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Niu Y, Yang Y, Li C, Zhao R, Hou X. Latent profile analysis of death education needs and its relationship with hospice attitude among intern nursing students. NURSE EDUCATION TODAY 2025; 153:106788. [PMID: 40411962 DOI: 10.1016/j.nedt.2025.106788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2024] [Revised: 03/11/2025] [Accepted: 05/19/2025] [Indexed: 05/27/2025]
Abstract
BACKGROUND As a critical force for the future development of hospice care, death education for nursing students plays an essential role in the provision of hospice care services. However, current research has overlooked the heterogeneity of death education needs among individuals, and few studies have explored the influencing factors of death education needs and its relationship with hospice attitude of nursing interns. OBJECTIVE A latent profile analysis (LPA) was conducted to identify the unique characteristics of death education needs among nursing interns in China and to explore the influencing factors of death education needs and its relationship with hospice attitude of nursing interns. DESIGN Cross-sectional survey. SETTINGS A tertiary hospital in Shandong Province, China. PARTICIPANTS The sample consisted of nursing interns (N = 225) from five medical universities. METHODS Latent profile analysis (LPA) was used to establish a latent profile model for death education needs among nursing interns in China. Binary logistic regression analysis was then performed to examine the predictors of high death education needs based on the different latent profiles. RESULTS Nursing interns' death education needs could be categorized into two latent groups: a "Low-level needs-higher views of death" group (26.2 %) and a "High-level needs" group (73.8 %). Binary logistic regression analysis, with the Low-level needs-higher views of death as the reference, revealed that educational level, experience of bereavement, occasional opportunities to care for the dying, and attitudes toward hospice care were significant predictors of nursing interns' death education needs. CONCLUSIONS Death education needs among nursing interns in China exhibit distinct profiling characteristics. Nursing interns with higher educational levels, experience of bereavement, opportunities to care for the dying, and positive attitudes toward hospice care are more likely to fall into the "High-level needs" group. These findings provide valuable insights for the development of future death education training models.
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Affiliation(s)
- Yushuo Niu
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, China
| | - Yuxiang Yang
- Dezhou University of Medicine and Nursing, Dezhou, Shandong Province, China
| | - Cuicui Li
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, China
| | - Runan Zhao
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, China
| | - Xiaohong Hou
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, China.
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Yao Y, Liu M, Yuan T, Xiao J, Wang N, Wang Y, Zeng F, Zeng Y. Understanding nursing students' first experience of patient death in clinical practice: A qualitative systematic review and meta-synthesis. NURSE EDUCATION TODAY 2025; 147:106599. [PMID: 39889457 DOI: 10.1016/j.nedt.2025.106599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2024] [Revised: 12/09/2024] [Accepted: 01/27/2025] [Indexed: 02/03/2025]
Abstract
BACKGROUND Witnessing patient death for the first time poses significant challenges for nursing students. Understanding their experiences can inform improvements in educational and support strategies within nursing programs. AIM This qualitative systematic review aimed to examines nursing students' initial encounters with patient death, emphasizing their perceptions, emotional responses, and coping mechanisms. DESIGN Qualitative systematic review. REVIEW METHODS AND DATA SOURCES A comprehensive search was conducted across ten electronic databases from their inception until February 16, 2024, with an update on October 30, 2024. Eligible studies were evaluated for quality using the Joanna Briggs Institute Critical Appraisal Checklist. Data extraction was performed using the standardized tool from the Joanna Briggs Institute Qualitative Assessment and Review Instrument. The findings were synthesized, and the ConQual tool assessed the confidence in the results. RESULTS This systematic review included 16 studies involving 285 nursing students. Qualitative analysis identified 154 findings, categorized into six themes: (1) holistic support for patient comfort and dignity in dying, (2) perceptions of death, (3) confronting the challenges of patient death, (4) emotional impacts on students, (5) adjustments following patient death, and (6) witnessing death through novice perspectives. CONCLUSIONS The first encounter with patient death during clinical practice significantly impacts nursing students. Comprehensive death education and robust support systems are essential for enhancing students' coping abilities. Educators and clinical practitioners should implement support strategies that address students' needs, helping them confront patient death with composure and professionalism.
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Affiliation(s)
- Yue Yao
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Min Liu
- Department of Anesthesiology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Tingting Yuan
- Department of Gastrointestinal Surgery, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Jiangqin Xiao
- Nursing Department, People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang, China
| | - Na Wang
- Deyang People's Hospital, Deyang, Sichuan, China
| | - Yuqin Wang
- Chongqing Traditional Chinese Medicine Hospital, Chongqing, China
| | - Fanli Zeng
- Chongqing General Hospital, Chongqing, China
| | - Yanli Zeng
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
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Kurtgöz A, Koç Z. Nursing Students' Spiritual/Religious Coping Strategies Dealing With First Experience of Witnessing Death During Clinical Practices. OMEGA-JOURNAL OF DEATH AND DYING 2025; 90:1412-1429. [PMID: 37116220 DOI: 10.1177/00302228231174803] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
This study aims at determining spiritual/religious coping strategies of nursing students dealing with the first experience of witnessing death during clinical practices. One of the qualitative research approaches, a descriptive phenomenological study was designed. The study was carried out with 14 nursing students studying at a state university in Turkey. The students' first experiences of witnessing death were examined by the personal in-depth interviewing method. Data were analyzed using the thematic analysis method. The following five main themes were identified by the analysis: Perception of death; Witnessing death for the first time; Coping with death experience; Needs and recommendations; Impact of spirituality and religion. The obtained findings were presented according to the COREQ criteria. The findings showed that witnessing death for the first time is a difficult experience that affects students in various ways and students prayed and performed their prayers frequently to cope with the death experience.
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Affiliation(s)
- Aslı Kurtgöz
- Sabuncuoglu Serefeddin Health Services Vocational School, Amasya University, Amasya, Turkey
| | - Zeliha Koç
- Health Science Faculty, Ondokuz Mayıs University, Samsun, Turkey
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Nabirye AK, Munabi IG, Mubuuke AG, Kiguli S. Emotional and psychological experiences of nursing students caring for dying patients: an explorative study at a national referral hospital in Uganda. BMC MEDICAL EDUCATION 2025; 25:96. [PMID: 39833799 PMCID: PMC11744855 DOI: 10.1186/s12909-025-06708-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 01/14/2025] [Indexed: 01/22/2025]
Abstract
BACKGROUND Caring for dying patients is associated with psychological trauma, strong emotions and enormous stress for nursing staff and nursing students who are reliable health care providers in such difficult situations. Nursing students involved in End-of -life care need to work through these emotions during clinical placements. This study explored the lived experiences of nursing students caring for the dying patients at Mulago national referral hospital. METHODS An explorative study was conducted using in-depth interviews among fifteen 3rd and 4th year undergraduate nursing students of Makerere University college of Health sciences. Data was audio recorded, verbatim transcribed and thematically analyzed using Atlas. ti version 6 software. FINDINGS Two themes emerged from students' narratives of their emotional and psychological experiences while caring for dying patients; (1) Psychological and emotional reactions, (2) Coping mechanisms. The sub-themes under Psychological and emotional reactions were; feelings of anger, triggers of anxiety symptoms, triggers of sadness and guilt feelings. The sub themes under coping mechanisms were; peer to peer support through interacting with each other about the experiences, engagement in problem solving, distancing from patients, spirituality and engaging in personal stress reducing activities. CONCLUSION Nursing students experience various negative psychological and emotional reactions but devise different coping mechanisms to overcome them. There is need for development of clear guidelines on orientation of nursing students caring for dying patients, emphasis on building their emotional intelligence and more research on effectiveness of end of life educational interventions to mitigate the anticipated negative psychological and emotional reactions.
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Affiliation(s)
- Asha K Nabirye
- Department of Pediatrics, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
- School of Nursing, college of health sciences, Islamic University in Uganda, Kabbojja, Kampala, Uganda.
| | - Ian G Munabi
- Department of Human Anatomy, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, Uganda
| | - Aloysius G Mubuuke
- Department of Radiology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Sarah Kiguli
- Department of Pediatrics, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
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Setlogelo B, Nyoni CN. Grit, academic resilience, and mindset of nursing students: A cross-sectional study. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2024; 7:100253. [PMID: 39555386 PMCID: PMC11565537 DOI: 10.1016/j.ijnsa.2024.100253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 10/02/2024] [Accepted: 10/21/2024] [Indexed: 11/19/2024] Open
Abstract
Background Nursing students engage with the complex health system for competence development. These students are exposed to nerve-wrecking experience in addition to their everyday personal and social challenges. Non-cognitive attributes, namely grit, resilience and mindset can influence students' ability to overcome complexities as they become nurses resulting in academic success and well-being. Insights into the state of non-cognitive attributes among undergraduate nursing students are essential in developing tailor-made educational programmes to enhance their grit, resilience, and mindset. Objectives To describe the undergraduate nursing students' grit, academic resilience, and mindset at a university in South Africa. Design A quantitative descriptive cross-sectional design. Setting A School of Nursing at a public multi-campus university in South Africa. Participants All students (N = 315) registered for the undergraduate nursing programme were invited to participate, and 70 % (N = 221) chose to participate. Methods Data were collected using self-administered questionnaires that included a 7-item demographic survey, the 30-item Academic Resilience Scale (ARS-30) that measures affective, cognitive, and behavioural responses in an educational context, the 16-item Dweck Mindset Scale (DMI) that measures a personal belief about whether intelligence and talent are fixed or amenable to change, and the 8-item Grit-S scale measuring passion for long term goals and perseverance. The collected quantitative data were analysed statistically through the Statistical Analysis Software Version 9.4 computer programme. Findings The findings revealed that the participants have normal grit and a growth mindset, but low academic resilience. Conclusions Tailor-made educational programmes that target non-cognitive attributes must integrate interventions that are focused on enhancing academic resilience for undergraduate nursing students.
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Affiliation(s)
| | - Champion N Nyoni
- School of Nursing, University of the Free State, Bloemfontein, South Africa
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Majidipour P, Janatolmakan M, Andayeshgar B, Khatony A. Exploring patient death experiences among Iranian nursing students. Sci Rep 2024; 14:21345. [PMID: 39285223 PMCID: PMC11405672 DOI: 10.1038/s41598-024-72631-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Accepted: 09/09/2024] [Indexed: 09/22/2024] Open
Abstract
Patient death can be a stressful experience for nursing students, leading to various undesirable psychological and emotional effects. However, research documenting these experiences remains limited. This study explores the experiences of Iranian nursing students when facing patient death. This qualitative study employed a purposive sample of 14 undergraduate nursing students. Data was collected through semi-structured interviews and analyzed using conventional content analysis. Lincoln and Guba's (2004) criteria guided the data management process. Data analysis revealed three primary categories with six corresponding subcategories. These categories encompassed the significance of death, reactions to death, and the transformation of professional perspectives. Subcategories included positive and negative meanings attributed to death, emotional and behavioral responses, and the positive and negative effects on participants. The findings reveal that experiencing patient death significantly impacts nursing students psychologically and emotionally. Consequently, it is recommended that nursing curricula incorporate essential training modules addressing appropriate responses to death and effective communication with bereaved families. Further research should explore strategies to mitigate negative impacts and optimize positive outcomes related to this phenomenon.
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Affiliation(s)
- Parastoo Majidipour
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Maryam Janatolmakan
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahare Andayeshgar
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Khatony
- Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
- Infectious Diseases Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Yoong SQ, Wang W, Seah ACW, Chao FFT, Kumar N, Gan JON, Schmidt LT, Hong J, Zhang H. The impact of a student death doula service-learning experience in palliative care settings on nursing students: A pilot mixed-methods study. DEATH STUDIES 2024:1-13. [PMID: 39158318 DOI: 10.1080/07481187.2024.2391929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/20/2024]
Abstract
Through a mixed-methods approach (randomized controlled trial and thematic analysis of pre and post-service-learning reflections), this study evaluated the impact of a student death doula service-learning experience on nursing students' palliative competencies and learning experiences. The intervention group underwent a 2-day student death doula training workshop followed by a 6-month service-learning experience, while the control group received standard palliative care education. Attitudes toward the care of the dying significantly improved for the intervention group but not for compassion competence and palliative care knowledge. Six themes were developed: (1) Motivations for being a student death doula, (2) Improved perceptions of palliative care patients, (3) Perceptions of a good death, (4) Confidence in caring for palliative care patients, (5) Understanding the multifaceted nature of palliative care, and (6) Joys and challenges during service-learning. Service-learning helped students to understand palliative care patients and acquire confidence in engaging with them.
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Affiliation(s)
- Si Qi Yoong
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Alvin Chuen Wei Seah
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Felicia Fang Ting Chao
- Department of Psychology, Faculty of Arts and Social Sciences, National University of Singapore, Singapore
| | - Nivetha Kumar
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Joanne Oon Nee Gan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Assisi Hospice, Singapore
| | - Laura Tham Schmidt
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Hui Zhang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- St. Andrew's Community Hospital, Singapore
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Nabirye AK, Munabi IG, Mubuuke AG, Kiguli S. Perceptions and attitudes of Nursing students towards end-of-life care: a Phenomenological Study at a tertiary hospital in Uganda. RESEARCH SQUARE 2024:rs.3.rs-4594723. [PMID: 39108492 PMCID: PMC11302713 DOI: 10.21203/rs.3.rs-4594723/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/12/2024]
Abstract
Introduction Clinical practice is an important part of nursing education as it helps nursing students transition into competent health professionals who can provide quality services. However, research studies convey it as a significant stressor for nursing students when they are obliged to end of life during clinical practice. The perceptions of nursing students on caring for end-of-life care have not been exhaustively studied in the Ugandan context. This study was conducted to understand nursing students' perceptions of end-of-life care during clinical practice at Mulago Hospital. Methods It was a qualitative study with a phenomenology method carried out among 15 nursing students from Makerere University who were assigned to Mulago Hospital for clinical practice. Data was gathered using an in-depth interview guide, audio was captured, and transcriptions were analyzed thematically using Atlas.ti version 6. Results Three main themes emerged from the data; two themes on perceptions were (i) reactions when nursing students were informed about the physical process of caring for dying patients and (ii) how student ideas about the care changed during the process of caring for end-of-life. The third theme was the attitude of students towards patients when offering end of life care. participants described their reactions as chaotic, devastated and scared about their first-time encounter with caring for dying patients, the physical process also required preparation to handle the situation and understanding, and for positive personal values felt respected, appreciated, trusted and valued when informed about the physical process of caring for the end-of-life. Conclusion In this study, nursing students held divisive attitudes on care for dying patients. However, nursing students appear to transition from unfavorable impressions of the process and encounter of caring for dying patients to positive perceptions during the actual caregiving experience. Despite their differing perspectives on caring for dying patients, students were typically empathic towards them.
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Nabirye AK, Munabi IG, Mubuuke AG, Kiguli S. Emotional and Psychological Experiences of Nursing students caring for Dying Patients: A phenomenology study at Mulago National Hospital, Uganda. RESEARCH SQUARE 2024:rs.3.rs-4323878. [PMID: 38766228 PMCID: PMC11100906 DOI: 10.21203/rs.3.rs-4323878/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Introduction Caring for dying patients is associated with psychological trauma, strong emotions and enormous stress for nursing staff and nursing students who are relied on by patients and relatives in such difficult situations. Although nurses have an ability of self-control and calm approach towards death, there are still some emotions they need to "work through". Research studies have documented limited exposure of nursing students to end-of-life care and inadequate understanding of the psychological and emotional experiences they encounter during clinical placements. This study explored the psychological and emotional experiences of Ugandan student nurses on caring for the dying patients at Mulago national referral hospital during clinical placement. Methods A qualitative phenomenological study was conducted among fifteen undergraduate nursing students of Makerere University in clinical placement at Mulago hospital. An In-depth interview guide was used to gather data on nursing students' emotional and psychological experiences and coping mechanisms. Data was audio recorded, verbatim transcribed and thematically analyzed using Atlas. ti version 6 software. Results The nursing students emotional and psychological experiences when caring for dying patients were emerged into two themes; (1) Psychological and emotional reactions, (2) Coping mechanisms. The sub themes were; anger, anxiety and depression which is triggered by a combination of issues of pressure from relatives, failure to save the dying patient, thoughts of wasted efforts to reverse the dying process, limited resources, limited technical and emotional support. The students cope by seeking help from peers, engagement in problem solving, distancing from patients, spirituality and engaging in personal stress reducing activities. Conclusion Insights from this study provide educators with a snapshot of student encounters, emotions, and coping strategies when facing dying patients and their families. Nursing students experience various negative emotional and psychological stressors triggered by a combination of issues that need to be addressed during care of dying patients. However, they devise different coping mechanisms to continue with provision of necessary end of life care as the clinical placement contributes to their learning, experience and builds confidence among student nurses.
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Yoong SQ, Wang W, Seah ACW, Gan JON, Schmidt LT, Zhang H. The experiences of nursing students participating in a student death doula service-learning program in palliative care settings: A qualitative study. DEATH STUDIES 2024; 49:460-470. [PMID: 38587973 DOI: 10.1080/07481187.2024.2337205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
Nursing students desire more training and experience in palliative care due to a need for more skills and knowledge. This descriptive qualitative study explored nursing students' experiences in participating in a student death doula service-learning program in palliative care settings. Fourteen final-year undergraduate nursing students participated in semi-structured focus group discussions via Zoom. Four focus group discussions were conducted. Six themes with 19 subthemes were developed: (1) initial feelings of fear and uncertainty, (2) death doula training and orientation, (3) palliative wards being a happier place than expected, (4) experience of watching their patients deteriorate over time, (5) benefits of participating in service-learning in palliative care settings, and (6) improving the service-learning experience. The program was well received by the nursing students, who recommended incorporating it into the nursing curriculum to enhance palliative nursing education. Additional refinements were proposed to better support nursing students during service-learning.
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Affiliation(s)
- Si Qi Yoong
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Alvin Chuen Wei Seah
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Joanne Oon Nee Gan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Assisi Hospice, Singapore, Singapore
| | - Laura Tham Schmidt
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Hui Zhang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- St. Andrew's Community Hospital, Singapore, Singapore
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Ben Natan M, Makhoul Khuri M, Hammer H, Yarkoni M. Nursing Students' Intention to Work in Hospice Care in the Future: A Cross-sectional Study. J Hosp Palliat Nurs 2024; 26:E55-E61. [PMID: 37815276 DOI: 10.1097/njh.0000000000000990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
Studies reveal that nursing students rank hospice nursing among their least preferred career choices. The purpose of this study was to explore the association between nursing students' intention to work in hospice care in the future and their attitudes toward caring for dying patients, death anxiety, personal and/or professional experience of caring for dying patients, and type of nursing program studied. In this cross-sectional study, 200 nursing students completed an online survey based on the Frommelt Attitude Toward Care of the Dying Scale and the Turkish Death Anxiety Scale. Only 11% of the respondents were found to express interest in working in hospice care in the future. Studying in the accelerated program for nonnursing Bachelor of Arts graduates predicted a higher intention to work in hospice care in the future, than studying in the generic program (β = 0.27, P < .001). Completion of clinical experience in a medical ward predicted lower intention (β = -0.21, P < .01). These findings suggest that nursing students in the accelerated program for nonnursing Bachelor of Arts graduates should be provided with appropriate experience and support to maintain their interest in hospice nursing. Clinical experience in medical wards does not seem to be a good substitute for clinical experience in hospice care.
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Jiang J, Liu Y, Han P, Zhao J, Shi Y, Zhuang Y. Perceptions and experiences of Generation Z nursing students during their practicum in an intensive care unit: A qualitative study. Heliyon 2024; 10:e26205. [PMID: 38404831 PMCID: PMC10884845 DOI: 10.1016/j.heliyon.2024.e26205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 02/06/2024] [Accepted: 02/08/2024] [Indexed: 02/27/2024] Open
Abstract
Background Influenced by socio-cultural and world events, Chinese society has significant intergenerational differences. With rapid economic and cultural development, the unique characteristics of Generation Z nursing students in China may influence the clinical education environment. However, the research on Generation Z in China is still in its infancy. Objectives This study aimed to explore the experiences and perceptions of Generation Z nursing students during their practicum in an intensive care unit (ICU) in the context of China's unique cultural and historical background. Methods A phenomenological approach was used in this qualitative study. Semi-structured, face-to-face interviews were conducted with fifteen Generation Z nursing students doing practicum in the ICU in a third-level hospital in Shanghai, China. The data were analyzed using Colaizzi's seven-step method. Result Three themes emerged: intelligent medical services empowering critical care, perception of multiple challenges, and affirmation of the teaching work in the ICU. Conclusions and implications The clinical instructors should use a combination of online and offline pedagogy, give positive guidance through role modeling, and develop the self-learning skills of Generation Z nursing students. This might help Generation Z nursing students relieve the stress of practicum in the ICU, more quickly adapt to the clinical environment, and enter nursing positions. The result of this research provided valuable information to help clinical practicum programs in China effectively educate Generation Z nursing students. Good education ensures that health care is safe and effective, making it easier for patients to get better.
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Affiliation(s)
- Jinxia Jiang
- Emergency Department, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, China
| | - Yue Liu
- Emergency Department, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, China
| | - Peng Han
- Emergency Department, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, China
| | - Jian Zhao
- Emergency Department, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, China
| | - Yan Shi
- Nursing Department, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, China
| | - Yugang Zhuang
- Emergency Department, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, China
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Çekiç Y, Çalişkan BB, Küçük Öztürk G, Kaya Meral D, Bağ B. "It was the first time someone had died before my eyes…": A qualitative study on the first death experiences of nursing students. NURSE EDUCATION TODAY 2024; 133:106075. [PMID: 38134812 DOI: 10.1016/j.nedt.2023.106075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 12/05/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND Accompanying a person at their death is a common experience in nurse education. In addition to all death experiences that are a meaningful part of the nursing profession, the first death experience is very important. However, there is limited understanding of nursing students' first death experiences. OBJECTIVES This study aimed to explore nursing students' experiences of the death of a person for the first time during clinical practice. DESIGN This study was conducted as a qualitative study using a phenomenological design. PARTICIPANTS A total of 17 nursing students participated in this study. METHODS Data were collected through online individual in-depth interviews and were analyzed using content analysis. RESULTS Four main themes and eleven sub-themes emerged. The themes were meaning of death (first death, a part of life), process management (death information, physical environment, bad news), after death (empty bed, questioning, death with dignity) and education (curriculum, support, professional perception). CONCLUSIONS While the first experience of death provides an opportunity for students to learn, this experience reveals various negative emotions and the need for support.
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Affiliation(s)
- Yasemin Çekiç
- Ankara University, Faculty of Nursing, Department of Psychiatric Nursing, Ankara, Turkey.
| | - Behice Belkıs Çalişkan
- İstanbul Beykent University, Faculty of Health Sciences, Department of Nursing, İstanbul, Turkey
| | - Gülhan Küçük Öztürk
- Nevşehir Hacı Bektaş Veli University, Semra and Vefa Küçük Faculty of Health Sciences, Department of Psychiatric Nursing, Nevşehir, Turkey
| | - Deniz Kaya Meral
- Istanbul Gelisim University, Faculty of Health Sciences, Department of Nursing, Istanbul, Turkey
| | - Beyhan Bağ
- Ludwigshafen University of Business and Society, Mannheim, Germany
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Zhu Y, Bai Y, Wang A, Liu Y, Gao Q, Zeng Z. Effects of a death education based on narrative pedagogy in a palliative care course among Chinese nursing students. Front Public Health 2023; 11:1194460. [PMID: 38026299 PMCID: PMC10665499 DOI: 10.3389/fpubh.2023.1194460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 10/26/2023] [Indexed: 12/01/2023] Open
Abstract
Background Death education has been confirmed to be an effective method to enhance nursing students' attitudes and coping abilities toward death. However, integrated Narrative Pedagogy into the death education to explore educational effectiveness is still limited. The study aimed to evaluate the effects of a death education based on Narrative Pedagogy in a palliative care course on the attitude toward death, coping with death, and attitude toward caring for the dying among undergraduate nursing students in China. Methods The study was designed as a pre-post intervention study with a quasi-experimental design. All the participants received 6 class hours of death education which was designed in a palliative care course. The death education includes preparation, presentation, discussion, reflection, and practice of the narrative materials. Death Attitude Profile-Revised (DAP-R), Coping with Death Scale (CDS), and Frommelt Attitude Toward Care of the Dying-Form B (FATCOD-Form B) were used to measure outcomes. Results Sixty undergraduate nursing students who consented. There were statistically significant increases in the mean score of neutral acceptance and approach acceptance in the DAP-R, CDS, and FATCOD-Form B before and after the intervention. Conclusion This death education integrated Narrative Pedagogy which indicated to improve attitude toward death, competence to cope with death, and attitude toward the care of dying patients. The findings assist teachers in understanding the importance and urgency of death education, as well as providing a favorable approach to death education. However, the long-term effectiveness still needs to study in further.
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Affiliation(s)
- Yuanyuan Zhu
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Yamei Bai
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Aihong Wang
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Yuexian Liu
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Qinyi Gao
- Nursing Department, Nanjing Jiangning Hospital, Nanjing, Jiangsu, China
| | - Zhi Zeng
- School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
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Yoong SQ, Schmidt LT, Devi KM, Zhang H. Using palliative and end-of-life simulation to enhance pre-licensure nursing students' emotional intelligence, palliative care knowledge and reflective abilities: A single group, pretest-posttest study. NURSE EDUCATION TODAY 2023; 130:105923. [PMID: 37549556 DOI: 10.1016/j.nedt.2023.105923] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 07/12/2023] [Accepted: 07/31/2023] [Indexed: 08/09/2023]
Abstract
BACKGROUND Nursing students have reported that they lack skills and knowledge in palliative and end-of-life care, and as a result, they faced numerous challenges caring for patients and families receiving palliative and end-of-life care during clinical attachments. OBJECTIVES To develop a palliative and end-of-life care simulation program and evaluate its effects on nursing students' emotional intelligence, palliative care knowledge and reflective abilities. DESIGN A single group, pretest-posttest quasi-experimental study. SETTINGS A simulation center in a Singapore university. PARTICIPANTS A convenience sample of 135 third-year undergraduate nursing students. METHODS Students attended a two-day simulation program consisting of four scenarios in total. Outcomes were measured before and after the study. Palliative care knowledge was measured using the Palliative Care Knowledge Test, emotional intelligence using the Trait Meta-Mood Scale-24, and reflective abilities using the Groningen Reflective Ability Scale. Outcome and demographic data were analyzed using descriptive and inferential statistics. RESULTS Total Palliative Care Knowledge Test scores (p = 0.003) and total Trait Meta-Mood Scale-24 scores (p < 0.001) improved significantly, but there was no significant change in Groningen Reflective Ability Scale scores (p = 0.650). Demographic characteristics did not significantly influence most outcome variables. Students' highest education level and experience with caring for a person receiving palliative or end-of-life care significantly affected the posttest scores of the Palliative Care Knowledge Test. Students with prior experience in caring for a person receiving palliative or end-of-life care scored significantly better in the Palliative Care Knowledge Test post-simulation compared to those who did not (p = 0.011). CONCLUSIONS The palliative and end-of-life simulation program significantly improved nursing students' emotional intelligence and palliative care knowledge. Further research is needed on developing a reliable tool to measure nursing students' palliative care knowledge. Future simulations should include structured and deliberate reflection features aside from debriefings to enhance reflective abilities, which is an important nursing competency. More research is needed on the effect of palliative and end-of-life care simulations on emotional intelligence and reflective abilities, and the influence of demographic variables on nursing students' outcomes.
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Affiliation(s)
- Si Qi Yoong
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Laura Tham Schmidt
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Kamala M Devi
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Hui Zhang
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; St Andrew's Community Hospital, Singapore.
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Rahnama M, Abdollahimohammad A, Asadi-Bidmeshki E, Shahdadi H. Nurses' Caring Experiences for Dying Patients: A Meta-Synthesis Review. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231206513. [PMID: 37837313 DOI: 10.1177/00302228231206513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2023]
Abstract
Nurses play an important role in caring for dying patients. The ability to face a dying patient is a vital necessity and skill for nurses. Nurses' experiences in dealing with dying patients help to identify the factors affecting nursing care. Therefore, this meta-synthesis explains nurses caring experiences for dying patients. In this meta-synthesis review, English qualitative articles related to nurses' caring experiences with dying patients that were published in Google Scholar, PubMed, Web of Science, Scopus, and CINAHL databases were selected. The results presented in 4 themes and 4 sub-themes, including (i) dual parallel nursing care (patient care and family care), (ii) conflict between nurses' beliefs and care duties, (iii) care reflections on the nurse (positive and negative care reflection, and (iv) coping strategies of nurses. This study shows that nurses provide diverse care to dying patients and their families, which has had positive and negative reflections on their personal and professional lives. Nurses sometimes had a conflict with their beliefs and treatment protocols, which hesitate to perform the treatment. Although nurses use various coping strategies when caring for dying patients and their families, they need more strategies to cope with multi-faceted physical, mental, spiritual, educational, and management issues.
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Affiliation(s)
- Mozhgan Rahnama
- Department of Nursing, Faculty of Nursing and Midwifery, Zabol University of Medical Sciences, Zabol, Iran
| | | | - Elaheh Asadi-Bidmeshki
- Department of Nursing, Faculty of Nursing and Midwifery, Zabol University of Medical Sciences, Zabol, Iran
| | - Hossein Shahdadi
- Department of Nursing, Faculty of Nursing and Midwifery, Zabol University of Medical Sciences, Zabol, Iran
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Zhou L, Chankoson T, Wu Y, Cai E. Thriving psychological well-being in undergraduate nursing student: a grounded theory study with the life grid approach. BMC Nurs 2023; 22:240. [PMID: 37454074 DOI: 10.1186/s12912-023-01338-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 05/14/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Psychological well-being (PWB) plays a vital role in successful adaptation to the Bachelor of Nursing journey and affects career development. However, there is little known about the functional and social processes associated with enhancing well-being specific to the subjective perspective of nursing students. AIM To investigate how nursing students promote their psychological well-being to conceptualize thriving psychological well-being. METHOD This qualitative study analyzed and reviewed a life grid and semi-structured in-depth interviews of 20 Chinese Nursing graduates by investigators and participants, following Charmaz's constructivist grounded theory. The constant comparative method was used to analyze data. This study took place between 2020 and 2022. RESULTS All participants experienced fluctuations in psychological well-being. This study identified a new understanding of how nursing students enhance their psychological well-being. Thriving awareness was co-constructed as the core category and based on the relationship with a supportive environment, the thriving psychological well-being of nursing students is conceptualized. CONCLUSIONS It is imperative to enhance the psychological counseling and support for nursing students during their clinical placements, during the period just entering university as well as after repeated outbreaks of COVID-19. Nursing educators and administrators could develop appropriate educational programs and interventions based on the theoretical model-Thriving psychological well-being.
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Affiliation(s)
- Lu Zhou
- School of Nursing, Yunnan University of Chinese Medicine, Kunming, China
- Chakrabongse Bhuvanarth International Institute for Interdisciplinary Studies, Rajamangala University of Technology Tawan-OK, Bangkok, Thailand
| | - Thitinan Chankoson
- Faculty of Business Administration for Society, Srinakharinwirot University, Bangkok, Thailand
| | - YuMing Wu
- School of Medicine, Yunnan University of Chinese Medicine, Kunming, China
| | - EnLi Cai
- School of Nursing, Yunnan University of Chinese Medicine, Kunming, China.
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18
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Yoong SQ, Wang W, Seah ACW, Kumar N, Gan JON, Schmidt LT, Lin Y, Zhang H. Nursing Students’ Experiences With Patient Death and Palliative and End-of-life Care: A Systematic Review and Meta-synthesis. Nurse Educ Pract 2023; 69:103625. [PMID: 37004470 DOI: 10.1016/j.nepr.2023.103625] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 03/06/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023]
Abstract
AIM To synthesise the experiences of nursing students encountering patient death and caring for patients under palliative care or at end-of-life and their families in clinical settings BACKGROUND: Nurses are pivotal in caring for dying patients and families. It has been reported that nursing students feel unprepared in caring for dying patients and handling patient death. Understanding their experiences would better inform how palliative care education can be improved and how students can be better supported in clinical settings. DESIGN A qualitative systematic review and meta-synthesis METHODS: PubMed, Embase, CINAHL, PsycINFO, ProQuest and Google Scholar were searched for peer-reviewed articles and theses/dissertations published between 1 January 2012-25 Feb 2023. Qualitative studies of any design reporting nursing students' experiences of patient death, caring for patients under palliative care, at end-of-life, or with time-limiting diseases in clinical settings in English were included. Study quality was evaluated using the Critical Appraisal Skills Programme tool. Data were synthesised using Sandelowski and Barroso's 2-step framework through a meta-summary using thematic analysis, which were then integrated into meta-syntheses using an event timeline. RESULTS The review included 71 studies from 26 countries (n = 1586 nursing students). The meta-summary contained 8 themes and 23 subthemes: (1) Communication experience with patients and families, (2) Satisfaction with care provided to patients and families, (3) Impact of the COVID-19 pandemic on death and dying, (4) Perceptions of death and dying, (5) Impact of death, (6) Nursing education on palliative end-of-life care, (7) Support systems and coping methods, (8) Learning outcomes. The meta-synthesis depicted nursing students' experiences before, during and after encountering dying patients, families and patient death. Suggestions for nursing faculty and clinical staff on how they could equip students with necessary skills and knowledge and support them in clinical settings were also provided. CONCLUSIONS While caring for dying patients and families was beneficial to nursing students' learning and professional development, they encountered many challenges. Governments, clinical and academic nursing leaders must prioritise the integration of palliative care content into the curricula across nursing schools in face of increasing palliative and end-of-life care needs in patients. Nursing schools should ensure that students are adequately prepared by designing culturally and socioeconomically relevant curricula, integrating theoretical and experiential learning and offering students a thorough understanding of palliative and end-of-life care. Clinical staff and nursing instructors should support students emotionally and guide them in patient care.
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Affiliation(s)
- Si Qi Yoong
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Wenru Wang
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Alvin Chuen Wei Seah
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Nivetha Kumar
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Joanne Oon Nee Gan
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Assisi Hospice, Singapore
| | - Laura Tham Schmidt
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yanjuan Lin
- Department of Nursing, Fujian Medical University Union Hospital, Fuzhou, China
| | - Hui Zhang
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; St. Andrew's Community Hospital, Singapore
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Zhou S, Wei L, Hua W, He X, Chen J. Correction: A qualitative study of phenomenology of perspectives of student nurses: experience of death in clinical practice. BMC Nurs 2022; 21:347. [PMID: 36476490 PMCID: PMC9727866 DOI: 10.1186/s12912-022-01122-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- ShiShuang Zhou
- grid.410570.70000 0004 1760 6682Department of Nursing Aministration, School of Nursing, Army Medical University, Chongqing, China
| | - LiZhen Wei
- grid.216417.70000 0001 0379 7164XiangYa Nursing School of Central South University, 172 TongZiPou Rd, Yuelu District, Changsha, 410000 Hunan China
| | - Wei Hua
- JiangNing Hospital, Nanjing, China
| | - XiaoChong He
- grid.410570.70000 0004 1760 6682Department of Nursing Aministration, School of Nursing, Army Medical University, Chongqing, China
| | - Jia Chen
- grid.216417.70000 0001 0379 7164XiangYa Nursing School of Central South University, 172 TongZiPou Rd, Yuelu District, Changsha, 410000 Hunan China
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García-Montes R, Fares-Medina S, Diaz-Caro I, Corral-Liria I, García-Gómez-Heras S. The impact of violence on women’s health. The present as a reflection of the past: A qualitative study. PLoS One 2022; 17:e0273973. [PMID: 36084074 PMCID: PMC9462808 DOI: 10.1371/journal.pone.0273973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 08/19/2022] [Indexed: 11/18/2022] Open
Abstract
The objective of the study is to analyze the impact of violence on women’s health and the feelings generated during the period of exposure to violence. This is a qualitative study with an interpretative phenomenological design in which 16 women participated—4 through interviews and 12 through stories. The data obtained were analyzed using the Colaizzi approach. The results were structured into 3 themes according to how the women interpreted their experiences. The themes were physical consequences: visible traces; psychological consequences: stormy days and sunny days; and social consequences: from loneliness to a new world. In conclusion, the women in this study considered all those (very diverse) physical pathologies to be important. They encompassed a series of psychological disorders that lasted over time, causing considerable suffering and complicating the participants’ ability to relate to the rest of society, especially men. Similarly, the participants identified a series of positive consequences when they left the traumatic situation empowered after overcoming gender-based violence.
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Affiliation(s)
- Rebeca García-Montes
- Student International Doctoral School, Health Sciences Faculty, King Juan Carlos University, Alcorcón (Madrid), Spain
| | - Sandra Fares-Medina
- Student International Doctoral School, Health Sciences Faculty, King Juan Carlos University, Alcorcón (Madrid), Spain
| | | | - Inmaculada Corral-Liria
- Nursing and Stomatology Department, King Juan Carlos University, Alcorcón (Madrid), Spain
- * E-mail:
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