Nursing students perceptions of death and dying: A descriptive quantitative study

Emotional and Psychological Experiences of Nursing students caring for Dying Patients: A phenomenology study at Mulago National Hospital, Uganda

Introduction

Caring for dying patients is associated with psychological trauma, strong emotions and enormous stress for nursing staff and nursing students who are relied on by patients and relatives in such difficult situations. Although nurses have an ability of self-control and calm approach towards death, there are still some emotions they need to "work through". Research studies have documented limited exposure of nursing students to end-of-life care and inadequate understanding of the psychological and emotional experiences they encounter during clinical placements. This study explored the psychological and emotional experiences of Ugandan student nurses on caring for the dying patients at Mulago national referral hospital during clinical placement.

Methods

A qualitative phenomenological study was conducted among fifteen undergraduate nursing students of Makerere University in clinical placement at Mulago hospital. An In-depth interview guide was used to gather data on nursing students' emotional and psychological experiences and coping mechanisms. Data was audio recorded, verbatim transcribed and thematically analyzed using Atlas. ti version 6 software.

Results

The nursing students emotional and psychological experiences when caring for dying patients were emerged into two themes; (1) Psychological and emotional reactions, (2) Coping mechanisms. The sub themes were; anger, anxiety and depression which is triggered by a combination of issues of pressure from relatives, failure to save the dying patient, thoughts of wasted efforts to reverse the dying process, limited resources, limited technical and emotional support. The students cope by seeking help from peers, engagement in problem solving, distancing from patients, spirituality and engaging in personal stress reducing activities.

Conclusion

Insights from this study provide educators with a snapshot of student encounters, emotions, and coping strategies when facing dying patients and their families. Nursing students experience various negative emotional and psychological stressors triggered by a combination of issues that need to be addressed during care of dying patients. However, they devise different coping mechanisms to continue with provision of necessary end of life care as the clinical placement contributes to their learning, experience and builds confidence among student nurses.

Correlation between hospice competence and death coping ability among nursing students in China: A cross-sectional survey

BACKGROUND

Palliative care involves providing comprehensive physical, psychological, and social care to improve clinical symptoms and quality of life, as well as to ensure patients' dignity at the end of life. Nurses are important members of hospice care teams, and undergraduate nursing students are the hospice care providers of the future. The ability of undergraduate nursing students to provide hospice care will, thus, directly affect service quality.

OBJECTIVE

To understand the relationship between hospice competence and the death-coping abilities of nursing students and provide a theoretical basis for promoting the development of hospice education for nursing students.

METHODS

A convenience sample of 204 nursing students from a university in China completed the general conditions questionnaire, Hospice Competency Assessment Questionnaire, and a simplified version of the Coping with Death Scale.

RESULTS

The participants' overall average hospice competency score was 46 (35-52), with an average score of 3.0 (2.3-3.3) for effective caregiving skills, 2.6 (2.0-3.0) for cultural and ethical values, and 3.0 (2.2-3.4) for interprofessional teamwork. The average death-coping competency score was 92 (72-107). Multivariate logistic regression and Spearman's correlation analysis showed a positive correlation between death-coping and hospice competencies (P < 0.05).

CONCLUSION

Nursing students' overall hospice competency is low to moderate. Consequently, nurse educators should effectively modify the hospice education curriculum using the Dedicated Education Unit model.

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.

Effects of a death education based on narrative pedagogy in a palliative care course among Chinese nursing students

Background

Death education has been confirmed to be an effective method to enhance nursing students' attitudes and coping abilities toward death. However, integrated Narrative Pedagogy into the death education to explore educational effectiveness is still limited. The study aimed to evaluate the effects of a death education based on Narrative Pedagogy in a palliative care course on the attitude toward death, coping with death, and attitude toward caring for the dying among undergraduate nursing students in China.

Methods

The study was designed as a pre-post intervention study with a quasi-experimental design. All the participants received 6 class hours of death education which was designed in a palliative care course. The death education includes preparation, presentation, discussion, reflection, and practice of the narrative materials. Death Attitude Profile-Revised (DAP-R), Coping with Death Scale (CDS), and Frommelt Attitude Toward Care of the Dying-Form B (FATCOD-Form B) were used to measure outcomes.

Results

Sixty undergraduate nursing students who consented. There were statistically significant increases in the mean score of neutral acceptance and approach acceptance in the DAP-R, CDS, and FATCOD-Form B before and after the intervention.

Conclusion

This death education integrated Narrative Pedagogy which indicated to improve attitude toward death, competence to cope with death, and attitude toward the care of dying patients. The findings assist teachers in understanding the importance and urgency of death education, as well as providing a favorable approach to death education. However, the long-term effectiveness still needs to study in further.

Nursing students' experiences of a home visiting programme for older adults with multimorbidity (VISITAME project): A phenomenological study

INTRODUCTION

Nursing students should acquire competence in promoting self-care in older adults with chronic multimorbidity, but opportunities for clinical practice are limited. The implementation of a home visiting programme to community-dwelling older adults with chronic multimorbidity could contribute to nursing students' acquisition of this competence.

OBJECTIVE

The aim of our study was to understand the experience of nursing students participating in a home visiting programme to community-dwelling older adults with chronic multimorbidity.

DESIGN

Qualitative study based on Gadamer's hermeneutic phenomenology.

METHOD

Twenty-two in-depth interviews were conducted with nursing students participating in a home visiting programme. Data were recorded, transcribed and analysed following the procedure developed by Fleming.

RESULTS

Three main themes were extracted in the data analysis process: (1) 'living the theory. Experience as a catalyst for learning', (2) 'the home visiting programme as a tool for promoting competence in caring for older adults', and (3) 'when learning sparks interest in working with older adults'.

CONCLUSION

The home visiting programme to community-dwelling older adults has an important impact on the personal and professional development of nursing students. The experience of the home visiting programme leads to deep learning that sparks interest in caring for older adults. The implementation of a home visiting programme could be a beneficial strategy for the acquisition of competence to promote health and self-care.

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.

Optimizing palliative care education through undergraduate nursing students' perceptions: Application of importance-performance analysis and Borich needs assessment model

BACKGROUND

With the aging of the population and the increasing trend of chronic illnesses, the demand for palliative care is growing. Undergraduate nursing students will be the main providers of palliative care in the future. Therefore, it's important to enhance their capability for palliative care.

OBJECTIVES

The purpose of this study was to optimize palliative care education, based on undergraduate nursing students' perceptions and educational needs through the application of the importance-performance analysis and Borich needs assessment model.

DESIGN

A cross-sectional descriptive study.

SETTING

Nursing department in Wenzhou, China.

PARTICIPANTS

A total of 448 full-time undergraduate nursing students were recruited for the study.

METHODS

Importance-performance analysis was used to identify items that obtain high priority for improvement, and the Borich needs assessment model and the Locus for focus model were used to prioritize educational needs. The three methods were integrated to determine the top-priority content to meet undergraduate nursing students' educational needs in palliative care.

RESULTS

The items located in Quadrant II of Importance-performance analysis, ranked in the first 10 in Borich needs assessment, and located in Quadrant I of the Locus for focus model were defined as top-priority content. These included: "respiratory symptoms: pleural effusion, superior vena cava syndrome, respiratory difficulty," "Care of terminal symptoms," "Awareness of dying," "Care of remains," "Cooperation between interdisciplinary teams," and "Rights and interests of dying patients."

CONCLUSION

Several years of development of palliative care education have made nursing students aware of its importance. However, they have reported that education remains insufficient. A greater focus on palliative care education is needed to ensure they are better prepared. Specific attention should be given to cooperation between interdisciplinary teams, dealing with death and dying, rights and interests of people who were dying.

Student Nurses' Perception of Good Death and Religious Coping Styles

This research aims to examine the perception of the good death and religious coping styles of student nurses. The research is a correlational descriptive study. The research was conducted with 358 nursing students at a state university in the east of Turkey. It was found in the study that students had a good perception of death (58.83 ± 6.12) and mostly used positive religious coping styles (positive/24.55 ± 3.71, negative/13.31 ± 4.21). As a result of the correlation analysis, a weakly significant positive relationship was determined between good death perception and positive religious coping (p < .001).This study observed that students' perceptions of good death increased along with their positive religious coping styles.

Using a mediating model of death attitude and meaning in life to understand nursing students attitude about hospice care

BACKGROUND

Nurse-led hospice teams are an emerging trend in contemporary health care practice in China. However, Chinese nursing students are often ill-prepared to work in hospice care. Study findings on the attitude of nursing students toward the care of people who are dying and death varied among different countries and regions.

OBJECTIVES

To propose and empirically test a mediating model that examines how death attitude and meaning in life interact to affect Chinese undergraduate nursing students and their attitude toward the care of people who are dying.

DESIGN

A cross-sectional study.

PARTICIPANTS

A convenience sample of 1410 Chinese undergraduate nursing students.

METHODS

Data were collected from July to December 2020 using Chinese versions of the Frommelt Attitude Toward Care of the Dying Scale, Form B (FATCOD-B-C), Death Attitude Profile-Revised (DAP-R-C), and Purpose in Life Test (CPLT-C). SPSS version 22.0 and AMOS version 24.0 were used for statistical analysis.

RESULTS

The average FATCOD-B-C score was 98.28 ± 8.02. Death attitude and meaning in life were positively correlated with attitude toward care of the dying (p < 0.001), but death attitude was negatively correlated with meaning in life (p < 0.001). Pathway analysis showed that fear of death was significantly and positively correlated with attitude toward care of people who are dying. A mediating role was found among neutral acceptance, escape acceptance, and meaning in life to some extent. Meaning in life suppressed effects among the model.

CONCLUSION

This study revealed that Chinese undergraduate nursing students' attitude toward care of the dying was a positive nurturing process. Future nurse education should first identity the fear of death, neutral acceptance, or escape acceptance of nursing students' death attitude, and then develop a hospice curriculum based on fear management.

Fear of Death between Nursing Students in the Academic and Professional Programs

BACKGROUND OF THE STUDY:. Nurses inevitably witness death in their professional practice. These experiences can trigger fear of a patient’s death, fear of their own death or fear of the dying process. A review of literature revealed the absence of studies on dying and feelings towards the dying process particularly fear of death among students in the Indonesian context. AIM OF THE STUDY: This study explored the levels of fear of death and the differences between students enrolled sophomore academic program and those in the professional program. METHODOLOGY: This was a quantitative comparative study that utilized a cross-sectional design. Collett-Lester Fear of Death Scale was adapted to measure the fear of death among the respondents by using univariate analysis. Bivariate analysis was also utilized by applying the independent T-test to determine the significance of the difference in the data results. All 50 professional students were included in the study while simple random sampling was done to select 50 students enrolled in the academic program.   RESULTS: The level of fear of death among the sophomore students was moderate to high, while those in the professional program was moderate. Furthermore, the T-test revealed a p-value of 0.010 indicating a significant difference in the level of fear of death among sophomore academic program students compared to students in the professional program. CONCLUSION: There is a significant difference in the level of fear of death between sophomore nursing students in the academic program compared to those in the professional nursing program.