Hospital Nurses’ Perception of Death and Self-Reported Performance of End-of-Life Care: Mediating Role of Attitude towards End-of-Life Care

Abstract

Few studies have explored how nurses in acute care hospitals perceive and perform end-of-life care in Korea. Therefore, this study aimed to evaluate the influence of nurses’ perceptions of death on end-of-life care performance and analyze the mediating role of attitude towards end-of-life care among hospital nurses. This cross-sectional study included a total of 250 nurses who have had experience with end-of-life care from four general hospitals in Korea. We used the Korean validated tools with the View of Life and Death Scale, the Frommelt Attitudes Toward Care of the Dying (FATCOD) scale, and the performance of end-of-life care. Hierarchical linear regression and mediation analysis, applying the bootstrapping method. The results of hierarchical linear regression showed that nurses’ positive perceptions of death and attitude towards end-of-life care were significantly associated with their performance of end-of-life care. A mediation analysis further revealed that nurses’ attitude towards end-of-life care mediates the relationship between the perceptions of death and performance of end-of-life care. Our findings suggest that supportive and practical death educational programs should be designed, based on nurses’ professional experience and work environment, which will enable them to provide better end-of-life care.

Factors Associated with Behaviors Toward End-of-life Care Among Chinese Oncology Nurses: A Cross-Sectional Study

“…Some studies found the frequency of EOL care supportive behaviors was the factor affecting EOL care competency [37,38]. This is mainly because if a nurse has more EOL patient experience, the more positive their nursing attitude will be, and they are more willing to talk about EOL care problems and death [3,39]. Weigel and colleagues [40] proposed that this phenomenon occurs because nurses' various care skills, especially communication skills, develop as the number of patients increases.…”

“…Indeed, we found that EOL care courses played an important role in affecting behavior toward EOL care. Offering these courses can help directly either by improving nurses' attitudes or enhancing direct patient care skills [39,46]. Systematic EOL care training generally includes death education, psychological and spiritual care, and communication skills [47].…”

A genealogy of what nurses know about ‘the good death’: A socio‐materialist perspective

“…Nurses' recognition of, and response to, ‘sovereign expressions of life’ and ‘the ethical demand’ (Rushton & Edvardsson, 2018), manifested wherever misalignments occurred regarding the decisions taken during end‐of‐life care, and were a significant source of moral and emotional distress among nurses during end‐of‐life care and in the event of a death (Hinderer, 2012; McCourt et al, 2013; Park, Lee, et al, 2020; Park, Yun‐Mi, et al, 2020; Ranse et al, 2012; Zheng et al, 2018). Misalignments occurred most often when a person transitioned from curative to palliative care or from palliative to end‐of‐life care.…”

“…Adequate preparation increased newer nurses' resilience by providing opportunities for them to express and work through their ‘fear of death’ or ‘death anxiety’. ‘On the job’ experience exposed new nurses to healthy coping behaviours modelled by more experienced nurses while at the same time, provided coaching opportunities that enabled them to become proficient in the relevant practical skills and assume the ‘correct’ comportment in the advent of a death (Croxon et al, 2018; Ek et al, 2014; Kisorio & Langley, 2016; McCourt et al, 2013; Park, Yun‐Mi, et al, 2020; Zomorodi & Lynn, 2010).…”

COVID-19 Contagion and Death Anxiety of Nurses Working in Pandemic Clinics

“…The perception of death is also formed as a result of individuals' personal experiences and develops depending on what they have seen concerning death, the age period they are in, and their religious and cultural values. Hence, everyone's perception of death is unique (3,4).…”