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Chen C, Li W. Changes Due to Patient Deaths: Medical Students' Expectations vs. Health Professionals' Experiences. J Pain Symptom Manage 2024:S0885-3924(24)00831-5. [PMID: 38906424 DOI: 10.1016/j.jpainsymman.2024.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 06/10/2024] [Accepted: 06/14/2024] [Indexed: 06/23/2024]
Abstract
CONTEXT Preparing healthcare professionals for inevitable encounters with patient deaths is crucial to preventing maladaptive professional bereavement outcomes. OBJECTIVES This study aimed to explore the discrepancies between medical students' pre-patient death expectations and healthcare professionals' post-patient death experiences regarding accumulated global changes due to patient deaths (AGC), identify heterogeneous expectation patterns among students, and reveal risk factors for worthy-of-concern expectation patterns. METHODS Cross-sectional survey data from 231 professional caregivers and 405 medical and nursing students were used. Independent t tests and analyses of covariance were run for staff-student AGC comparisons. Latent profile analysis (LPA) among students was followed by logistic regression. RESULTS The students scored higher than did the staff in two AGC factors: more acceptance of limitations and more death-related anxiety. LPA identified four latent expectation patterns, with the "overoptimistic" (27.8%) group being worthy of concern, as students overestimated positive changes and underestimated negative changes. The overoptimistic pattern was predicted by students' motivations to study medicine, which were driven by "interests," "career opportunities," and "improving medical services in the hometown," rather than "by chance," and higher scores on the death attitude of "neutral acceptance." CONCLUSION In general, students tend to overestimate the long-term impacts of patient deaths. However, approximately 1/4 of students hold overly optimistic expectations, which are predicted by motivations to study medicine and death attitudes.
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Affiliation(s)
- Chuqian Chen
- Department of Medical Humanities (C.C.), School of Humanities, Southeast University, Nanjing, China..
| | - Weiying Li
- School of Nursing (W.L.), Nanjing Medical University, Nanjing, China
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Molefe L. R425 first year student nurses 'experience of encounters with death of a patient during clinical placement. BMC Nurs 2024; 23:246. [PMID: 38627725 PMCID: PMC11020469 DOI: 10.1186/s12912-024-01922-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 04/07/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND In the course of caring, nurses often experience the death of patients, and this experience has an effect on the nurse. Every nurse responds to this experience in a different way, and it can be either a negative emotional response, or a positive emotional response. As part of their curriculum, R425 first-year student nurses are placed in clinical facilities to acquire competency in nursing skills, and here they may be exposed to patients dying. R425 is a South African Nursing Council regulation relating to the approval of and the minimum requirements for the education and training of a nurse (General, Psychiatric, and Community) and Midwife, leading to registration. End-of-life care can be rewarding, yet emotionally and psychologically challenging. Little is known about R425 first-year student nurses' experiences of patients dying while being cared for by nurses on clinical placement. The study, therefore, explored and describes R425 first-year student nurses' experiences of the death of a patient during clinical placement. METHOD A qualitative exploratory descriptive and contextual research design was adopted, and a purposive, nonprobability sampling approach applied. Data were collected through unstructured individual interviews with 15 R425 first-year student nurses. Data were analysed using content analysis. RESULTS Four themes emerged, namely, knowledge, psychological trauma, low self-esteem, and nutritional disorders, and subthemes were identified. Results reveal both negative and positive responses to encountering the death of patients, with more negative responses, and fewer positive responses. CONCLUSION Results show that first-year student nurses struggle to cope with the death of a patient, mainly because they lack knowledge and the skills required to provide end-of-life nursing. It is the requirement for student nurses to be competent in a skill, 'last office', which involves laying out of a dead person. Such skill can be deferred in the first year of study, and can only be introduced at a later stage, either in third year or fourth year of study, when students are better equipped with knowledge and skills relating to dealing with death. There is a need to review the curriculum of R425 first-year student nurses, so that outcomes such as death and dying can be introduced in the third or fourth year of study.
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Affiliation(s)
- Lebogang Molefe
- Sefako Makgatho Health Sciences University, Garankuwa, Pretoria, South Africa.
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Çekiç Y, Çalişkan BB, Küçük Öztürk G, Kaya Meral D, Bağ B. "It was the first time someone had died before my eyes…": A qualitative study on the first death experiences of nursing students. NURSE EDUCATION TODAY 2024; 133:106075. [PMID: 38134812 DOI: 10.1016/j.nedt.2023.106075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 12/05/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023]
Abstract
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.
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Affiliation(s)
- Yasemin Çekiç
- Ankara University, Faculty of Nursing, Department of Psychiatric Nursing, Ankara, Turkey.
| | - Behice Belkıs Çalişkan
- İstanbul Beykent University, Faculty of Health Sciences, Department of Nursing, İstanbul, Turkey
| | - Gülhan Küçük Öztürk
- Nevşehir Hacı Bektaş Veli University, Semra and Vefa Küçük Faculty of Health Sciences, Department of Psychiatric Nursing, Nevşehir, Turkey
| | - Deniz Kaya Meral
- Istanbul Gelisim University, Faculty of Health Sciences, Department of Nursing, Istanbul, Turkey
| | - Beyhan Bağ
- Ludwigshafen University of Business and Society, Mannheim, Germany
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Stelcer B, Bendowska A, Karkowska D, Baum E. Supporting elderly patients in strengthening their personal and spiritual health resources. Front Psychol 2023; 14:1237138. [PMID: 38023038 PMCID: PMC10667473 DOI: 10.3389/fpsyg.2023.1237138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Care for the sick, including spiritual support is sometimes called holistic medicine. The term bio-psycho-social-spiritual model is sometimes used to describe this type of therapeutic approach patient-oriented medicine. This report indicates the importance of taking into account the spiritual aspect of life due to its beneficial impact on the coping resources activated and the patient's well-being. Existential and spiritual issues are on the verge of new clinical and research interest in medicine, especially in gerontology, oncology, and palliative care. Clinicians focus not only on symptom control but also on spiritual and existential issues such as spirituality, hope, and meaning. This paper reviews the topic of spirituality in the context of illness and end-of-life care trying to define spirituality within the context of health resources of the subject. Spirituality is perceived in two of its main components: faith/religious beliefs and spiritual well-being. Especially this second construct is reviewed and described as a health resource.
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Affiliation(s)
- Bogusław Stelcer
- Department of Human Nutrition and Dietetics, Faculty of Food Science and Nutrition, Poznan University of Life Sciences, Poznań, Poland
- Department of Clinical Psychology, Poznan University of Medical Sciences, Poznań, Poland
| | - Aleksandra Bendowska
- Department of Social Sciences and the Humanities, Poznan University of Medical Sciences, Poznań, Poland
| | - Dorota Karkowska
- Institute of Nursing and Midwifery, Collegium Medicum, Jagiellonian University in Krakow, Kraków, Poland
| | - Ewa Baum
- Department of Social Sciences and the Humanities, Poznan University of Medical Sciences, Poznań, Poland
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Kurtgöz A, Koç Z. Nursing Students' Spiritual/Religious Coping Strategies Dealing With First Experience of Witnessing Death During Clinical Practices. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231174803. [PMID: 37116220 DOI: 10.1177/00302228231174803] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
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.
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Affiliation(s)
- Aslı Kurtgöz
- Sabuncuoglu Serefeddin Health Services Vocational School, Amasya University, Amasya, Turkey
| | - Zeliha Koç
- Health Science Faculty, Ondokuz Mayıs University, Samsun, Turkey
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Conley CE. Student nurses' end-of-life and post mortem care self-efficacy: A descriptive study. NURSE EDUCATION TODAY 2023; 121:105698. [PMID: 36549255 DOI: 10.1016/j.nedt.2022.105698] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 12/02/2022] [Accepted: 12/10/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Student nurses providing end-of-life care reported that caring for a person dying created anxiety, fear, and increased stress and reflected low self-efficacy. New nurses felt unprepared academically and emotionally. High self-efficacy is necessary to handle adverse emotional reactions. However, the literature lacks an instrument to evaluate nursing students' self-efficacy in caring for someone who is dying. OBJECTIVE The study aims to investigate the reliability and validity of the "End-of-Life and Postmortem Self-Efficacy Scale" and explore nursing students' self-efficacy associated with the nursing duties and responsibilities of caring for individuals during the active phase of dying and immediately after death. DESIGN The study was a quantitative descriptive, cross-sectional design. PARTICIPANTS National Student Nurses' Association members enrolled in undergraduate registered nurse associate's, bachelor's degree programs, or a nursing diploma program. METHOD National Student Nurses' Association members responded to an electronic survey containing 18 items related to end-of-life and post mortem nursing responsibilities. RESULTS A total of 498 responses were analyzed. Cronbach's alpha (α = 0.938) showed high reliability of the 18 items on the instrument. The Kaiser-Meyer-Olkin was 0.925 and indicated sampling adequacy. Bartlett's test of sphericity was highly significant (p = .001). The nursing students' mean end-of-life and post mortem self-efficacy score was 62 (scale of 0-100). CONCLUSION The "End-of-Life and Postmortem Self-Efficacy Scale" showed high reliability in evaluating the latent concept of end-of-life and post mortem self-efficacy. The low mean self-efficacy score indicated that nursing students might be underprepared to provide EOL and post mortem care as new graduates. Faculty can use the "End-of-Life and Postmortem Self-Efficacy Scale" to assess student readiness and identify gaps in knowledge in the care of someone who is dying. Future research is needed to determine how increasing nursing students' end-of-life and post mortem self-efficacy influences the perception of end-of-life preparedness.
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Affiliation(s)
- Carol E Conley
- Department of Nursing, Cox College, United States of America.
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Chiou RJ, Tsai PF, Han DY. Exploring the impacts of a coffin-lying experience on life and death attitudes of medical and nursing students: preliminary findings. BMC MEDICAL EDUCATION 2023; 23:6. [PMID: 36604738 PMCID: PMC9815673 DOI: 10.1186/s12909-022-03975-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 12/19/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Physicians and nurses often exhibit strong negative emotional and behavioral reactions when patients they care for die, and death education helps them cope with these difficulties. When implementing death education, the literature shows that experiential activities are more effective than lecturing, and progressive exposure is the best way to reduce death anxieties. This study examined the effects of coffin-lying, an activity sometimes seen in Asian cultures, on life and death attitudes of medical and nursing students. METHODS During a period from 2020 to 2021, 134 medical and nursing students from a medical university in northern Taiwan voluntarily participated in this study. Among them, 53 were in the experimental group, who participated in a coffin-lying activity for nearly 3 hours, and the other 81 were in the control group. All participants filled out questionnaires 1 week before the activity (T1), 1 week after the activity (T2), and 6 ~ 11 weeks after the activity (T3). Three waves of data were analyzed by a repeated-measure multivariate analysis of variance (MANOVA). RESULTS The effects of "love and care" and "feeling of existence" were only manifested at T2, however, the scores of "fear of death" and "death avoidance" between the experimental and control groups significantly differed at T2 and T3. In addition, there were no significant differences between the experimental and control groups in "neutral acceptance", "approach acceptance", or "escape acceptance". CONCLUSIONS The coffin-lying activity based on desensitization was effective in improving "fear of death" and "death avoidance", and the effects were sustained to 6 ~ 11 weeks. Coffin-lying is not only a well-designed activity that quickly reduces negative tendencies toward death, but it is also worth adopting by medical and nursing schools to make death education more comprehensive.
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Affiliation(s)
- Ruei-Jen Chiou
- Department of Anatomy and Cell Biology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Po-Fang Tsai
- Graduate Institute of Humanities in Medicine, College of Humanities and Social Sciences, Taipei Medical University, Taipei, Taiwan
- Department of Education and Humanities in Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Der-Yan Han
- Department of Education and Humanities in Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
- Section of Liberal Arts, Center for General Education, Taipei Medical University, Taipei, Taiwan.
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Zhu P, Shi G, Wu Q, Ji Q, Liu X, Xu H, Wang W, Qian M, Zhang Q. Ethical challenges of death faced by nursing undergraduates in clinical practice: A qualitative study. NURSE EDUCATION TODAY 2022; 118:105516. [PMID: 36054977 DOI: 10.1016/j.nedt.2022.105516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/24/2022] [Accepted: 08/15/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The characteristics of nursing work determine that nursing practice is inseparable from ethical considerations and decision-making. Nursing students have difficulty in dealing with death and it is necessary to explore the ethical challenges faced by nursing undergraduates in the process of clinical practice of nursing dead or dying patients. OBJECTIVE To explore the ethical challenges faced by undergraduate nursing students in nursing of dead or dying patients. DESIGN This study was conducted with a phenomenological approach in a qualitative design. SETTINGS, PARTICIPANTS, METHODS The purposive sample of the study consisted of 35 nursing undergraduates in their last year of education at the bachelor level in nursing who had experience of clinical practice. They voluntarily participated in the study. Data were collected through semi-structured interviews and analyzed using the Colaizzi analysis method. RESULTS Through analysis of interviews, four themes were identified: (1) Distant death is coming-inadequate preparation; (2) Making decisions between the needs of different positions-difficult balance; (3) Experience a patient's death up close-irresistible resistance; (4) Providing bereavement care after a patient's death-insurmountable obstacle. CONCLUSION This study shows that nursing undergraduates face ethical challenges in the process of caring for dead or dying patients and the early identification of these ethical challenges is of great significance. University and hospital leaders should pay attention to the ethic and death education of nursing undergraduates so as to help nursing students prepare for clinical practice.
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Affiliation(s)
- 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.
| | - Guanghui Shi
- School of Nursing, Yangzhou University, 136 Jiangyang Middle Road, Hanjing County, Yangzhou City 225009, Jiangsu Province, China
| | - Qiwei Wu
- School of Nursing, Yangzhou University, 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
| | - Xinyi Liu
- 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
| | - Wen Wang
- 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
| | - Qianqian Zhang
- School of Nursing, Yangzhou University, 136 Jiangyang Middle Road, Hanjing County, Yangzhou City 225009, Jiangsu Province, China
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ÇAKMAK B, İNKAYA B, ALTUNSOY A. Investigation of The Relationship Between Nursing Students' Fear of Death and Their Perceptions of Patient Care. KOCAELI ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2022. [DOI: 10.30934/kusbed.1075019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Amaç: Bu araştırma hemşirelik öğrencilerinin yaşadıkları ölüm korkusu ile hasta bakım algıları arasındaki ilişkinin incelenmesi amacıyla gerçekleştirilmiştir.
Yöntem: Araştırma kesitsel, tanımlayıcı ve ilişki arayıcı tipte olup araştırmanın örneklemini, Ekim-Kasım 2021 tarihleri arasında bir üniversitenin hemşirelik bölümünde öğrenim gören 326 öğrenci oluşturmuştur. Verilerin toplanmasında, ‘Kişisel bilgi formu’, ‘Ölüm korkusu Ölçeği’ ve ‘Bakım Davranışları ölçeği-24’ kullanılmıştır. Veriler yüz yüze toplanmış olup form ve ölçeklerin doldurulması ortalama 15 dakika sürmüştür.
Bulgular: Çalışmaya katılanların çoğunun 280’inin (%85,9) kadın olduğu, 179’unun (%54,9) ölmekte olan hasta bakımı ile ilgili bilgi kaynaklarını okuduğunu, 245 öğrencinin (%75,2) çevresinde ölüm olgusuyla karşılaştığı, 306’sının (%93,9) yaşam sonu dönemde olan hastaya bakım verme deneyiminin olmadığı ve 175’inin (%53,7) ölümden korktuğu belirlenmiştir. Cinsiyete bağlı olarak kadınların hem ölüm korkusunun hem de yaşam sonu hasta bakımı hemşirelik algılarının, BDÖ-24 Ölçeği alt boyutlarından bağlılık ve saygılı olma alanlarında daha yüksek puan aldıkları belirlenmiştir. Yaşam sonu dönemde bir hastaya bakım verme deneyimi olmayan hemşirelik öğrencilerinin, ölüm korkusu ve bakım davranışları arasında anlamlı bir fark olmadığı belirlenmiştir (p>0,05).
Sonuç: Hemşirelik öğrencilerinin hemşirelik bakım algıları yüksektir. Kadın öğrencilerin hem ölüm korkuları hem de hemşirelik bakımı algıları erkeklerden yüksek olarak bulunmuştur. Yaşam sonu dönemde olan hastaya bakım verme deneyimi olmayan hemşirelik öğrencilerinin daha fazla güvence verme algısına sahip oldukları belirlenmiştir. Öğrencilerin yaşam sonu dönemde olan hastaya güvence verme algılarının yüksek olması açık bir şekilde yaşam sonu hemşirelik bakımı konusunda yetersiz bilgiye sahip olduklarını göstermektedir. Bu nedenle lisans eğitimi boyunca yaşam sonu dönem hasta bakımı ve ölüm korkusu konularında müfredatta daha fazla başlığın ve eğitim metodlarının yer almasının gerekli olduğu düşünülmektedir.
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Ozpulat F, Tasdelen Bas M, Molu B. Nursing Students' Compassion and Their Attitudes Toward Death and the Care of the Dying: An Intervention Study ın Turkey. OMEGA-JOURNAL OF DEATH AND DYING 2022; 87:283-298. [PMID: 35167381 DOI: 10.1177/00302228211066982] [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: 11/16/2022]
Abstract
This pretest-posttest quasi-experimental study investigated the effect of an educational intervention on nursing students' compassion levels and their attitudes toward death and the care of the dying. Data were collected using the Death Attitude Profile - Revised (DAP-R), the Frommelt Attitude Toward Care Of The Dying (FATCOD) Scale, and the Compassion Scale (CS). The intervention improved participants' DAP-R scores. Participants had higher posttest FATCOD scores than the pretest scores. However, the difference was statistically insignificant. Participants had high CS scores. There was a slight increase in CS scores after the intervention. The results showed that the intervention improved participants' attitudes toward death and the care of the dying. The results also showed that compassion was an important factor.
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Affiliation(s)
- Funda Ozpulat
- Public Health Nursing, Selcuk University, Konya, Turkey
| | | | - Birsel Molu
- Child Health Nursing, Selcuk University, Konya, Turkey
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