Académique Documents
Professionnel Documents
Culture Documents
I. Introduction
Main Problem
Secondary Problems
III. Evidences
IV. Synthesis
Strength
Weaknesses
V. Conclusion
VI. Recommendation
VII. Appendices
References
Curriculum Vitae
I. Introduction
permanent stoppage of the heart, respiration, and brain activity: the end of life.
According to the world health organization, 55.3 million people die each year. In the
experiences and socio-cultural beliefs. Death anxiety, a negative affective state that is
incited by mortality salience, may be experienced by nurses and other health care
workers who are exposed to sickness, trauma, violence, and death factors that may
While health care environments throughout the developed world have expanded the use
institutional settings. Nurses play critical roles globally in preventing death, and also
they help patients and their family members with advanced directives, and end of life
decision-making. Nurses may become anxious and feel overwhelmed with the work
Nurses are especially vulnerable to the debilitating condition because of the nature of
their work and the constant exposure to death, according to Mike Brady, a doctoral
many registered nurses (RNs) aspire. Also known as ICU nurses, critical care nurses
use their advanced skills to care for patients who are critically ill and at high risk for life-
The care of death and dying patients is a challenge for nurses that has raised a special
interest in the recent years. Due to this concern, researchers would like to determine
how does death anxiety affects the nurses caring towards patients who are at the end
of life stage. Secondarily, on do nurses able to cope up on death of patient/s and the
Main Problem:
1. How does death anxiety affects the nurses caring towards patients who are at the
Secondary Problems:
1. Nurses' characteristics and their Attitudes toward Death and Caring for Dying
Introduction: Nurses are expected to care for death and many patients at their
end-of-life (EOL) stage. Care of death and the dying provoke many undesired emotions
and attitudes that reflect on the quality of patients' care. However, there are many
factors that can affect nurses' attitudes towards caring for death and dying patients,
such as nurses' demographics (age, gender, nursing experience, and others). Which
deserve carefully designed studies. Yet, limited Jordanian studies addressing these
The present study aims to assess how Jordanian nurses providing care for
terminal ill patients feel about death and caring for dying patients and to examine any
of this study. A total of 155 nurses were recruited to participate in the study. The nurses'
attitudes toward caring for dying patients were measured using the Frommelt Attitude
toward Care of the Dying (FATCOD) scale. The nurses' attitudes toward death were
measured using the Death Attitude Profile-Revised (DAP-R) scale. The t-test and F-test
were computed to examine the relationships between nurses' attitudes toward care of
Result: The present study showed that statistical significant association was
existed among age (P=.048; P=.049) and nursing experience (P=.000; P=.000) with
nurses' attitudes toward death and caring for terminal ill patients, and the total scores on
the FATCOD and DAP-R respectively. It also showed a significant correlation between
nurses' attitudes toward death and caring for dying patients (P=.002).
Conclusion: Based on the obtained results, older registered nurses with more
experience tended to have more positive attitudes toward death and caring for dying
patients. Therefore, understanding the effect of nurses' factors that are associated with
their attitudes toward care of dying and death can guide hospital and health care
agencies to devel.
As revealed in this study, older registered nurses with more experience tended to
have more positive attitudes toward death and caring for dying patients. RNs without
this experience had more negative attitudes, reported more feelings of fear toward
death, and avoided thoughts of death as much as possible. Therefore, the need to
educate the youngest and less experienced nurses caring for dying patients is
warranted. Thus, improving quality care to dying patients and their families.
2. How Death Anxiety Impacts Nurses Caring for Patients at the End of Life: A
Introduction: Numerous studies over the last 30 years have explored death
anxiety among individuals. This is a feeling of dread, anxiety or fear at the thought of
death or anything to do with dying: a common fear or phobia. Nurses, in the course of
their clinical work are frequently exposed to the processes surrounding patient deaths.
Nurses personal attitudes towards death and dying may, however, influence the quality
of care they provide during the terminal stages of a persons life. Faced with emotional
issues such as the reality of deaths, nurses need skills and experience to manage such
fears.
global search engines Google and GoogleScholar. Few studies were identified using
common healthcare databases- perhaps owing to the terms used in indexing. For
example a search of Ovid Medline using key search terms was unproductive with regard
to nursing studies. The search terms included death anxiety; attitude to death; anxiety
The main sources were PubMed and the reference lists of identified studies.
Studies conducted prior to 1990 were excluded in order to maintain the currency of
data. The titles of papers and the abstracts were examined and where relevant the full
papers were read to select articles for review. Owing to various designs, sampling
methods, levels of evidence and outcomes the results are presented as a descriptive
Result: It was unsurprising, then, that some nurses facing the prospect of a
patient dying felt anxious and were uncertain how to cope with the procedures that
between staff attitudes to death and intention to discuss death and dying. Depending on
a nurses orientation to fear of death, nurses who held higher anxiety scores on fear of
death were less likely to have a positive attitude towards caring for a patient at the end
of life. There was evidence that short courses in death education could reduce the
death anxiety of registered nurses with likely subsequent improvement in nurses coping
with death and dying. Hutchison and Shermans work with student nurses also showed
positive results after participation in a 6 hour workshop on death and dying. Thus, there
are opportunities to improve education for nurses at both undergraduate level and post-
mentoring for younger, inexperienced nurses in the workplace could provide further
requires nursing skill and also necessitates nurses to have insight into their personal
beliefs about death and dying. Nurses who had a more positive attitude towards death
were more likely to have a positive attitude towards providing end of life care for
patients. Nurses need to consider their own race and spiritual beliefs (as well as those
of the dying patient) because these may affect their objectivity in caring for a patient and
the end of their life. Regardless of the cultural settings in which nurses work (or their
continent) younger nurses under age 30, with less ability to cope with negative attitudes
and the demands of emotional work would benefit from death education in the
workplace.
3. Death Anxiety among Nurses and Health Care Professionals: A Review Article
(Nia, 2016)
other health care workers who are exposed to sickness, trauma, violence, and death
factors that may influence the experience and level of death anxiety in health providers
include age, ego integrity, physical problems, psychiatric conditions, religiosity ethnicity,
occupational stressors, personal death experiences, and media influences. While there
is an increasing focus on burnout and compassion fatigue among nurses who care for
patients at the end of life, there has been limited research that has examined the role of
focus on death anxiety among nurses who care for patients in a variety of environments
including intensive care units, psychiatric wards, emergency rooms, and inpatient and
outpatient settings. Nursing staff have also perceived educational gaps relative to their
preparation to provide effective care for dying patients. The purpose of this review is to
examine death anxiety and management strategies among health providers in different
anxiety in nurses globally may ultimately lead to interventions that can offset serious
consequences such as leaving positions, poor patient care, and decrements in personal
health.
and search engines was undertaken using the keywords death anxiety, fear of death,
nursing, health care, and thanatophobia. To maintain the currency of the findings,
inclusion criteria incorporated only research articles that were published since 2000 in
the English language. Exclusion criteria included commentary and theory papers, non-
research studies, and non-English language articles. Data sources included PubMed,
Science direct, CINAHL, and PsychInfo. Titles and abstracts were first examined to
After the articles were retrieved, two reviewers conducted an analysis of each
study using quality criteria for qualitative and quantitative studies. Following this
rigorous process, we were left with 38 articles that met the review inclusion criteria.
Result: The studies that have tested interventions to manage death anxiety in
necessary for auxiliary nurses to manage the stressors associated with caring for dying
patients. Strengthening adaptive and individualized coping strategies for nurses and
offset burnout. While the interventional studies have identified important information that
can be used to expand psycho-education programs related to death and dying content,
these studies have primarily used the pre-posttest design, which is a limitation. While
research examining death anxiety and its implications for nursing is growing, most
self-report measures increases the possibility of social desirability bias. The studies
have largely used convenience samples that limit generalizability of the findings. Also,
convenience sampling may lead to samples that are more comfortable with engagement
relative to thanatology content. While extensive research has examined the role of
culture and religiosity as factors that impact death anxiety, there is yet only limited
research in nursing that has examined these factors along with cross-cultural
comparative approaches.
Conclusion: There are few practice areas where nurses are not inclined to be
faced with death, e.g. life-threatening illnesses, accidents, code situations, post-
operative compromise, long term care, psychiatric nursing with post-traumatic stress
disorder victims, to name a few. There has been an increasing recognition of the
importance of death education for nursing and allied health professionals. Coincident
with the need for heightened training in optimizing death and dying care are curriculum
Introduction: In the United States in the 20th century, with advances in medical
technology and science, the care of the dying patient shifted from family and community
to health professionals. Throughout history, nurses have sought ways to improve quality
of life for individuals, families, and communities during every phase of life's journey.
pain and symptom management, ethical decision making, competent culturally sensitive
care, and assistance through the death and dying process. The foundation of advocacy
is the nurse-patient relationship. Advocacy has 2 parts: information and support. The
nurse experiences the patient as uniquely human, with individual strengths and beliefs,
and uses this understanding to intervene on the patient's behalf. Patients exhibit the
illness, hospitalization, or change in diagnosis, require decision making and action; thus,
the act of advocacy begins. The nurse's ability to represent the patient and
revealed acute care nurses' perceptions of advocacy behaviors in EOL nursing practice
and offered insight into supports and barriers that nurses at various skill levels
experience. The 3 most frequently identified barriers were the physician, the patient's
family, and fear. Novice nurses reported that lack of communication and lack of
time/support are barriers to their practice of advocacy. Today's nurse also faces barriers
with differing policies and practices in healthcare systems and professional relationships
with multidisciplinary caregivers. On the other hand, EOL nursing education and
cultural disparities and their impact on EOL issues, including the grieving process. As
patient advocates, nurses must ensure that patients and families of all ethnicities
experience death with dignity. But first, we must be educated about the grieving process
and how cultural differences affect that process. Our duty is then to communicate the
dying individual's beliefs to the physician(s) caring for that individual. Communication
between physician and nurse is the key to successful advocacy. Cultural sensitivity
Method: Their attitudes were measured with the Frommelts Attitude Toward
Result: The results indicated that the participating Iranian students were more
afraid of death and less likely to give care to dying persons than the Swedish
participants.
and culturally sensitive in order to positively influence the students attitudes, and
IV. Synthesis
Strengths
Research shows adequate evidences on aspects that influences the nurses caring
towards dying patients such as anxiety and how does it affect the type of care to be
rendered.
Weakness
Focusing only on the level of anxiety of patient towards caring on dying patients.
Researchers could also focus on patients such as critically ill or Grade 1-4 types of
patients.
1. How does death anxiety affects the nurses caring towards patients who are at the
Nurses who held higher anxiety scores on fear of death were less likely to have a
positive attitude towards caring for a patient at the end of life. Nurses who had a more
positive attitude towards death were more likely to have a positive attitude towards
providing end of life care for patients. Nurses need to consider their own race and
spiritual beliefs (as well as those of the dying patient) because these may affect their
Nurses cope up on death of patient/s through emphasizing personal growth and building
capacities to regulate emotions appear necessary for auxiliary nurses to manage the
stressors associated with caring for dying patients. Strengthening adaptive and
individualized coping strategies for nurses and teaching the important self-care qualities
The 3 most frequently identified barriers were the physician, the patient's family, and
fear. Novice nurses reported that lack of communication and lack of time/support are
barriers to their practice of advocacy. Today's nurse also faces barriers with differing
multidisciplinary caregivers.
V. Conclusion
Researchers conclude that death anxiety affects the caring of nurses to patients in end
of life stage wherein the higher their anxiety level is, the poorer their caring is towards
the patient. It was also determined that the coping abilities of the nurses is based on
their age, experience, and the emotional capacity in managing stressors. Barriers in
VI. Recommendation
In light of the findings of the current research, the following recommendations were
suggested:
1. This study remark that nurses will be responsible for the care of a larger population of
dying patients in the future and, therefore, the need to be educated about death and
2. The researchers do believe that strong faith and satisfactory salaries contribute to
closer relations and understanding between nurses in one hand and the patients and
their families in the other. Therefore, investigation of the influence of the religious belief,
and economic status on nurses' attitudes toward death and care of dying is needed.
VII. Appendices
References
Hasheesh, P., Nurses' characteristics and their Attitudes toward Death and Caring for
Iranmanesh, C., Caring for Dying People: Attitudes Among Iranian and Swedish
https://www.aorn.org/websitedata/cearticle/pdf_file/CEA13508- 0001.pdf.
March 2012.
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104-
http://onlinelibrary.wiley.com/doi/10.1046/j.1365-2044.2001.01842.x/pdf.
December 2012.
2012.
NATIONAL UNIVERSITY
COLLEGE OF NURSING
551 MF Jhocson Street, Sampaloc Manila
EVIDENCE-BASED PRACTICE
(MIDTERM)
Submitted by:
NUR131 Group 2
Dimaporo, Nor Hazel
Fua, Sean Harvey
Gacayan, Wency
Venus, Paola Marie
Submitted to:
Ms. Teresita Santiago
Clinical Instructor
Curriculum Vitae
EDUCATION
School/University
NONE
Curriculum Vitae
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School/University
Blue Scholar
Photojournalist
Science Feature Editor
Marian youth Movement Member
Curriculum Vitae
EDUCATION
Gacayan, Wency G.
#562 Main St. Sampaloc, Manila
(+63)9305214459
wencygacayan@yahoo.com
wencgacayan1196@gmail.com
EDUCATION
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Swimming Athlete
Drum and Lyre Member
Young Mens Christian Association Member
ASG Leader