New Graduate Nurses’ Approaches to Death and Dying Patients and the Relationship Between Death Anxiety and Death Awareness: A Cross-Sectional Study

Abstract

Background

One of the challenges experienced by new graduate nurses during the transition into practice is caring for dying patients. This study aimed to determine new graduate nurses’ approaches to death and dying patients and the relationship between death anxiety and death awareness.

Methods

This descriptive, cross-sectional study was conducted with 226 new graduate nurses in Istanbul, Türkiye. A personal and work environment characteristics form, the Approach to Death and Dying Patients Attitude Scale, Templer’s Death Anxiety Scale, and Multidimensional Mortality Awareness Measure were used to collect data.

Results

Hardness in communicating with the dying patients (hardness: meaning difficulty) and their relatives and avoiding death and dying patients were considered moderate, with mean scores of 2.64 ± .63 and 2.45 ± .40, out of 4. Death anxiety accounted for approximately 7% of the variance of hardness in communicating with dying patients and their relatives, which is statistically significant. Death awareness statistically significantly explained 9.7% of avoiding death and dying patients.

Conclusion

For new graduate nurses, besides simulation-based training on end-of-life care, approaches to sharing their experiences about death and programs to determine a value system related to death may be recommended.

Keywords

attitudes to death death death anxiety dying nurses nursing administration research terminal care

Get full access to this article

View all access options for this article.

References

The Ministry of Health of Türkiye . Health statistics yearbook. 2020. https://dosyasb.saglik.gov.tr/Eklenti/43400,siy2020-eng-26052022pdf.pdf?0. Accessed July 5, 2023.

Turkish Statistical Institute . Death and death causes statistics. 2020. https://data.tuik.gov.tr/. Accessed March 10, 2024.

Croxon

Deravin

Anderson

. Dealing with end of life newly graduated nurse experiences. J Clin Nurs. 2018;27(1-2):337-344. doi:10.1111/jocn.13907.

Şahin

Demirkıran

Adana

. Nursing students’ death anxiety, influencing factors and request of caring for dying people. Journal of Psychiatric Nursing. 2016;7(3):135-141. doi:10.5505/phd.2016.66588.

Norouzi

Ghorbani Vajargah

Falakdami

, et al. A systematic review of death anxiety and related factors among nurses. OMEGA (Westport). 2022;2:302228221095710. doi:10.1177/00302228221095710.

Kızıltepe

Kurtgöz

. Investigation of studies in Turkey on nurses’ perceptions, attitudes, and anxieties regarding death. Journal of Higher Education and Science. 2022;12(1):244-253. doi:10.5961/higheredusci.1014418.

Levasseur

McDermott

Lafreniere

. The multidimensional mortality awareness measure and model: development and validation of a new self-report questionnaire and psychological framework. OMEGA (Westport). 2015;70(3):317-341. doi:10.1177/0030222815569440.

Lee

. Awareness of good death and attitudes toward terminal care among geriatric hospital nurses. Korean Journal of Hospice and Palliative Care. 2014;17(3):122-133. doi:10.14475/kjhpc.2014.17.3.122.

Jung

Kim

. Influence of positive psychological capital and death awareness on terminal care performance of hematooncology unit nurses. Korean Journal of Hospice and Palliative Care. 2019;22(2):76-88. doi:10.14475/kjhpc.2019.22.2.77.

10.

Göktaş

Determining the Relationship between the Death Awareness Levels of the Nurses Working in Risky Units and Their Attitudes to the Terminally Patient. (Publication No. 684672) Çankırı

Karatekin University Institute of Health Sciences; 2021. Master Thesis in Nursing, Türkiye. https://tez.yok.gov..tr/UlusalTezMerkezi (Accessed by July 5, 2023).

11.

Zheng

Lee

Bloomer

. How nurses cope with patient death: a systematic review and qualitative meta-synthesis. J Clin Nurs. 2018;27(1-2):e39-e49. doi:10.1111/jocn.13975.

12.

Alnuqaidan

Alhajraf

Mathew

Ahmad

. Transitional shock of multi-nationality newly graduated nurses in Kuwait. SAGE Open Nurs. 2021;7:2377960821998530. doi:10.1177/2377960821998530.

13.

Kim

Shin

. Exploring barriers and facilitators for successful transition in new graduate nurses: a mixed methods study. J Prof Nurs. 2020;36(6):560-568. doi:10.1016/j.profnurs.2020.08.006.

14.

Qiao

. Stress, coping and psychological well-being among new graduate nurses in China. Home Health Care Manag Pract. 2011;23(6):398-403. doi:10.1177/108482231140582.

15.

Labrague

McEnroe-Petitte

. Job stress in new nurses during the transition period: an integrative review. Int Nurs Rev. 2018;65(4):491-504. doi:10.1111/inr.12425.

16.

Anderson

Kent

Owens

. Experiencing patient death in clinical practice: nurses' recollections of their earliest memorable patient death. Int J Nurs Stud. 2015;52(3):695-704. doi:10.1016/j.ijnurstu.2014.12.005.

17.

Kent

Anderson

Owens

. Nurses' early experiences with patient death: the results of an on-line survey of registered nurses in New Zealand. Int J Nurs Stud. 2012;49(10):1255-1265. doi:10.1016/j.ijnurstu.2012.04.005

18.

Thompson

Austin

Profetto-McGrath

. Novice nurses' first death in critical care. Dynamics. 2010;21(4):26-36.

19.

Öcalan

Kovancı

Uslu-Sahan

Özdemir

. First death experiences of newly graduated nurses: a qualitative phenomenological study. Death Stud. 2023;9:1-9. doi:10.1080/07481187.2023.2219648.

20.

Zheng

Lee

Bloomer

. How new graduate nurses experience patient death: a systematic review and qualitative meta-synthesis. Int J Nurs Stud. 2016;53:320-330. doi:10.1016/j.ijnurstu.2015.09.013.

21.

Malone

Anderson

Croxon

. Are newly graduated nurses ready to deal with death and dying? A literature review. Nursing and Palliative Care. 2016;1(4):89-93. doi:10.15761/NPC.1000123.

22.

Laschinger

Cummings

Leiter

, et al. Starting out: a time-lagged study of new graduate nurses' transition to practice. Int J Nurs Stud. 2016;57:82-95. doi:10.1016/j.ijnurstu.2016.01.005.

23.

Zheng

Bloomer

Guo

Lee

. New graduate nurses’ coping with death the relationship with death-self efficacy and death anxiety: a multicentre cross-sectional study. J Adv Nurs. 2021;77(2):795-804. doi:10.1111/jan.14621.

24.

Kudubeş

Özkan

Semerci

. Status of palliative care course in undergraduate and postgraduate nursing programs: practice of Turkey. Journal of Pediatric Emergency and Intensive Care Medicine. 2022;9:17-26. doi:10.4274/cayd.galenos.2021.00922.

25.

Uysal

Ceylan

Koç

. Nursing students’ attitudes on care of dying individuals. Gumushane University Journal of Health Sciences. 2019;8(1):98-105.

26.

Kavas

Öztuna

. Thanatophobia in medical students: approach to death and dying patients attitude scale (ADDPAS) for undergraduate years in medicine. J Cancer Educ. 2011;26(4):774-781. doi:10.1007/s13187-011-0197-z.

27.

Templer

. The construction and validation of a death anxiety scale. J Gen Psychol. 1970;82(2):165-177. doi:10.1080/00221309.1970.9920634.

28.

Akça

Köse

İA

. Adaptation of death anxiety scale (DAS): validity and reliability studies. J Clin Psychiatry. 2008;11:7-16.

29.

Bulut

McDermott

McEwan

. Adapting the multidimensional mortality awareness measure: a study of validity and reliability. J Int Soc Res. 2017;10(49):268-275.

30.

Üstükuş

Eskimez

. The effect of death anxiety in nurses on their approach to dying patients: a cross-sectional study. Psychiatr Care. 2021;57(4):1929-1936. doi:10.1111/ppc.12768.

31.

Yildirim

Işık

Yalcin

. Relationship between physician’s and nurses’ attitudes towards futile treatment and their approach to death and terminally ill patients. OMEGA (Westport) 2023;Jan 23:302228231153712. doi:10.1177/00302228231153712

32.

Cybulska

Żołnowska

Schneider-Matyka

, et al. Analysis of nurses' attitudes toward patient death. Int J Environ Res Publ Health. 2022;19(20):13119. doi:10.3390/ijerph192013119.

33.

Özçelik

Aksoy

Sönmez

Fadıloğlu

. Attitudes to death of nurses in Turkey and factors affecting them. Hospice and Palliative Medicine International Journal. 2018;2(6):303-309. doi:10.15406/hpmij.2018.02.00112.

34.

Park

Lee

Won

Lim

Son

. Hospital nurses' perception of death and self-reported performance of end-of-life care: mediating role of attitude towards end-of-life care. Healthcare. 2020;8(2):142. doi:10.3390/healthcare8020142.

35.

Duran

Polat

. Nurses’ attitudes towards death and its relationship with anxiety levels. OMEGA (Westport) 2022;88(44):1530-1544. doi:10.1177/00302228211065963