Journal of Hospice and Palliative Care

  • 제26권4호
  • /
  • Pages.160-170
  • /
  • 2023
  • /
  • 2765-3072(pISSN)
  • /
  • 2765-3080(eISSN)
한국호스피스완화의료학회 (Korean Society for Hospice and Palliative Care)
권호 표지
DOI QR코드

DOI QR Code

Effects of Death Anxiety and Perceived End-of-Life Care Competencies on Fear of Terminal Care among Clinical Nurses

  • Heewon Kim (Daegu Veterans Hospital) ;
  • So-Hi Kwon (College of Nursing, Research Institute of Nursing Science, Kyungpook National University)
  • 투고 : 2023.07.18
  • 심사 : 2023.11.14
  • 발행 : 2023.12.01
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: The aim of this study was to examine the effects of death anxiety and perceived end-of-life care competencies on the fear of terminal care among clinical nurses. Methods: This correlational study was conducted from June to July 2021. The study included 149 clinical nurses employed at a tertiary hospital and seven other hospitals. The measurement tools used in this study were the Thanatophobia Scale (Cronbach's α=0.87), the Death Anxiety Scale (Cronbach's α=0.80), and the Scale of End-of-life Care Competencies (Cronbach's α=0.94). These instruments were chosen to assess the levels of fear of terminal care, death-related anxiety, and competencies in end-of-life care. Results: The mean score for fear of terminal care was 3.32±1.32. Differences in fear of terminal care were observed based on the working unit, position, number of patients requiring terminal care, and experience with end-of-life care education. Fear of terminal care was significantly positively correlated with death anxiety and significantly negatively correlated with end-of-life care competencies. In multiple regression analysis, the factors influencing fear of terminal care were attitudes toward end-of-life care competencies (𝛽=-0.39, P<0.001), death anxiety (𝛽=0.24, P<0.001), knowledge of end-of-life care competencies (𝛽=-0.22, P=0.005), and behaviors related to end-of-life care competencies (𝛽=-0.16, P=0.021). These factors explained 64.6% of the total variance (F=25.54, P<0.001). Conclusion: This study suggests that developing nurses' end-of-life care competencies and reducing death anxiety are crucial for managing the fear of terminal care. Therefore, providing end-of-life care education and psychological support programs is important.

키워드

과제정보

We would like to express our special appreciation to nurses who participated in this study. This article is a revision of the first author's master's thesis from Kyungpook National University.

참고문헌

  1. Statistics Korea. Results of birth and death statistics in 2020 [Internet]. Daejeon: Statistics Korea; c2021 [cited 2021 Jun 10]. Available from: https://www.kostat.go.kr.
  2. Kim JA, Kim K, Kang HS, Kim JS. Nursing need and satisfaction of patients in hospice ward. Korean J Hosp Palliat Care 2014;17:248-58. https://doi.org/10.14475/kjhpc.2014.17.4.248
  3. Kim HJ, Ku JI, Byun JH, Kim SM, Choe WS. Nurse's experience of changing role in the hospice unit of medical ward. Korean J Hosp Palliat Care 2008;11:30-41.
  4. Kostka AM, Borodzicz A, Krzeminska SA. Feelings and emotions of nurses related to dying and death of patients - a pilot study. Psychol Res Behav Manag. 2021;14:705-17. https://doi.org/10.2147/PRBM.S311996
  5. Lee MK. Nurses' coping experience on caring for dying patients with cancer [dissertation]. Seoul: Chung-Ang Univ.; 2018. Korean.
  6. American Psychological Association. APA dictionary of psychology [Internet]. Washington, DC: American Psychological Association: c2023 [cited 2023 Jun 10]. Available from: https://dictionary.apa.org/death-anxiety.
  7. Merril J, Lorimor R, Thornby J, Woods A. Caring for terminally ill persons: comparative analysis of attitudes (thanatophobia) of practicing physicians, student nurses, and medical students. Psychol Rep 1998;83:123-8. https://doi.org/10.2466/pr0.1998.83.1.123
  8. Hwang JO, Kim SH. Influence of death perception, attitude toward terminal care, mental health on the terminal care stress of intensive care unit nurses. J Korean Clin Nurs Res 2019;25:323-32.
  9. Wilson O, Avalos G, Dowling M. Knowledge of palliative care and attitudes towards nursing the dying patient. Br J Nurs 2016;25:600-5. https://doi.org/10.12968/bjon.2016.25.11.600
  10. Parola V, Coelho A, Cardoso D, Sandgren A, Apostolo J. Burnout in palliative care settings compared with other settings: a systematic review. J Hosp Palliat Nurs 2017;19:442-51. https://doi.org/10.1097/NJH.0000000000000370
  11. Park HJ, Kang EH. Factors influencing nurses' attitudes toward terminal care. J Korean Crit Care Nurs 2020;13:76-86. https://doi.org/10.34250/jkccn.2020.13.1.76
  12. Braun M, Gordon D, Uziely B. Associations between oncology nurses' attitudes toward death and caring for dying patients. Oncol Nurs Forum 2010;37:E43-E49. https://doi.org/10.1188/10.ONF.E43-E49
  13. Melo CG, Oliver D. Can addressing death anxiety reduce health care workers' burnout and improve patient care? J Palliat Care 2011;27:287-95. https://doi.org/10.1177/082585971102700405
  14. Kwon SH, Cho YS. Current status of end-of-life care education in undergraduate nursing curriculum. Korean J Hosp Palliat Care 2019;22:174-84. https://doi.org/10.14475/kjhpc.2019.22.4.174
  15. Schlairet MC. End-of-life nursing care: statewide survey of nurses' education needs and effects of education. J Prof Nurs 2009;25:170-7. https://doi.org/10.1016/j.profnurs.2008.10.005
  16. Croxon L, Deravin L, Anderson J. Dealing with end of life-New graduated nurse experiences. J Clin Nurs 2018;27:337-44. https://doi.org/10.1111/jocn.13907
  17. Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods 2009;41:1149-60. https://doi.org/10.3758/BRM.41.4.1149
  18. Blood A, Park YS. Critical synthesis package: thanatophobia scale. MedEdPORTAL 2013;9:9629.
  19. Templer DI. The construction and validation of a death anxiety scale. J Gen Psychol 1970;82:165-78. https://doi.org/10.1080/00221309.1970.9920634
  20. Ko HG, Choi JO, Lee HP. The reliability and factor structure of K-Templer death anxiety scale. J Korean Health Psychol 2006;11:315-28.
  21. Rietze LL, Tschanz CL, Richardson HRL. Evaluating an initiative to promote entry-level competence in palliative and end-of-life care for registered nurses in Canada. J Hosp Palliat Nurs 2018;20:568-74. https://doi.org/10.1097/NJH.0000000000000502
  22. Montagnini M, Smith H, Balistrieri T. Assessment of self-perceived end-of-life care competencies of intensive care unit providers. J Palliat Med 2012;15:29-36. https://doi.org/10.1089/jpm.2011.0265
  23. Lee HJ. Critical care nurses' perceived and of life care competencies and supportive behaviors and barriers [dissertation]. Seoul: Seoul National Univ.; 2015. Korean.
  24. O'Shea ER, Mager D. End-of-life nursing education: Enhancing nurse knowledge and attitudes. Appl Nurs Res 2019;50:151197.
  25. Lee JW, Kim JW, Kim TS, Kim CM. Communication about death and confidence levels concerning death-related issues among Koreans. Korean J Fam Pract 2019;9:303-10. https://doi.org/10.21215/kjfp.2019.9.3.303
  26. Shim SH. A study on the historical development and theoretical perspective on American death education. J Korean Educ Idea 2021;35:21-52.
  27. Ramjan JM, Costa CM, Hickman LD, Kearns M, Phillips JL. Integrating palliative care content into a new undergraduate nursing curriculum: The University of Notre Dame, Australia-Sydney experience. Collegian 2010;17:85-91. https://doi.org/10.1016/j.colegn.2010.04.009
  28. Ferrell B, Malloy P, Virani R. The end of life nursing education nursing consortium project. Ann Palliat Med 2015;4:61-9.
  29. Lautrette A, Darmon M, Megarbane B, Joly LM, Chevret S, Adrie C, et al. A communication strategy and brochure for relatives of patients dying in the ICU. N Engl J Med 2007;356:469-78. https://doi.org/10.1056/NEJMoa063446
  30. Kim DH, Lee LJ. Long-term care hospital nurse's experience in coping with end-of-life care nursing. The Jour of KoCon a 2021;21:710-21.