Exploring the needs and barriers for death education in China: Getting answers from heart transplant recipients' inner experience of death

Background Promoting reflection about death may support better living, and how to carry out death education is an important issue to be addressed across the world. The purpose of the current study was to explore the attitude of heart transplant recipients toward death and their inner real experience to provide information for the development of death education strategies. Methods A phenomenological qualitative study was conducted using a snowball method. A total of 11 patients who had undergone heart transplantation more than 1-year ago were recruited for the current study for semi-structured interviews. Results A total of five themes were identified: “Not avoid talking about death,” “Feeling fear about the pain in the process of death”, “Wanting a good death at the end of life,” “The richness of feelings during near-death is surprising,” and “Being close to death makes people more receptive to death.” Conclusion Heart transplant recipients have a positive attitude toward death and wish for “good death” at the end of life. These patients' near-death experiences and positive attitudes toward death during the course of their illness provided evidence of the need for death education in China and supported the experiential approach to death education.

[1]  Xiaojun Liu,et al.  Fiscal autonomy of subnational governments and equity in healthcare resource allocation: Evidence from China , 2022, Frontiers in Public Health.

[2]  G. Juckel,et al.  Death Anxiety and Attitudes towards Death in Patients with Multiple Sclerosis: An Exploratory Study , 2021, Brain sciences.

[3]  O. Gosseries,et al.  Losing the Self in Near-Death Experiences: The Experience of Ego-Dissolution , 2021, Brain sciences.

[4]  I. Chi,et al.  Engaging Chinese older adults in death education and advance planning: clinical practice implications , 2021, Journal of Ethnic & Cultural Diversity in Social Work.

[5]  Nazaret Martínez-Heredia,et al.  Health Education as a Means of Addressing Death in the Elderly , 2021, International journal of environmental research and public health.

[6]  A. Y. Arredondo,et al.  Traumatic experiences and resilience: Associations with mental health, death attitudes, and religion in university students , 2021, Death studies.

[7]  Oreofe O. Odejide,et al.  Goal of a “Good Death” in End-of-Life Care for Patients with Hematologic Malignancies—Are We Close? , 2021, Current Hematologic Malignancy Reports.

[8]  Kipton D. Smilie.  Death education’s “period of popularity”: Lessons for contemporary P-12 schools in the United States during the COVID-19 pandemic , 2021, Death studies.

[9]  Der Internist,et al.  Problem Überversorgung , 2021, Der Internist.

[10]  B. Ngu,et al.  Introducing the Study of Life and Death Education to Support the Importance of Positive Psychology: An Integrated Model of Philosophical Beliefs, Religious Faith, and Spirituality , 2020, Frontiers in Psychology.

[11]  Donna Epp,et al.  Death education for children and young people in public schools. , 2020, International journal of palliative nursing.

[12]  Sara E. Stemen.  “I can’t explain it”: An examination of social convoys and after death communication narratives , 2020, Death studies.

[13]  Batool Tirgari,et al.  Near-Death Experience among Iranian Muslim Cardiopulmonary Resuscitation Survivors , 2020, Iranian journal of nursing and midwifery research.

[14]  Stephen Asatsa.  Death Attitudes as Possible Predictors of Death Preparedness across Lifespan among Nonclinical Populations in Nairobi County, Kenya , 2020, Indian journal of palliative care.

[15]  K. Khoshnood,et al.  Gender Differences in Attitudes Toward Death Among Chinese College Students and the Implications for Death Education Courses , 2020, Omega.

[16]  Peter Baldwin Panagore.  My Deaths Direct My Life: Living with Near-Death Experience , 2020, Narrative inquiry in bioethics.

[17]  D. Lester,et al.  The effectiveness of 8A model death education on the reduction of death depression: A preliminary study , 2019, Nursing open.

[18]  In Gyu Song,et al.  Effectiveness of home hospice care: a nationwide prospective observational study , 2019, Supportive Care in Cancer.

[19]  J. Kobashigawa,et al.  Updates on Heart Transplantation , 2019, Current Heart Failure Reports.

[20]  L. Qiu,et al.  A preliminary study , 2018, Medicine.

[21]  D. Lester,et al.  8A Conceptual Model for Death Education , 2017 .

[22]  Wai-ying Wong.  The Concept of Death and the Growth of Death Awareness Among University Students in Hong Kong , 2017, Omega.

[23]  S. Parnia.  Understanding the cognitive experience of death and the near-death experience. , 2016, QJM : monthly journal of the Association of Physicians.

[24]  A. Milberg,et al.  A good death from the perspective of palliative cancer patients , 2017, Supportive Care in Cancer.

[25]  B. Birashk,et al.  P6: The Effectiveness of Didactic Approach on the Reduction of Death Obsession , 2016 .

[26]  C. Leget,et al.  Ready to give up on life: The lived experience of elderly people who feel life is completed and no longer worth living. , 2015, Social science & medicine.

[27]  Laura M. Holdsworth.  Bereaved carers’ accounts of the end of life and the role of care providers in a ‘good death’: A qualitative study , 2015, Palliative medicine.

[28]  T. Wangmo,et al.  Ageing Prisoners’ Views on Death and Dying: Contemplating End-of-Life in Prison , 2014, Journal of Bioethical Inquiry.

[29]  D. Grossoehme.  Overview of Qualitative Research , 2014, Journal of health care chaplaincy.

[30]  Andrew C. W. Tang,et al.  Introducing the 8A Model in Death Education Training: Promoting Planning for End-Of-Life Care for Hong Kong Chinese , 2010 .

[31]  P. Burnard,et al.  SOMEBODY ELSE'S HEART INSIDE ME: A DESCRIPTIVE STUDY OF PSYCHOLOGICAL PROBLEMS AFTER A HEART TRANSPLANTATION , 2005, Issues in mental health nursing.

[32]  Chantal Wouters,et al.  An exploratory study , 2003 .

[33]  P. Cardon,et al.  A qualitative study. , 2001 .

[34]  Zhicheng Liang.  Evidence from China , 2001 .

[35]  J. Baggerly.  Clinical Practice Implications , 1999 .