Exploring the needs and barriers for death education in China: Getting answers from heart transplant recipients' inner experience of death

Background

Promoting reflection about death may support better living, and how to carry out death education is an important issue to be addressed across the world. The purpose of the current study was to explore the attitude of heart transplant recipients toward death and their inner real experience to provide information for the development of death education strategies.

Methods

A phenomenological qualitative study was conducted using a snowball method. A total of 11 patients who had undergone heart transplantation more than 1-year ago were recruited for the current study for semi-structured interviews.

Results

A total of five themes were identified: "Not avoid talking about death," "Feeling fear about the pain in the process of death", "Wanting a good death at the end of life," "The richness of feelings during near-death is surprising," and "Being close to death makes people more receptive to death."

Conclusion

Heart transplant recipients have a positive attitude toward death and wish for "good death" at the end of life. These patients' near-death experiences and positive attitudes toward death during the course of their illness provided evidence of the need for death education in China and supported the experiential approach to death education.

Reminiscence in the Face of Death of a Filipino Elderly With Substance Use Disorder: The Case of Burt

Death is an important reality that the elderly face. In preparation for death, old people engage in reminiscence. However, the presence of addiction in the elderly may influence this process. The current study examined the life of Burt, a sixty-five year old man with substance use disorder, his reflections on death, and the different types of reminiscence he uses. Using a case study, six themes were uncovered. Burt's reflections on death revealed his awareness of his death, how he plans to spend his dying days, and his idea of a symbolic death by losing his loved ones. Burt engages in reminiscence patterns that are composed of identity recollections, life milestones, and painful experiences. These themes were examined in order to understand how an elderly person with addiction prepares for his own death. Research limitations, recommendations, and implications in clinical practice and human development research are also discussed.

The effectiveness of 8A model death education on the reduction of death depression: A preliminary study

Aim

Death education using the 8A model can reduce death distress and promote mental health. The aim of the present study was to investigate the effectiveness of the 8A model death education programme for reducing death depression among nurses. The hypothesis was that participating in the 8A model death education programme would reduce death depression.

Design

A pre-test-post-test intervention.

Methods

Ten nurses were selected randomly from the intensive care units and critical care units wards of the Khatom-Al-Anbia General Hospital in Tehran, Iran. They completed the Death Depression Scale before and after intervention. The 8A model was conducted in six workshops weekly, each of 6 hr, for a total of 36 hr.

Results

There was a significant difference between pre-test and post-test on the Death Depression Scale scores.

Discussion

The 8A model appears to be useful for the reduction of death depression and the promotion of mental health in the sample. However, the model should be tested on larger samples and with a control group before concluding that the model is effective in reducing death distress.

Effectiveness of an experiential workshop for enhancing helping professionals' self-competence in death work in Hong Kong: a randomised controlled trial

Helping professionals require self-competence in coping with the existential and emotional challenges of death work. Previous training often focused on knowledge and skills rather than on this competence. This study aimed to examine the effectiveness of a 3-day workshop in Hong Kong to enhance helping professionals' self-competence in death work. A randomised controlled trial was conducted to examine the effects of the training between January and May 2014. Targeted participants were helping professionals who had been doing death work for at least 6 months. The 112 participants were openly recruited from hospitals and NGOs and were assigned to an intervention group or a waitlist control group. Data were collected at pre-intervention and post-intervention. Primary outcome was self-competence in death work. All participants were grouped for analysing the changes in outcomes at pre-intervention, post-intervention and 3-month follow-up. Participants in the intervention group experienced a significant increase in the total score of the Self-competence in Death Work Scale (SC-DWS) and in scores of the Existential and Emotional subscales of SC-DWS. The positive effects of training on self-competence in death work were maintained at the 3-month follow-up. This study provides evidence of the effectiveness of training in enhancing helping professionals' self-competence in death work. Further research is required to examine the long-term effects of training.

DEATH CONCERN AND DEATH OBSESSION IN IRANIAN NURSES

The goal of the present study was to examine whether nurses had increased death concern and death obsession compared to non-nursing staff. A Death Concern Scale and a Death Obsession Scale, translated into Persian, were administered to 56 female Iranian nurses (55% in their 30s) and compared to 56 female hospital staff members (45% in their 30s). The two groups did not differ significantly in their scores on either scale. It is, therefore, recommended that death education programs in hospitals be given to all staff, nursing and non-nursing.

Beyond knowledge and skills: self-competence in working with death, dying, and bereavement

This study explored helping professionals' views on death work competencies. A total of 176 helping professionals were invited to state what the necessary competencies in death work are. Content analysis was conducted. Results showed that death work competencies can be categorized into 4 major areas: (a) knowledge competence, (b) practice competence, (c) self-competence, and (d) work-environment competence. Self-competence was the most frequently mentioned by the participants. Self-competence was further categorized into 3 themes: (a) personal resources, (b) existential coping, and (c) emotional coping. Findings reflect helping professionals' emphasis on the role of self and personal preparation in doing death work. Implications on future death education and training for helping professionals were discussed.