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Yildiz Çifçioğlu Z, Harmanci Seren AK. The Validity and Reliability of the Thanatophobia Scale-Turkish Form: A Psychometric Study Among Nurses. OMEGA-JOURNAL OF DEATH AND DYING 2024; 89:718-728. [PMID: 35343307 DOI: 10.1177/00302228221082755] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose: To examine the validity and reliability of the Thanatophobia Scale-Turkish Form among nurses. Design and methods: This methodological study included 154 nurses. Content and construct validity, item analysis, confirmatory factor analysis, and internal consistency were used to evaluate the data. Findings: The content validity index of the scale was 0.91. Item-total score correlation values varied between 0.453 and 0.718. As a result of the confirmatory factor analyses, one factor was confirmed. Cronbach's alpha internal consistency coefficient was 0.854. Practice Implications: Thanatophobia Scale-Turkish Form is a valid and reliable tool used to evaluate the fear of death among nurses.
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Lorenzo Allegue L, Laredo Velasco L, Recio Vivas AM, Mansilla Domínguez JM, Moñino Ruiz P, Rey LB, Font‐Jiménez I, Vargas Castrillón E. Do we really know if they are in pain? A cross-sectional study in hospitalised adult patients in Spain. Nurs Open 2023; 10:7668-7675. [PMID: 37789558 PMCID: PMC10643832 DOI: 10.1002/nop2.2007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 01/08/2023] [Accepted: 09/17/2023] [Indexed: 10/05/2023] Open
Abstract
AIMS To describe the prevalence and characteristics of pain in adult hospitalised patients, as well as to analyse the concordance between patient-reported and recorded pain and its impact on analgesic management. DESIGN A cross sectional study. METHODS The study was performed on a sample of 611 patients, from October to December 2017. Data were obtained from patient interviews, review of medical and nursing records and review of electronic prescribing. RESULTS The prevalence of pain at the time of the interview was 36.7%. The median VAS score was 4. 90% of the patients had their pain assessed within the last 24 h; however, concordance between patient-reported pain and recorded pain in the nursing record was slight. CONCLUSION Pain is still often documented inadequately. Despite the wide use of analgesics, half of the patients with moderate to severe pain do not have adequate pain management. A systematic assessment and recording of pain promotes appropriate analgesic prescription. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE The findings of our study provide insight into the main gaps in the correct management of pain in hospitalised patients. A systematic assessment and recording of the pain suffered by the patient facilitates its control and allows a better management of the analgesic prescription by the physician. This information could help hospital managers to develop training programmes on pain assessment and on the importance of doctor-nurse collaboration to improve pain management, increasing the quality of care and reducing hospital costs. REPORTING METHOD The study has adhered to the relevant EQUATOR guidelines, according to The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies.
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Affiliation(s)
- Laura Lorenzo Allegue
- Faculty of Biomedical and Health Science, Nursing DepartmentUniversidad Europea de MadridMadridSpain
| | - Leonor Laredo Velasco
- Clinical Pharmacologist in the Department of Clinical PharmacologyHospital Universitario Clínico San CarlosMadridSpain
| | - Ana María Recio Vivas
- Faculty of Biomedical and Health Science, Nursing DepartmentUniversidad Europea de MadridMadridSpain
| | | | - Pedro Moñino Ruiz
- Anaesthesiologist at the Anaesthesia DepartmentHospital Universitario Clínico San CarlosMadridSpain
| | - Luz Bueno Rey
- Head of Clinical Clinical Pharmacology DepartmentHospital Universitario Clínico San CarlosMadridSpain
| | - Isabel Font‐Jiménez
- Faculty of Biomedical and Health Science, Nursing DepartmentUniversidad Europea de MadridMadridSpain
| | - Emilio Vargas Castrillón
- Head of Clinical Clinical Pharmacology DepartmentHospital Universitario Clínico San CarlosMadridSpain
- Institute for Health Research of the Hospital Clínico San Carlos (IdISSC)MadridSpain
- Department of PharmacologyFaculty of Medicine, Universidad Complutense de MadridMadridSpain
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Chen X, Su M, Arber A, Qiao C, Wu J, Sun C, Wang D, Zhou H, Zhu Z. Exploring the variations in death anxiety among oncology nurses in China: a latent class analysis. BMC Palliat Care 2023; 22:176. [PMID: 37946173 PMCID: PMC10634125 DOI: 10.1186/s12904-023-01282-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 10/12/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Various factors have been found to be associated with high levels of death anxiety experienced by oncology nurses. The aim of this study was to use a person-oriented approach to examine the death anxiety patterns of Chinese oncology nurses and to analyze the differences in anxiety characteristics and their associated influencing factors. METHODS A cross-sectional survey regarding palliative care among registered oncology nurses was conducted in Jiangsu Province, China.Latent class analyses was applied to identify their patterns of death anxiety. The score of PCQN-C (The Chinese version of the Palliative Care Quiz for Nursing) and FATCOD-B-C (The Chinese version of the Frommelt Attitude Toward Care of the Dying scale), the demographic and working characteristics were further analyzed through covariance analysis (ANCOVA) and multivariate (or logistic) regression across the subgroups. RESULTS A two-potential-category model was selected based on the fit index. The results showed that 79% of oncology nurses belonged to the high pressure and pain group and 21% belonged to the low death anxiety group. The high pressure and pain group had significantly higher scores in the dimensions of emotion, stress and pain, time awareness, and cognition compared to the low death anxiety group. Factors influencing the high pressure and pain group included shorter working years, non-national or provincial oncology nursing specialists, non-national palliative care specialists, never discussing the topic of death with patients or family members, no palliative care related training, and PCQN and FATCOD scores. CONCLUSIONS Our study suggests that oncology nurses' death anxiety can be divided into two categories: low death anxiety and high stress pain, and certain factors, such as being female, having a short work experience, and lacking palliative care-related training, increase the likelihood of death anxiety.
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Affiliation(s)
- Xian Chen
- Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital), Nanjing, Nanjing, 210004, China
| | - Mengyu Su
- School of Nursing, Nanjing Medical University, Nanjing, 211166, China
| | - Anne Arber
- School of Health and Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, GU2 7XH, UK
| | - Chengping Qiao
- Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital), Nanjing, Nanjing, 210004, China
| | - Jinfeng Wu
- Geriatrics Department, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Cuihua Sun
- Jiangsu Nursing Association, Nanjing, 210008, China
| | - Dan Wang
- Oncology Department, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221002, China
| | - Hui Zhou
- Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital), Nanjing, Nanjing, 210004, China.
| | - Zhu Zhu
- Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital), Nanjing, Nanjing, 210004, China.
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Phillips CD, Hemphill JC. Importance of Mental Health Education in Nursing. Issues Ment Health Nurs 2023; 44:918-922. [PMID: 37379506 DOI: 10.1080/01612840.2023.2217908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Affiliation(s)
- Cindy D Phillips
- College of Nursing, East Tennessee State University, Johnson City, Knoxville, Tennessee, USA
| | - Jean Croce Hemphill
- College of Nursing, East Tennessee State University, Johnson City, Knoxville, Tennessee, USA
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Wu Q, Zhu P, Ji Q, Shi G, Qian M, Xu H, Gu X, Wang W, Zhang Q. The effect of death education course utilizing constructivist learning theory on first grade undergraduate nursing student attitudes and coping abilities towards death: A mixed study design. NURSE EDUCATION TODAY 2023; 126:105809. [PMID: 37058871 DOI: 10.1016/j.nedt.2023.105809] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 02/26/2023] [Accepted: 03/28/2023] [Indexed: 05/25/2023]
Abstract
Inadequate clinical preparation for palliative care is often reflected in inadequate education about death. Nursing students as nurses of the future, it is necessary to make them aware of death and overcome fear of it so that they can cope with their future careers and provide qualified and warmly care service. OBJECTIVES To determine the effect of death education course using constructivist learning theory on first grade undergraduate nursing student attitudes and coping abilities towards death. DESIGN This study was designed using a mixed-methods design. SETTING Two campuses of a university school of nursing in China. PARTICIPANTS First grade Bachelor of Nursing Science students (n = 191). METHODS Data collection includes questionnaires and reflective writing as after class task. Quantitative data were analyzed using descriptive statistics, the Wilcoxon Signed Rank test, and the Mann-Whitney U test. As for reflective writing, content analysis was hired to analysis. RESULTS The intervention group's attitude towards death tended to be neutral acceptance. The intervention group's ability to deal with death (Z = -5.354, p < 0.001) and expression of thoughts about death (Z = -3.89 b, p < 0.001) greater than that of the control group. Four themes (Awareness of death before class, Knowledge, The meaning of palliative care, New cognition) were identified from reflecting writing. CONCLUSION Compared with the conventional teaching, death education course utilizing constructivist learning theory was found to be a more effective method for developing students' death coping skills and reducing fear of death.
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Affiliation(s)
- Qiwei Wu
- School of Nursing, Yangzhou University, 136 Jiangyang Middle Road, Hanjing County, Yangzhou City 225009, Jiangsu Province, China
| | - Pingting Zhu
- School of Nursing, Yangzhou University, 136 Jiangyang Middle Road, Hanjing County, Yangzhou City 225009, Jiangsu Province, China; Jiangsu Key Laboratory of Zoonosis, 136 Jiangyang Middle Road, Hanjing County, Yangzhou City 225009, Jiangsu Province, China.
| | - Qiaoying Ji
- School of Nursing, Yangzhou University, 136 Jiangyang Middle Road, Hanjing County, Yangzhou City 225009, Jiangsu Province, China
| | - Guanghui Shi
- School of Nursing, Yangzhou University, 136 Jiangyang Middle Road, Hanjing County, Yangzhou City 225009, Jiangsu Province, China
| | - Meiyan Qian
- School of Nursing, Yangzhou University, 136 Jiangyang Middle Road, Hanjing County, Yangzhou City 225009, Jiangsu Province, China
| | - HuiWen Xu
- School of Nursing, Yangzhou University, 136 Jiangyang Middle Road, Hanjing County, Yangzhou City 225009, Jiangsu Province, China
| | - Xinyue Gu
- School of Nursing, Yangzhou University, 136 Jiangyang Middle Road, Hanjing County, Yangzhou City 225009, Jiangsu Province, China
| | - Wen Wang
- School of Nursing, Yangzhou University, 136 Jiangyang Middle Road, Hanjing County, Yangzhou City 225009, Jiangsu Province, China
| | - Qianqian Zhang
- School of Nursing, Yangzhou University, 136 Jiangyang Middle Road, Hanjing County, Yangzhou City 225009, Jiangsu Province, China
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Öcalan S, Kovanci MS, Uslu-Sahan F, Ozdemir L. First death experiences of newly graduated nurses: A qualitative phenomenological study. DEATH STUDIES 2023; 48:303-311. [PMID: 37296532 DOI: 10.1080/07481187.2023.2219648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
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.
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Affiliation(s)
- Sinem Öcalan
- Faculty of Nursing, Psychiatric Nursing Department, Hacettepe University, Ankara, Turkey
| | - Mustafa Sabri Kovanci
- Faculty of Nursing, Psychiatric Nursing Department, Hacettepe University, Ankara, Turkey
| | - Fatma Uslu-Sahan
- Faculty of Nursing, Department of Obstetrics and Gynecologic Nursing, Hacettepe University, Ankara, Turkey
| | - Leyla Ozdemir
- Faculty of Nursing, Medical Nursing Department, Hacettepe University, Ankara, Turkey
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Guo Z, Wu K, Shan H, Kim Y, He Q. Experience of chinese counter-marching nurses with COVID-19 patients' death in Wuhan: a qualitative study. BMC Nurs 2023; 22:141. [PMID: 37106366 PMCID: PMC10133906 DOI: 10.1186/s12912-023-01270-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 03/26/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic was occurring worldwide with over a 6.5 million deaths. It's important to explore the instructions for the global nursing community by identifying the personal coping methods of Chinese nurses in Wuhan to deal with patient deaths. METHODOLOGY The study used a qualitative conventional content analysis with 14 Chinese Counter-marching nurses. Purposive sampling, snowball sampling, and semi-structured interviews were used for participants and data collection. To assess the quality of the findings, Guba and Lincoln's criteria for confidence were fulfilled. RESULTS The data analysis results in 4 main categories:(1) psychological shocks related to COVID-19 patient's death; (2) personal psychological adjustment and demands; (3) insights on life and values; (4) Needs for relevant knowledge and skills. CONCLUSIONS During the outbreak of the epidemic or pandemic, adequate psychological care resources need to be provided to nurses when facing the death of infectious patients, to reduce the negative emotions brought by death. Effective coping strategies should also be formulated to enhance their resilience and promote their professional competence.
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Affiliation(s)
- Zhifang Guo
- College of Nursing, Dali University, Dali, China
| | - Kunli Wu
- Department of Infection Disease, Kunming Third People's Hospital, Kunming, China
| | - Huibin Shan
- People's Hospital of Dali Bai Autonomous Prefecture, Dali, China
| | - Younglee Kim
- Department of Nursing, College of Natural Science, California State University, San Bernardino, CA, 92407, USA
| | - Qilian He
- College of Nursing, Dali University, Dali, China.
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He S, Zhao H, Wang H, Chen F, Lv T, Li L, Zhang H. The mediating effects of attitude toward death and meaning of life on the relationship between perception of death and coping with death competence among Chinese nurses: a cross-sectional study. BMC Nurs 2023; 22:87. [PMID: 36997960 PMCID: PMC10060942 DOI: 10.1186/s12912-023-01245-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 03/11/2023] [Indexed: 03/31/2023] Open
Abstract
Abstract
Background
It is important to understand how the perception of death affects the competence to cope with death.
Objectives
To explore whether the perception of death has an indirect effect on competence to cope with death through the mediation of attitude toward death and meaning of life.
Methods
A total of 786 nurses from Hunan Province, China, selected by random sampling method and asked to complete an online electronic questionnaire between October and November 2021 were included in the study.
Results
The nurses’ scored 125.39 ± 23.88 on the competence to cope with death. There was a positive correlation among perception of death, competence to cope with death, the meaning of life, and attitude toward death. There were three mediating pathways: the separate mediating effect of natural acceptance and meaning of life, and the chain mediating effect of natural acceptance and meaning of life.
Conclusion
The nurses’ competence to cope with death was moderate. Perception of death could indirectly and positively predict nurses’ competence to cope with death by enhancing natural acceptance or sense of meaning in life. In addition, perception of death could improve natural acceptance and then enhance the sense of meaning in life to positively predict nurses’ competence to cope with death.
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Yoong SQ, Wang W, Seah ACW, Kumar N, Gan JON, Schmidt LT, Lin Y, Zhang H. Nursing Students’ Experiences With Patient Death and Palliative and End-of-life Care: A Systematic Review and Meta-synthesis. Nurse Educ Pract 2023; 69:103625. [PMID: 37004470 DOI: 10.1016/j.nepr.2023.103625] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 03/06/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023]
Abstract
AIM To synthesise the experiences of nursing students encountering patient death and caring for patients under palliative care or at end-of-life and their families in clinical settings BACKGROUND: Nurses are pivotal in caring for dying patients and families. It has been reported that nursing students feel unprepared in caring for dying patients and handling patient death. Understanding their experiences would better inform how palliative care education can be improved and how students can be better supported in clinical settings. DESIGN A qualitative systematic review and meta-synthesis METHODS: PubMed, Embase, CINAHL, PsycINFO, ProQuest and Google Scholar were searched for peer-reviewed articles and theses/dissertations published between 1 January 2012-25 Feb 2023. Qualitative studies of any design reporting nursing students' experiences of patient death, caring for patients under palliative care, at end-of-life, or with time-limiting diseases in clinical settings in English were included. Study quality was evaluated using the Critical Appraisal Skills Programme tool. Data were synthesised using Sandelowski and Barroso's 2-step framework through a meta-summary using thematic analysis, which were then integrated into meta-syntheses using an event timeline. RESULTS The review included 71 studies from 26 countries (n = 1586 nursing students). The meta-summary contained 8 themes and 23 subthemes: (1) Communication experience with patients and families, (2) Satisfaction with care provided to patients and families, (3) Impact of the COVID-19 pandemic on death and dying, (4) Perceptions of death and dying, (5) Impact of death, (6) Nursing education on palliative end-of-life care, (7) Support systems and coping methods, (8) Learning outcomes. The meta-synthesis depicted nursing students' experiences before, during and after encountering dying patients, families and patient death. Suggestions for nursing faculty and clinical staff on how they could equip students with necessary skills and knowledge and support them in clinical settings were also provided. CONCLUSIONS While caring for dying patients and families was beneficial to nursing students' learning and professional development, they encountered many challenges. Governments, clinical and academic nursing leaders must prioritise the integration of palliative care content into the curricula across nursing schools in face of increasing palliative and end-of-life care needs in patients. Nursing schools should ensure that students are adequately prepared by designing culturally and socioeconomically relevant curricula, integrating theoretical and experiential learning and offering students a thorough understanding of palliative and end-of-life care. Clinical staff and nursing instructors should support students emotionally and guide them in patient care.
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Affiliation(s)
- Si Qi Yoong
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Wenru Wang
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Alvin Chuen Wei Seah
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Nivetha Kumar
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Joanne Oon Nee Gan
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Assisi Hospice, Singapore
| | - Laura Tham Schmidt
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yanjuan Lin
- Department of Nursing, Fujian Medical University Union Hospital, Fuzhou, China
| | - Hui Zhang
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; St. Andrew's Community Hospital, Singapore
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Lv T, Li L, Wang H, Zhao H, Chen F, He X, Zhang H. Relationship between Death Coping and Death Cognition and Meaning in Life among Nurses: A Cross-Sectional Study. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231158911. [PMID: 36803151 DOI: 10.1177/00302228231158911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
To explore nurses' ability to cope with death and its relationship with death cognition and meaning in life in the context of Chinese traditional culture. 1146 nurses from six tertiary hospitals were recruited. Participants completed the Coping with Death Scale, the Meaning in Life Questionnaire, and the self-made Death Cognition Questionnaire. Multiple regression analysis revealed that the search for meaning, the understanding of "good death", receiving education related to life-and-death, cultural aspect, the presence of meaning, and the number of patient deaths experienced in career explained 20.3% of the variance in the ability to cope with death. Lacking a correct understanding of death, nurses are not sufficiently prepared to deal with death and their ability to cope with death is influenced by the unique cognition of death and the sense of the meaning in life in the context of Chinese traditional culture.
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Affiliation(s)
- Tingting Lv
- School of Nursing, Hunan University of Chinese Medicine, Changsha, China
- Clinical Nursing Teaching and Research Section, Second Xiangya Hospital, Central South University, Changsha, China
| | - Lezhi Li
- Clinical Nursing Teaching and Research Section, Second Xiangya Hospital, Central South University, Changsha, China
| | - Huiping Wang
- Clinical Nursing Teaching and Research Section, Second Xiangya Hospital, Central South University, Changsha, China
| | - Hong Zhao
- Clinical Nursing Teaching and Research Section, Second Xiangya Hospital, Central South University, Changsha, China
| | - Fengzhi Chen
- Clinical Nursing Teaching and Research Section, Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiachan He
- Clinical Nursing Teaching and Research Section, Second Xiangya Hospital, Central South University, Changsha, China
| | - Huilin Zhang
- Clinical Nursing Teaching and Research Section, Second Xiangya Hospital, Central South University, Changsha, China
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Wang Y, Huang Y, Zheng R, Xu J, Zhang L, Zhu P, Lu Z, Wang L, Xie J, Zhao J, Dong F. The contribution of perceived death competence in determining the professional quality of life of novice oncology nurses: A multicentre study. Eur J Oncol Nurs 2023; 62:102273. [PMID: 36709716 DOI: 10.1016/j.ejon.2023.102273] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 01/04/2023] [Accepted: 01/22/2023] [Indexed: 01/25/2023]
Abstract
PURPOSE Novice nurses find it challenging to cope with patient dying and death, especially in a death taboo cultural context, such as mainland China. By taking the example of Chinese novice oncology nurses, this study aimed to explore the contribution of their perceived death competence in determining their professional quality of life. METHOD A multicentre, cross-sectional study was conducted in six tertiary cancer hospitals in mainland China involving 506 novice oncology nurses. Measurements were the Coping with Death Scale-Chinese version, the Professional Quality of Life Questionnaire, and the Coping Style Questionnaire. Hierarchical multiple regression analyses were used to analyse the data. RESULTS Death competence was significantly associated with compassion satisfaction (r = 0.509, P < 0.001), burnout (r = -0.441, P < 0.001) and secondary traumatic stress (r = -0.154, P < 0.001) which are the three dimensions of professional quality of life. The results of hierarchical multiple regression analyses demonstrated that death competence positively predicted compassion satisfaction and negatively predicted burnout (P < 0.01), but had no significant impact on secondary traumatic stress after coping style was entered into the model (P > 0.05). CONCLUSIONS Novice oncology nurses who perceive themselves to be incompetent in dealing with patient dying and death are more likely to experience poor professional quality of life in the death taboo cultural context. Cultural-sensitive interventions and a supportive work environment are important to enhance these nurses' death competence, increasing their professional quality of life and ultimately contributing to better end-of-life cancer care management.
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Affiliation(s)
- Yanhui Wang
- Department of Hepatobiliary Cancer, Tianjin Medical University Cancer Hospital and Institute, National Clinical Research Centre for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Centre for Cancer, Tianjin, China
| | - Ying Huang
- School of Nursing, Chengde Medical College, Chengde, China
| | - Ruishuang Zheng
- Department of Hepatobiliary Cancer, Tianjin Medical University Cancer Hospital and Institute, National Clinical Research Centre for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Centre for Cancer, Tianjin, China.
| | - Jingyu Xu
- Department of Hepatobiliary Cancer, Tianjin Medical University Cancer Hospital and Institute, National Clinical Research Centre for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Centre for Cancer, Tianjin, China
| | - Liuliu Zhang
- Department of Nursing, Jiangsu Province Cancer Hospital, Nanjing, China
| | - Ping Zhu
- Department of Nursing, Jiangsu Province Cancer Hospital, Nanjing, China
| | - Zhenqi Lu
- Department of Nursing, Fudan Cancer Hospital, Shanghai, China
| | - Li Wang
- Department of VIP Medical Services, Cancer Hospital Chinese Academy of Medical Sciences, Beijing, China
| | - Juan Xie
- Department of Nursing, Shanxi Province Cancer Hospital, Xi'an, China
| | - Jiang Zhao
- Department of Nursing, Shanxi Province Cancer Hospital, Xi'an, China
| | - Fengqi Dong
- Department of Hepatobiliary Cancer, Tianjin Medical University Cancer Hospital and Institute, National Clinical Research Centre for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Centre for Cancer, Tianjin, China.
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Joseph RA, Turner T, Lee C, Akers SW, Whorley E, Goodrich C. Impact of COVID-19 on Nursing Students: Factors Associated with PTSD Risk. J Christ Nurs 2022; 39:250-257. [PMID: 36048598 PMCID: PMC9444291 DOI: 10.1097/cnj.0000000000000951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
ABSTRACT The COVID-19 pandemic rapidly transformed nursing education, creating multiple stressors for students. The researchers in this study examined how undergraduate and graduate nursing students at a faith-based university perceived the impact of COVID-19. A multiple linear regression model explored the effect of 17 variables on the Impact of Events Scale-Revised (IES-R) scores. Anxiety level, quality of sleep, and perceived health demonstrated a statistically significant influence on IES-R scores; 27% of students had IES-R scores above 33, indicating high risk for posttraumatic stress disorder. Strategies to help address student stress and anxiety are discussed.
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Zhang J, Cao Y, Su M, Cheng J, Yao N. The experiences of clinical nurses coping with patient death in the context of rising hospital deaths in China: a qualitative study. BMC Palliat Care 2022; 21:163. [PMID: 36138401 PMCID: PMC9494800 DOI: 10.1186/s12904-022-01054-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 09/14/2022] [Indexed: 11/23/2022] Open
Abstract
Background Chinese clinical nurses are increasingly confronting patient death, as the proportion of hospital deaths is growing. Witnessing patient suffering and death is stressful, and failure to cope with this challenge may result in decreased well-being of nurses and impediment of the provision of “good death” care for patients and their families. To our knowledge, few studies have specifically explored clinical nurses’ experiences coping with patient death in mainland China. Objective We aimed to explore nurses’ experiences coping with patient death in China in order to support frontline clinical nurses effectively and guide the government in improving hospice care policy. Methods Clinical nurses were recruited using purposive and snowball sampling between June 2020 and August 2020. We gathered experiences of clinical nurses who have coped with patient death using face-to-face, semi-structured, in-depth interviews. Audio recordings were transcribed verbatim and analyzed using thematic analysis. Results Three thematic categories were generated from data analysis. The first was “negative emotions from contextual challenges.” This category involved grief over deaths of younger persons, pity for deaths without family, and dread related to coping with patient death on night duty. The second category was “awareness of mortality on its own.” Subthemes included the ideas that death means that everything stops being and good living is important because we all die and disappear. The third category was “coping style.” This category included focusing on treating dying patients, recording the signs and symptoms, and responding to changes in the patient’s condition. It also involved subthemes such as avoiding talk about death due to the grief associated with dying and death, and seeking help from colleagues. Conclusions Clinical nurses’ emotional experiences are shaped by intense Chinese filial love, charity, and cultural attitudes towards death. Reasonable nurse scheduling to ensure patient and staff safety is a major priority. “Good death” decisions based on Chinese ethical and moral beliefs must be embedded throughout hospital care. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-022-01054-8.
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Affiliation(s)
- Jinxin Zhang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China.,School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yingjuan Cao
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China.,Department of Nursing, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Mingzhu Su
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Joyce Cheng
- Johns Hopkins University School of Medicine, Baltimore, United States
| | - Nengliang Yao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China. .,NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China.
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14
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Lin X, Li X, Bai Y, Liu Q, Xiang W. Death-coping self-efficacy and its influencing factors among Chinese nurses: A cross-sectional study. PLoS One 2022; 17:e0274540. [PMID: 36094947 PMCID: PMC9467326 DOI: 10.1371/journal.pone.0274540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 08/28/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Nurses are the main caregivers of dying patients. Facing or dealing with death-related events is inevitable. Death-coping self-efficacy (DCS) is very important, as it can reduce the risk of nursing staff to adverse emotional distress, help them participate in end-of-life care and improve the quality of care of patients.
Methods
Using the convenient sampling method, this study included a total of 572 nurses from a tertiary hospital in Hangzhou, China. The status and influencing factors of the DCS of nurses were explored using a general information questionnaire and DCS scale.
Results
The scores of each parameter, ranging from low to high, were in the order of coping with grief, preparation for death and hospice care. Factors influencing nurses’ DCS included attendance in hospice care education courses within the previous year, experience of accompanying the family members of the deceased and attitude towards death.
Conclusions
The overall self-efficacy of nurses in palliative care was at a medium level. Moreover, their self-efficacy in coping with grief and preparation for death should be strengthened. Managers of medical institutions can assess the death-coping ability of nurses, which helps provide corresponding support and training for nurses at an early stage. Nurses should receive guidance in grief adjustment and emotion regulation. Medical units should provide nurses with a platform for continuous training and education, use of death-related theoretical models and frameworks to guide nurses in dealing with death-related events, reduce nurses’ negative mood and jointly promote their mental health.
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Affiliation(s)
- Xi Lin
- Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Sichuan Clinical Research Center for Birth Defects, Luzhou, Sichuan, China
- Department of Nursing, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Xiaoqin Li
- Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Sichuan Clinical Research Center for Birth Defects, Luzhou, Sichuan, China
| | - Yongqi Bai
- Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Sichuan Clinical Research Center for Birth Defects, Luzhou, Sichuan, China
- * E-mail: (YB); (QL)
| | - Qin Liu
- Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Sichuan Clinical Research Center for Birth Defects, Luzhou, Sichuan, China
- Department of Nursing, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- * E-mail: (YB); (QL)
| | - Weilan Xiang
- Department of Nursing, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China
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15
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Norouzi M, Ghorbani Vajargah P, Falakdami A, Mollaei A, Takasi P, Ghazanfari MJ, Miri S, Javadi-Pashaki N, Osuji J, Soltani Y, Aghaei I, Moosazadeh M, Emami Zeydi A, Karkhah S. A Systematic Review of Death Anxiety and Related Factors Among Nurses. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221095710. [PMID: 35500143 DOI: 10.1177/00302228221095710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
This systematic review aimed to summarize the evidence regarding death anxiety (DA) and related factors among nurses. Scopus, PubMed, Web of Science, Iranmedex, and Scientific Information Database (SID) databases were extensively searched using purpose-related keywords from the earliest to October 5, 2021. A total of 6819 nurses were included in 31 studies. The DA of nurses based on the Templer's Death Anxiety Scale was moderate. Factors such as personal anxiety, frequency and severity of job stress, burnout, dying patient avoidance behavior, euthanasia, sex, mental health status, social desirability, attitude toward the elderly, humor, social maturity, psychological hardiness, quality of life, lack of social activity, self-efficacy, coping with death, and life satisfaction were associated with nurses' DA. Therefore, nursing policymakers can promote nurses' health to improve the quality of nursing care by considering these related factors.
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Affiliation(s)
- Masoumeh Norouzi
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, 549118Guilan University of Medical Sciences, Rasht, Iran
| | - Pooyan Ghorbani Vajargah
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, 549118Guilan University of Medical Sciences, Rasht, Iran
| | - Atefeh Falakdami
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, 549118Guilan University of Medical Sciences, Rasht, Iran
| | - Amirabbas Mollaei
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, 549118Guilan University of Medical Sciences, Rasht, Iran
| | - Poorya Takasi
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, 549118Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammad Javad Ghazanfari
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Kashan University of Medical Sciences, 549118 Kashan, Iran
| | | | - Nazila Javadi-Pashaki
- Social Determinants of Health Research Center (SDHRC), 549118Guilan University of Medical Sciences, Rasht, Iran
- Department of Nursing, Cardiovascular Diseases Research Center, School of Nursing and Midwifery, 549118Guilan University of Medical Sciences, Rasht, Iran
| | - Joseph Osuji
- School of Nursing and Midwifery, Faculty of Health, Community, and Education, 2123Mount Royal University, Calgary, Ab, Canada
| | - Yasaman Soltani
- Medical Education Research Center, Educational Development Center, 549118Guilan University of Medical Sciences, Rasht, Iran
| | - Iraj Aghaei
- Neuroscience Research Center, Poursina Hospital, 549118Guilan University of Medical Sciences, Rasht, Iran
| | - Mahmood Moosazadeh
- Epidemiology, Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, 92948Mazandaran University of Medical Sciences, Sari, Iran
| | - Amir Emami Zeydi
- Department of Medical-Surgical Nursing, Nasibeh School of Nursing and Midwifery, 108890Mazandaran University of Medical Sciences, Sari, Iran
| | - Samad Karkhah
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, 549118Guilan University of Medical Sciences, Rasht, Iran
- Burn and Regenerative Medicine Research Center, 549118Guilan University of Medical Sciences, Rasht, Iran
- Quchan School of Nursing, Mashhad University of Medical Sciences, 549118Mashhad, Iran
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16
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How to prepare Chinese-born nurses to care for patients at the end-of-life in Western settings: A discussion paper. Collegian 2022. [DOI: 10.1016/j.colegn.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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17
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Personal and Emotional Factors of Nursing Professionals Related to Coping with End-of-Life Care: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189515. [PMID: 34574439 PMCID: PMC8465186 DOI: 10.3390/ijerph18189515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/06/2021] [Accepted: 09/07/2021] [Indexed: 02/03/2023]
Abstract
The death of a patient can be a traumatic event, causing emotional and psychological distress in professional nurses and potentially hampering the quality of their care. Optimal self-perceived coping with death involves valuing these difficult situations as challenges and actively coping with work-related stress during the care of the dying patient. Thus, the aim of this study was to assess Spanish nurses’ self-perceived competence with patient death and investigate its relationship with their personality traits, anxiety and fear of death. A cross-sectional study based on a web-based survey was conducted. A sample of 534 Spanish nurses provided socio-demographic information and answered validated questionnaires. Most participants perceived their coping with death as optimal. Men and nurses older than 31 years coped better with death. Professionals with an optimal self-perception showed significantly lower scores on all personality dimensions evaluated, while a higher level of the anxiety trait predicted worse coping. Although with medium explanatory power, psychoticism, anxiety, and fear of death were the main predictors of the development of optimal coping with death among Spanish nurses. These characteristics together with information from the work environment and evidence-based practice could help to develop better routines and contexts of care for nurses working in end-of-life care.
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18
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García-Navarro EB, Araujo-Hernández M, Rigabert A, Rojas-Ocaña MJ. Attitudes of nursing degree students towards end of life processes. A cultural approach (Spain-Senegal). PLoS One 2021; 16:e0254870. [PMID: 34415902 PMCID: PMC8378746 DOI: 10.1371/journal.pone.0254870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 07/05/2021] [Indexed: 11/21/2022] Open
Abstract
Introduction The concept of death is abstract, complex and has a number of meanings. Thus, its understanding and the approach taken to it depend, to a large extent, on aspects such as age, culture, training and religion. Nursing students have regular contact with the process of death and so it is of great interest to understand the attitudes they have towards it. As we live in a plural society it is even more interesting to not only understand the attitudes of Spanish students but, also, those of students coming from other countries. In the present article, we seek to identify and compare the attitudes held by nursing degree students at Hekima-Santé University (Senegal) and the University of Huelva (Spain) about end of life processes. The study identifies elements that condition attitudes and coping with death, whilst considering curricular differences with regards to specific end of life training. Method A descriptive, cross-sectional and multi-center study was conducted. The overall sample (N = 142) was divided into groups: Hekima-Santé University (Dakar, Senegal) and the University of Huelva (Huelva, Spain). The measurement instruments used were an ad-hoc questionnaire and Bugen´s Coping with Death Scale. Results Statistically significant differences (p = 0.005, 95%CI) were found in relation to overall Bugen Scale scores. We can confirm that specialized end of life training (University of Huelva, Spain) did not lead to better coping when compared with a population whose academic curriculum did not provide specific training and who engaged in more religious practices (Hekima-Santé University, Senegal). Conclusions In cultures where religion not only influences the spiritual dimension of the individual, but acts in the ethical and moral system and consequently in the economic, educational and family sphere, the accompaniment at the end of life transcends the formative plane. Considering the plural society in which we live, the training that integrates the Degree in Nursing with regard to the care of the final process, must be multidimensional in which spirituality and faith are integrated, working emotional and attentional skills, as well as cultural competence strategies in this process.
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Affiliation(s)
- E. Begoña García-Navarro
- Department of Nursing and Health Sciences, University of Huelva, Huelva, Spain
- Research Group ESEIS, Social Studies and Social Intervention, Center for Research in Contemporary Thought and Innovation for Development (COIDESO), University of Huelva, Huelva, Spain
| | | | - Alina Rigabert
- Methodology and Data Analysis Department, Andalusia Beturia Foundation for Health Research (FABIS), Huelva, Spain
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