Death attitudes and associated factors among health professional students in China

Background China is entering an era of aging population with an increased mortality rate among this category of population. Health professional students' attitudes toward death directly affect their quality of palliative care in their future careers. It is thus important to understand their death attitudes and associated factors to guide future educational and training development. Objectives This study aimed to investigate death attitudes and analyze the associated factors among health professional students in China. Methods In this cross-sectional study, 1,044 health professional students were recruited from 14 medical colleges and universities. The Chinese version of the Death Attitude Profile-Revised (DAP-R) was used to evaluate their death attitudes. A multiple linear regression model was used to analyze the influencing factors of attitudes toward death. Results Health professional students tended to accept death more neutrally. Multivariate analysis showed that their negative death attitudes were associated with age (β = −0.31, p < 0.001) and religious belief (β = 2.76, p = 0.015), while positive death attitudes were associated with age (β = −0.42, p < 0.001), hearing of Advance Care Plan (ACP) (β = 2.21, p = 0.001), and attending funeral/memorial services (β = 2.69, p = 0.016). Conclusion Our study stresses the importance of including death and palliative care education in healthcare courses among health professional students in China. Incorporation of ACP education along with experiences of funeral/memorial services may help promote health professional students' positive attitudes toward death and improve the quality of palliative care in their future careers.

[1]  Fei Liu,et al.  The impact of death attitudes on death education needs among medical and nursing students. , 2023, Nurse education today.

[2]  S. Polat,et al.  Nurses' Attitudes Towards Death and Its Relationship With Anxiety Levels. , 2022, Omega.

[3]  Siqi Liu,et al.  Knowledge, attitude and practice of advance care planning among nursing interns: A mixed-methods approach. , 2021, Nurse education in practice.

[4]  B. Husebø,et al.  Managing Pain and Psychosis Symptoms in Nursing Home Patients: Results From a Cluster-Randomized Controlled Trial (COSMOS). , 2021, Journal of the American Medical Directors Association.

[5]  A. Pandya,et al.  Death Anxiety, Religiosity and Culture: Implications for Therapeutic Process and Future Research , 2021, Religions.

[6]  Wei Zhang,et al.  Undergraduate nursing students’ knowledge, attitudes and self‐efficacy regarding palliative care in China: A descriptive correlational study , 2020, Nursing open.

[7]  A. Sanagoo,et al.  The Relationship Between Death and Do Not Resuscitation Attitudes Among Intensive Care Nurses , 2020, Omega.

[8]  J. Jong Death anxiety and religion. , 2020, Current opinion in psychology.

[9]  Jie Shen Introduction of social media to aid active-learning in medical teaching , 2020, Interact. Learn. Environ..

[10]  So Jeong Lee,et al.  Systematic Review on the Influencing Factors of Nurses' and Nursing Students' Attitudes Toward Hospice and Palliative Care. , 2020, Journal of hospice and palliative nursing : JHPN : the official journal of the Hospice and Palliative Nurses Association.

[11]  Yan Wang Nursing students’ experiences of caring for dying patients and their families: a systematic review and meta-synthesis , 2019, Frontiers of Nursing.

[12]  Huihan Zhao,et al.  Attitudes and knowledge of undergraduate nursing students about palliative care: An analysis of influencing factors. , 2019, Nurse education today.

[13]  J. Donne,et al.  Teaching Palliative Care to Health Professional Students: A Systematic Review and Meta-Analysis of Randomized Controlled Trials , 2019, The American journal of hospice & palliative care.

[14]  E. Patiraki,et al.  Undergraduate nursing students' knowledge about palliative care and attitudes towards end-of-life care: A three-cohort, cross-sectional survey. , 2019, Nurse education today.

[15]  E. Sampson,et al.  Advance Care Planning in Nursing Homes – Improving the Communication Among Patient, Family, and Staff: Results From a Cluster Randomized Controlled Trial (COSMOS) , 2018, Front. Psychol..

[16]  E. Karadağ,et al.  Attitudes of Nurses in Turkey Toward Care of Dying Individual and the Associated Religious and Cultural Factors , 2018, Journal of Religion and Health.

[17]  Liping Wang,et al.  Clinical nurses' attitudes towards death and caring for dying patients in China. , 2018, International journal of palliative nursing.

[18]  Mariana Cristina Cunha Souza,et al.  AVALIAÇÃO DO PERFIL DE ATITUDES ACERCA DA MORTE: ESTUDO COM GRADUANDOS DA ÁREA DE SAÚDE , 2017 .

[19]  J. V. van Delden,et al.  Definition and recommendations for advance care planning: an international consensus supported by the European Association for Palliative Care. , 2017, The Lancet. Oncology.

[20]  R. Neimeyer Death Anxiety Handbook: Research, Instrumentation, And Application , 2015 .

[21]  S. Payne,et al.  How Death Anxiety Impacts Nurses’ Caring for Patients at the End of Life: A Review of Literature , 2013, The open nursing journal.

[22]  L. J. White,et al.  Death Anxiety in a National Sample of United States Funeral Directors and its Relationship with Death Exposure, Age, and Sex , 2009, Omega.

[23]  M. Vansteenkiste,et al.  The Role Of Religion in Death Attitudes: Distinguishing Between Religious Belief and Style of Processing Religious Contents , 2008, Death studies.

[24]  Xiaowei Ma,et al.  A Comparative Study of Chinese and English Taboos , 2020 .

[25]  D. Guilhem,et al.  EVALUATION OF THE DEATH ATTITUDE PROFILE-REVISED: A STUDY WITH HEALTH SCIENCE UNDERGRADUATE STUDENTS1 , 2017 .

[26]  I. Harris,et al.  A Systematic Review and Meta-Analysis of Randomized Controlled Trials , 2010 .

[27]  Paul T. P. Wong,et al.  Death Attitude Profile—Revised: A multidimensional measure of attitudes toward death. , 1994 .

[28]  D. Wulff Psychology of Religion: Classic and Contemporary Views , 1991 .