53.3%. Significant differences in knowledge and attitude levels were observed according to educational level, experience, and hospital type.

CONCLUSIONS

ICU nurses have insufficient knowledge and inappropriate attitudes toward palliative care. Knowledge of psychological and spiritual aspects of palliative care was particularly lacking as were appropriate attitudes towards communication with dying patients. Improving knowledge and attitudes toward palliative care in nursing schools and hospitals would help overcome this problem.

The Relationship Between the Levels of Thanatophobia and the Attitudes Towards the Care of Dying Patients Among Student Nurses

This study aims to examine the relationship between the levels of thanatophobia and the attitudes towards the care of dying patients among student nurses. It is descriptive, cross-sectional, and correlational. 140 student nurses studying at the faculty of health sciences of one foundation university participated in it. We collected research data using 'Defining Features of a Student Nurse Form', 'Frommelt Attitude Toward the Care of the Dying Scale', and 'Thanatophobia Scale'. 17.1% of student nurses were deeply affected by death in the last year and 38.6% stated that a patient they cared for died during their internship. The thanatophobia scale scores of student nurses who chose their profession willingly were higher on a statistically meaningful level than those participants who did not choose their profession willingly. We found a statistically significant (p < .05) difference between the FATCOD scale scores of interns and their gender, family type, having been affected by death, and willingness to care for dying patients. We suggest that nursing students should more often provide care to dying patients before graduation.

Nursing Students' Spiritual/Religious Coping Strategies Dealing With First Experience of Witnessing Death During Clinical Practices

This study aims at determining spiritual/religious coping strategies of nursing students dealing with the first experience of witnessing death during clinical practices. One of the qualitative research approaches, a descriptive phenomenological study was designed. The study was carried out with 14 nursing students studying at a state university in Turkey. The students' first experiences of witnessing death were examined by the personal in-depth interviewing method. Data were analyzed using the thematic analysis method. The following five main themes were identified by the analysis: Perception of death; Witnessing death for the first time; Coping with death experience; Needs and recommendations; Impact of spirituality and religion. The obtained findings were presented according to the COREQ criteria. The findings showed that witnessing death for the first time is a difficult experience that affects students in various ways and students prayed and performed their prayers frequently to cope with the death experience.

Education nursing students' in Palliative Care and Pain Therapy: an observational study

BACKGROUND AND AIM

University education plays an important role in the preparation of future nurses, especially in the care of dying patients, which is one of the most emotionally engaging aspects. The objectives of the study were to describe the attitudes of students in end-of-life care and to analyze the possible relationship with some socio-demographic variables, through an observational study.

METHODS

Preliminarily, an analysis of the educational context of the Nursing Course  of the University of Parma was started, through a comparison of the university course with the recommendations of the MIUR concerning the teaching and learning of Palliative Care and Pain Therapy. Subsequently, a questionnaire containing the Frommelt Attitude Toward Care of the Dying Scale Form B and some socio-demographic context variables was administered to a sample of 109 students belonging to the CoS of Nursing in Parma.

RESULTS

From the data collected, it emerged that university planning partly reflects the recommendations of the MIUR and how, on average, nursing students have described positive attitudes in all the dimensions investigated. Interesting is the presence of a positive relationship between the personal experiences of bereavement and the attitudes of the students.

CONCLUSIONS

Nurses are essential in ensuring the quality of care provided to patients at the end of life; Nursing training in Palliative Care and Pain Therapy should include a complete and varied program (frontal activity, simulation, internship paths...) in order to develop positive student attitudes associated with high levels of satisfaction and improvement of the quality of care provided.

A new pedagogical approach to enhance palliative care and communication learning: A mixed method study

BACKGROUND

As palliative care increases in importance due to chronic illnesses in ageing populations, there is a need to develop primary palliative care, including patient-centred communication for nursing graduates. Simulation-based education was adopted to develop students clinical skills and communication in a safer and more controlled environment prior to their clinical practice. However curricula in palliative care and communication remain limited. The current study was to develop a simulation-based programme with clinical modelling prior to the simulation experience. Authentic case scenarios were also constructed through collaboration between the researchers and clinical colleagues in palliative care.

OBJECTIVES

To explore the effects of palliative care simulation-based experience on nursing students' palliative care and caring communication.

DESIGN

Mixed-methods with pre- and post-questionnaires and focus groups after the simulation-based experience.

SETTINGS

A nursing school at a university in Hong Kong.

PARTICIPANTS

Twenty-nine senior-year undergraduate nursing students.

METHODS

Students shadowed senior nurses in a palliative clinical setting, then engaged in simulation learning with two palliative scenarios in a laboratory environment. Focus group debriefings were conducted after the simulations.

RESULTS

Quantitatively, findings from the pre- and post-questionnaires revealed an improvement in the students' knowledge (t = -2.83, p = 0.02), attitudes (t = -4.21, p = 0.00), and efficacy (t = -2.07, p = 0.05) in palliative care after participating in this study. Results from the focus groups also indicated an enhancement in the students' learning of palliative care and communication.

CONCLUSION

This collaborative design of palliative scenarios and clinical shallowing with senior nurses in a palliative care setting followed by simulation enhanced the students' confidence, knowledge, skills, and attitudes in palliative care and communication.

A meta-analysis of nursing students' knowledge and attitudes about end-of-life care

OBJECTIVES

To synthesize nursing students' knowledge and attitudes about end-of-life care and to identify strategic directions for optimizing end-of-life care education.

DESIGN

A meta-analysis of observational studies.

DATA SOURCES

PubMed, Web of Science, EMBASE, CINAHL, PsycINFO, MEDLINE, CNKI, and WANFANG 8 electronic databases in English and Chinese were systematically searched from inception until 10 April 2022.

REVIEW METHODS

Two reviewers independently screened literature and extracted data using structured tables. The Agency for Healthcare Research and Quality (AHRQ) was used to appraise the methodological quality of included studies. The study outcomes were synthesized using a meta-analysis.

RESULTS

26 cross-sectional studies of medium or high quality from 13 countries met the eligibility criteria, involving 9749 nursing students. In our review, nursing students demonstrated insufficient knowledge about end-of-life care, with a pooled mean score of 7.50 (95 % CI: 6.55-8.45); of these, knowledge about philosophy and principles, psychosocial and spiritual care, and pain and symptom management were all deficient, with pooled mean scores of 1.49 (95 % CI: 0.78-2.21), 1.00 (95 % CI: 0.35-1.65), and 3.44 (95 % CI: 2.25-4.63), respectively. Conversely, nursing students showed positive attitudes toward end-of-life care, with a pooled mean score of 102.97 (95 % CI: 99.43-106.51). The subgroup analysis revealed that male nursing students had lower pooled mean scores for end-of-life care knowledge and attitudes.

CONCLUSION

There is a mismatch between nursing students' knowledge and attitudes about end-of-life care, they have a positive attitude but lack the necessary knowledge. Male nursing students seem to have a greater deficit of knowledge and a relatively conservative attitude toward end-of-life care. These findings may provide a significant reference for nursing educators to adjust educational strategies promptly.

Factors impacting pediatric registered nurse attitudes toward caring for dying children and their families: A descriptive study

PURPOSE

The purpose of this study was to gain knowledge of the educational preparation and attitudes of registered nurses at a southeastern pediatric hospital toward caring for dying children and their families.

DESIGN AND METHODS

A descriptive study with two independent samples was used to examine the attitudes of registered nurses at a pediatric hospital in southeastern United States. Participants completed the Frommelt Attitude Toward Care of the Dying Scale, Form B, a 30-item survey. Descriptive and inferential statistics were used to analyze data.

RESULTS

One hundred and thirty-two registered nurses participated in the study. Results indicated a statistically significant difference in attitudes toward caring for dying pediatric patient scores in registered nurses working in the hematology/oncology and intensive care units compared to the other units (p = 0.0017; 95% CI: 2.39-10.12).

CONCLUSIONS

This study described the educational preparation and attitudes of registered nurses who care for children who are dying and their families. Additionally, pediatric end-of-life care is complex and is further influenced by experiences and attitudes. Future research is needed to identify educational needs to care for pediatric patients and their families at the end of life.

PRACTICE IMPLICATIONS

Findings from this project indicated end-of-life care education should be integrated into undergraduate curricula. New nurse graduates who are entering the workforce should receive education on end-of-life care, especially if they are entering into a pediatric specific organization. Healthcare organizations should include end-of-life care education as part of the orientation process and annual competency process.

A qualitative study of phenomenology of perspectives of student nurses: experience of death in clinical practice

Aim

To describe the experiences of student nurses in confronting the death of their patients, and to understand how they cope with these events and to what extent there are unmet needs that can be addressed in their trainings.

Methods

Semi-structured interview method was used to collect data from Chinese nursing students and then Colaizzi’s seven-step analysis method was applied to identify recurrent themes in their responses to patient deaths. We listened the tape repeatedly combined with observations of their non-verbal behaviors, then transcribed them with emotional resonance, and entered them into Nvivo. After that, we extracted repeated and significant statements from the transcriptions, coded, then clustered codes into sub-themes and themes which were identified by the comparation with transcriptions and re-confirmation with our participants.

Results

After confirmation from the interviewees, five themes emerged: emotional experience, challenge, growth, coping and support.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-022-00846-w.