Factors associated with death literacy among Swedish adults: A cross-sectional exploratory study

Abstract

Objectives Death literacy is a recent conceptualization representing both individual and community competence, for example, a set of knowledge and skills for engaging in end-of-life-related situations. Little is yet known about which factors are associated with death literacy. A cross-sectional survey using the Swedish version of the Death Literacy Index, the DLI-S, was therefore conducted to explore associations between death literacy and sociodemographic, health, and experience variables. Methods A quota sample of 503 adults (mean age 49.95 ± 17.92), recruited from an online Swedish survey panel, completed a survey comprising the DLI-S and background questions. Results A hierarchical regression model with 3 blocks explained 40.5% of the variance in death literacy, F(22, 477) = 14.75. The sociodemographic factors age, gender, education, widowhood, and religious/spiritual belief accounted for 13.7% of the variance. Adding professional care factors contributed to an additional 15.8% of variance, with working in health care being significantly associated with death literacy. Including experiential factors explained another 11.0% of the variance, of which experiences of caring for and supporting dying and grieving people, both in a work, volunteer, or personal context, were positively associated with death literacy. Significance of results This study contributes a tentative explanatory model of the influence of different factors on death literacy, outlining both direct and indirect associations. Our findings also support the hypothesized experiential basis for death literacy development in the Swedish context. The moderate degree of overall variance explained suggests there may be additional factors to consider to better understand the death literacy construct and how its development may be supported.

Place of care and death preferences among recently bereaved family members: a cross-sectional survey

“…Furthermore, death literacy-the knowledge and understanding of end-of-life and death care options-has previously been shown to be positively influenced by being widowed and lived experiences of end-of-life care and death, both informal and formal through professional or volunteer work. 35 The bereaved family members' Original research preferences for place of care at the end of life, place of death and what is most important in end-of-life care are most likely influenced by their increased death literacy through their experiences as family members of a severely ill and dying person.…”

What we learnt from parents’ death experience: A cross-sectional study of death literacy and parent’s death quality among adult children in China

“…Scores were calculated by summing items and scaling by the number of items in a subscale (with a range of scores between 0 and 10). The DLI was tested and validated in Australia, the United Kingdom, Turkey, and Sweden (Abacigil et al 2019;Graham-Wisener et al 2022;Johansson 2022;Johansson et al 2023). The authorizations to use the GDI and the DLI in this study were obtained from the authors.…”

“…The findings in our study also highlighted that closeness with parents is positively correlated to an individual's level of death literacy. Research has shown that families with strong parent-child relationships tend to have higher levels of death literacy among adult children after experiencing the death of their parents (Johansson et al 2023), implying that experiencing the death of parents could be a learning process, particularly for those with close relationship with parents, in which one could develop a better understanding and acceptance of death through open communication and emotional support among family members. It can be seen that the inclusion of family support plays an essential role in achieving a good death.…”