Changes Due to Patient Deaths: Medical Students' Expectations vs. Health Professionals' Experiences.

CONTEXT: Preparing healthcare professionals for inevitable encounters with patient deaths is crucial to preventing maladaptive professional bereavement outcomes. OBJECTIVES: This study aimed to explore the discrepancies between medical students' pre-patient death expectations and healthcare professionals' post-patient death experiences regarding accumulated global changes due to patient deaths (AGC), identify heterogeneous expectation patterns among students, and reveal risk factors for worthy-of-concern expectation patterns. METHODS: Cross-sectional survey data from 231 professional caregivers and 405 medical and nursing students were used. Independent t tests and analyses of covariance were run for staff-student AGC comparisons. Latent profile analysis (LPA) among students was followed by logistic regression. RESULTS: The students scored higher than did the staff in two AGC factors: more acceptance of limitations and more death-related anxiety. LPA identified four latent expectation patterns, with the "overoptimistic" (27.8%) group being worthy of concern, as students overestimated positive changes and underestimated negative changes. The overoptimistic pattern was predicted by students' motivations to study medicine, which were driven by "interests," "career opportunities," and "improving medical services in the hometown," rather than "by chance," and higher scores on the death attitude of "neutral acceptance." CONCLUSION: In general, students tend to overestimate the long-term impacts of patient deaths. However, approximately 1/4 of students hold overly optimistic expectations, which are predicted by motivations to study medicine and death attitudes.

Attitudes toward Death among Health Care Professionals in the Balkan Region.

Background and Objectives: Death is an unavoidable experience in any person's life and affects not only the dying person but also their caregivers. The dying process has been displaced from homes to health care facilities in the majority of cases. Facing death and dying has become an everyday life of health care professionals (HCP), especially in palliative care (PC) settings. This study aimed to investigate the death attitudes among HCPs in Serbia. Materials and Methods: The Serbian version of the Death Attitude Profile-Revised (DAP-RSp) was used as a measurement instrument. Results: The average age of the 180 included participants was 42.2 ± 9.9 years; the majority were females (70.0%), with more than 10 years of working experience (73.0%), physicians (70.0%) and those working in a non-oncological (non-ONC) field (57.78%). The mean total score of DAP-RSp was 124.80 ± 22.44. The highest mean score was observed in the neutral acceptance dimension (NA) (5.82 ± 0.90) and lowest in the Escape acceptance (EA) (2.57 ± 1.21). Higher negative death attitudes were reported among nurses compared to physicians (p = 0.002). Statistically significant differences were observed in the fear of death (FD) and death avoidance (DA) domains, favoring PC specialists and oncologists (p = 0.004; p = 0.015). Physicians working in Oncology (ONC) showed lower FD values (p = 0.001) compared to non-ONC departments. Conclusions: Attitudes toward death among HCPs are of great importance for the well-being of both HCPs and patients. Negative attitudes can lead to deficient care. The fear of death is highly represented among Serbian HCPs working in non-ONC fields, including both nurses and physicians. This study emphasizes the need for further research to comprehensively explore and understand HCPs' attitudes toward death. This research highlights the need for the development of an educational curriculum across all levels of medical education, aimed at overcoming the fear of death and enhancing coping strategies, which will improve the care for patients diagnosed with terminal illnesses.

Factors influencing death attitudes of medical students: a scoping review.

Aim: To summarize factors influencing death attitudes of medical students, help identify intervention targets, and design precision interventions for improving death attitudes of medical students. Methods: Web of Science, PubMed, Embase, OVID, China National Knowledge Infrastructure, and Wanfang databases were searched. Retrieval time was from January 2012 to September 2023. Studies on factors influencing death attitudes of medical students were included. Results: Thirty-five studies were included in the final review. A total of 28 factors influencing death attitudes of medical students were summarized and divided into three categories comprising personal factors, social factors, and psychological factors. More than 15 studies confirmed that gender, religion, and discussing death with families were factors that influenced medical students' death attitudes. Conclusion: Results indicate that there are many types of factors that influence death attitudes of medical students. It is necessary for universities to implement death education based individual characteristics and guide medical students to cultivate generally optimistic death attitudes and appropriate life values.

Do People Prefer Home Palliative Care? A Survey Study and Assessment of Associated Factors in China.

Objectives: This study examined people's preference for the location to receive palliative care services and determined the associated factors. Methods: A questionnaire with reference to the Chinese version of the Hospice Attitude Scale and the Death Correspondence Scale was designed, piloted, revised, and distributed online and in person to collect data (N = 762). Binary logistic regression was used to analyze the effects of relevant factors. Results: The average age of the participants was 38.1, with a relatively even gender distribution. Over 90% of the participants were either single/never married (44.9%) or married with children (46.0%). 58.1% of the respondents (N = 428) indicated that they would like to receive palliative care at home, compared to 41.9% who preferred receiving such care in institutions or other places (N = 309). Each time people's attitudes toward death became one point more positive, they were 10.2% more likely to choose to receive palliative care services at home. People with a neutral attitude toward palliative care, single/never married or divorced with children, and having/had an occupation in health and social work had higher odds of preferring receiving palliative care at home. Those who had poor self-rated health or with an educational background of primary school or lower or some college had lower odds of preferring receiving palliative care at home. Conclusions: The research showed that attitudes toward death and other factors were associated with people's preferences for palliative care locations. More accessible and affordable community-based and home-based palliative care services should be further explored and provided.

The Effect of Mindfulness on Death Escape Acceptance in Young People: Emotion Regulation as a Mediator.

Few studies have examined young people's attitudes toward death escape acceptance and its relationship to mindfulness. This study addressed this issue and examined the mediating role of emotion regulation. In Study 1, 61 undergraduate students aged 19-22 years participated in a mindfulness intervention program, and the results showed that increasing young people's levels of mindfulness could improve their attitudes toward death escape acceptance. The Study 2, which recruited 440 young people aged 18-26 years to complete a cross-sectional survey, replicated the main effect and showed that young people's difficulty in emotion regulation fully mediated the coping effect of mindfulness. These findings suggest that individuals with high levels of mindfulness may have low levels of difficulty in emotion regulation and in turn promote healthy attitudes toward death escape acceptance.

Psychometric Properties of the Serbian Version of the Death Attitudes Profile- Revised (DAP-R) Instrument.

The Death Attitude Profile-Revised (DAP-R), one of the most widely used scales for assessing death attitudes is a multidimensional questionnaire capable of measuring a wide range of attitudes towards death. The aim of our study was to assess the reliability and validity of the Serbian version of the DAP-R. The study was conducted in October 2022 and included a total of 547 students of the Faculty of Medicine University of Belgrade (FMUB). Based on Cronbach's alpha coefficient values, our data show good reliability of the DAP-RSp (Serbian version). In our study, the confirmatory factor analysis showed a good fit of the data to the original factor structure with minor discrepancy; compared to the original version (five factors), our analysis yielded one more factor (six factors in total), however, almost all items had factor loading >0.3 on the appropriate scale.

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.

Exploring the impacts of a coffin-lying experience on life and death attitudes of medical and nursing students: preliminary findings.

BACKGROUND: Physicians and nurses often exhibit strong negative emotional and behavioral reactions when patients they care for die, and death education helps them cope with these difficulties. When implementing death education, the literature shows that experiential activities are more effective than lecturing, and progressive exposure is the best way to reduce death anxieties. This study examined the effects of coffin-lying, an activity sometimes seen in Asian cultures, on life and death attitudes of medical and nursing students. METHODS: During a period from 2020 to 2021, 134 medical and nursing students from a medical university in northern Taiwan voluntarily participated in this study. Among them, 53 were in the experimental group, who participated in a coffin-lying activity for nearly 3 hours, and the other 81 were in the control group. All participants filled out questionnaires 1 week before the activity (T1), 1 week after the activity (T2), and 6 ~ 11 weeks after the activity (T3). Three waves of data were analyzed by a repeated-measure multivariate analysis of variance (MANOVA). RESULTS: The effects of "love and care" and "feeling of existence" were only manifested at T2, however, the scores of "fear of death" and "death avoidance" between the experimental and control groups significantly differed at T2 and T3. In addition, there were no significant differences between the experimental and control groups in "neutral acceptance", "approach acceptance", or "escape acceptance". CONCLUSIONS: The coffin-lying activity based on desensitization was effective in improving "fear of death" and "death avoidance", and the effects were sustained to 6 ~ 11 weeks. Coffin-lying is not only a well-designed activity that quickly reduces negative tendencies toward death, but it is also worth adopting by medical and nursing schools to make death education more comprehensive.

Psychological support and demand for death education among Chinese college students during the COVID-19 pandemic: The mediating role of neutral death attitude.

AIM: This study aimed to explore the mediating role of neutral death attitude between psychological support and demand for death education among college students during COVID-19. DESIGN: A cross-sectional survey was conducted with 1800 college students selected by convenience and snowball sampling from 20 provinces and municipalities. METHODS: A questionnaire survey (The Psychological Support Scale, Demand for Death Education Scale and Neutral Death Attitude Scale) was distributed to 1800 college students. RESULTS: Psychological support had a significant positive predictive effect on demand for death education and neutral death attitude, with neutral death attitude partially regulating the demand for death education of college students after receiving psychological support.

The mediating effect of empathy between nursing students' personality traits and attitude towards death / 中华行为医学与脑科学杂志

Objective:To explore the mediating effect of empathy between personality traits and death attitude in nursing students.Methods:From April to May 2022, a total of 237 undergraduate nursing students were surveyed by general information questionnaire, big five inventory, Jefferson scale of empathy for nursing students, and death attitude profile-revised. Common method bias test, correlation analysis and descriptive analysis were conducted by SPSS 26.0 software.PROCESS macro program was used to test the mediating effect.Results:Agreeableness(32.78±4.92), empathy(110.03±16.83)were positively correlated with positive death attitude(57.95±12.35)( r=0.274, 0.571, both P<0.01), neuroticism(23.00±4.78)was positively correlated with negative death attitude(31.81±10.04)( r=0.199, P<0.01), empathy was negatively correlated with negative death attitude ( r=-0.226, P<0.01). Empathy partially mediated the relationship between neuroticism and negative death attitude, the mediating effect accounted for 16.08%(0.032/0.199) of the total effect, and empathy played a completely mediating role between the agreeableness and positive death attitude. Conclusion:The death attitude of undergraduate nursing students is mainly natural acceptance. Personality traits can directly affect death attitude and also indirectly affect death attitude through empathy.

Investigation and comparative study on death cognition and hospice care attitude of the graduate students of clinical medicine / 中华医学教育探索杂志

Objective:To investigate and analyze the status quo of death cognition and hospice care attitude of clinical medical graduate students, to compare the differences between the two groups, and to explore the correlation between death cognition and hospice care attitude, so as to provide the reference for the reform and construction of death cognition and hospice care education in medical colleges and universities in China.Methods:A survey was carried out on 496 doctoral and postgraduate students majoring in clinical medicine by using the "Questionnaire of General Sociology Survey", the Chinese version of the "Death Attitude Profile Revised Scale", and the Chinese version of the "Frommelt Attitudes Toward Care of the Dying Scale Form B (FATCOD-B)" to investigate the death cognition and hospice care attitude of 496 doctoral and postgraduate students majoring in clinical medicine, and classified and compared the survey results of the two groups. The results of this study were statistically analyzed by t-test, Pearson correlation analysis and other statistical methods. Results:A total of 469 valid questionnaires were recovered after excluding 27 unqualified questionnaires. Statistical analysis showed that the scores of each dimension in the death attitude description scale of doctoral students were ranked as follows: approach acceptance (4.28±0.53), neutral acceptance (3.99±0.41), death avoidance (2.74±0.63), fear of death (2.65±0.57) and escape acceptance (2.47±0.69) the scores of postgraduates were ranked as neutral acceptance (3.96±0.52), approach acceptance (2.84±0.61), fear of death (2.78±0.65), death escape (2.62±0.73), escape acceptance (2.39±0.77). At the same time, the scores of hospice care attitude in the doctoral group were higher than those in the master group [(110.63±8.96) vs. (106.78±6.52)], and the difference was statistically significant ( P<0.001). In addition, the scores of "fear of death" and the scores of hospice care attitudes were negatively correlated with the scores of doctoral and master students ( r=-0.25, r=-0.21), while the scores of hospice care attitudes were positively correlated with the scores of "neutral acceptance" in death cognition ( r=0.50, r=0.32). However, the hospice care attitude scores of doctoral students were negatively correlated with the "death avoidance" scores in death cognition ( r=-0.27). Conclusion:Doctoral and postgraduate students have a certain awareness of hospice care, while their death cognition and hospice care attitude still need to be improved and strengthened from sociology, psychology, ethics and other perspectives. The above will promote the harmony between doctors and patients while meeting the needs of an aging society in China.

A study on the relationship between nurses' death attitude, death competency and death education need in a tertiary care hospital / 中国实用护理杂志

Objective:To investigate the current situation of nurses′ death attitudes, death competency and death education need in tertiary care hospitals, and analyze their relationship and to provide suggestions and guidance for clinical death education.Methods:This was a cross-sectional survey. From January to March 2022, a random sample of 1 902 nurses from five tertiary hospitals in Hunan Province Changsha City was selected as the study population. The general information questionnaire the Death Attitude Profile-Revised (DAP-R), Coping with Death Scale (CDS) and Death Education Needs Scale were used to investigate the current situation of nurses′ death attitudes, death competency and death education needs in tertiary hospitals, and the correlations among them were analyzed.Results:The 1 837 valid questionnaires were finally collected. The total score of death attitude was (91.37 ± 11.26) points, the total score of death competency was (109.25 ± 21.67) points and the total score of death education needs was (214.13 ± 28.64) points. Natural acceptance was positively correlated with death education needs ( r=0.458, P<0.05), escape acceptance was positively correlated with death education needs ( r=0.312, P<0.05), convergent acceptance was positively correlated with death education needs ( r=0.347, P<0.05), death avoidance was negatively correlated with death education needs ( r=-0.291, P<0.05), and death competency was positively correlated with death education needs ( r=0.356, P<0.05). Conclusions:Nurses had some degree of positive death attitudes, moderate level of death competency and higher need for death education. The death education need was positively correlated with positive death attitudes and death competency. The death education should be strengthened to cultivate positive death attitudes and improve death competency to improve the quality of end-of-life care and the quality of patient death.

Using a mediating model of death attitude and meaning in life to understand nursing students attitude about hospice care.

BACKGROUND: Nurse-led hospice teams are an emerging trend in contemporary health care practice in China. However, Chinese nursing students are often ill-prepared to work in hospice care. Study findings on the attitude of nursing students toward the care of people who are dying and death varied among different countries and regions. OBJECTIVES: To propose and empirically test a mediating model that examines how death attitude and meaning in life interact to affect Chinese undergraduate nursing students and their attitude toward the care of people who are dying. DESIGN: A cross-sectional study. PARTICIPANTS: A convenience sample of 1410 Chinese undergraduate nursing students. METHODS: Data were collected from July to December 2020 using Chinese versions of the Frommelt Attitude Toward Care of the Dying Scale, Form B (FATCOD-B-C), Death Attitude Profile-Revised (DAP-R-C), and Purpose in Life Test (CPLT-C). SPSS version 22.0 and AMOS version 24.0 were used for statistical analysis. RESULTS: The average FATCOD-B-C score was 98.28 ± 8.02. Death attitude and meaning in life were positively correlated with attitude toward care of the dying (p < 0.001), but death attitude was negatively correlated with meaning in life (p < 0.001). Pathway analysis showed that fear of death was significantly and positively correlated with attitude toward care of people who are dying. A mediating role was found among neutral acceptance, escape acceptance, and meaning in life to some extent. Meaning in life suppressed effects among the model. CONCLUSION: This study revealed that Chinese undergraduate nursing students' attitude toward care of the dying was a positive nurturing process. Future nurse education should first identity the fear of death, neutral acceptance, or escape acceptance of nursing students' death attitude, and then develop a hospice curriculum based on fear management.

Death Attitudes and Death Anxiety Among Medical Interns After the 2020 Outbreak of the Novel Coronavirus.

This study investigates the status quo and influencing factors of death attitudes and death anxiety among medical interns in China as measured by the Death Attitude Scale and Death Anxiety Scale following the outbreak of "Novel Coronavirus Pneumonia" in China in early 2020. Results of this study show that under the influence of COVID-19, in terms of death attitude, medical interns scored the highest in neutral acceptance and the lowest in escape acceptance. There were significant differences in death attitude and anxiety among the groups with different backgrounds, including their families' approaches to discussions of death, the number of funeral experiences, and other factors. There were two additional factors affecting attitudes that were related to the epidemic situation: whether the individual had participated in work to treat COVID-19 and whether their close friends or relatives ("cherished persons") had been diagnosed with COVID-19. The study reveals the ways that the epidemic had an impact on death attitude and death anxiety.

Actitudes hacia la muerte expresadas por jóvenes en contexto COVID-19 en la región de Tarapacá

Esta investigación analizó las actitudes hacia la muerte expresadas por un grupo de adultos jóvenes en contexto COVID-19. Los participantes fueron 10 jóvenes residentes en la región de Tarapacá (60% mujeres, 40% hombres) entre 18 a 29 años. La metodología tuvo un enfoque mixto de preponderancia cualitativa y diseño secuencial. En la primera etapa, se administró el Perfil Revisado de Actitudes hacia la muerte [PAM-R] para medir cinco actitudes: Miedo a la muerte; Evitación de la muerte; Aceptación de acercamiento; Aceptación de escape; y Aceptación neutral. Posteriormente, se aplicaron entrevistas semiestructuradas que profundizaron los resultados, mediante la exploración de las percepciones, emociones y pensamientos de los participantes durante la pandemia. Finalmente, se triangularon los datos cuantitativos y cualitativos para obtener una mayor validez. Los resultados señalan a estas actitudes como un fenómeno contextual, cuya expresión depende de diversos elementos personales y del entorno, siendo los más importantes los miedos asociados a familiares. En jóvenes, la muerte fue comprendida como una realidad lejana. Esto influyó en una alta neutralidad y bajo miedo a la muerte propia. El contexto COVID-19 actuó como un factor influyente en las actitudes, particularmente en el miedo al contagio o a la posibilidad de morir. Si bien los jóvenes reconocieron la peligrosidad del virus, sus necesidades emocionales-afectivas se vislumbraron como problemas más urgentes. Por lo tanto, los miedos en contexto COVID-19 no evitaron la exposición al contagio en compañía de amigos. Estas conductas fueron significadas como medidas de autocuidado psicológico, particularmente en jóvenes con Aceptación de Escape.

This research analyzed the attitudes towards death expressed by a group of young adults in a COVID-19 context. The participants were 10 young residents in the Tarapacá region (60% women, 40% men) between 18 and 29 years old. The methodology had a mixed approach of qualitative preponderance and sequential design. First, the Death Attitude Profile-Revised [DAP-R] was administered to measure five attitudes: Fear of Death, Death Avoidance, Approach Acceptance, Escape Acceptance, and Neutral Acceptance. Subsequently, semi-structured interviews were applied that deepened the results, by exploring the perceptions, emotions and thoughts of the participants during the pandemic. Finally, the quantitative and qualitative data were triangulated to obtain greater validity. The results point to these attitudes as a contextual phenomenon, the expression of which depends on various personal and environmental elements, the most important being the fears associated with family members. In young people, death was understood as a distant reality. This influenced a high neutrality and low fear of own death. The COVID-19 context acted as an influencing factor in attitudes, particularly in fear of contagion or the possibility of dying. Although the young people recognized the dangerousness of the virus, their emotional-affective needs were seen as more urgent problems. Therefore, fears in the COVID-19 context did not prevent exposure to contagion in the company of friends. These behaviors were signified as measures of psychological self-care, particularly in young people with Escape Acceptance.

Este estudo teve como objetivo analisar as atitudes de um grupo de jovens adultos em relação a morte no contexto de COVID-19. Nela participaram 10 jovens que vivem na região de Tarapacá (60% mulheres, 40% homens) os quais tinham entre 18 e 29 anos. A metodologia da pesquisa teve uma abordagem mista de preponderância qualitativa e desenho de investigação sequencial. Na primeira etapa, foi administrado o Perfil Revisado de Atitudes em Relação a Morte [PAM-R] para medir cinco atitudes: Medo da morte; Evitar a morte; Aceitação de abordagem; Aceitação de fuga; e aceitação neutra. Posteriormente, foram aplicadas entrevistas semi-estruturadas que aprofundaram os resultados, explorando as percepções, emoções e pensamentos dos participantes durante a pandemia. Por fim, os dados quantitativos e qualitativos foram triangulados para obter maior validade. Os resultados apontam essas atitudes como um fenômeno contextual, cuja expressão depende de diversos elementos pessoais e do meio ambiente, sendo o mais importante deles, os medos associados aos parentes. Nos jovens, a morte era entendida como uma realidade distante. Isso influenciou uma alta neutralidade e pouco medo da propia morte. O contexto de COVID-19 atuou como um fator influente nas atitudes, particularmente no medo de contágio ou na possibilidade de morrer. Enquanto os jovens reconheciam o perigo do vírus, suas necessidades emotivas e afetivas eram vistas como problemas mais urgentes. Portanto, os temores no contexto de COVID-19 não impediram a exposição ao contágio na companhia de amigos. Esses comportamentos foram considerados como medidas de autocuidado psicológico, particularmente em jovens com Aceitação da Fuga da morte.

Actitudes hacia la muerte expresadas por jóvenes en contexto COVID-19 en la región de Tarapacá / The death attitudes expressed by young adults from Tarapacá region in COVID-19 context / Atitudes de jovens da região de Tarapacá em relação a morte no contexto de COVID-19

Resumen Esta investigación analizó las actitudes hacia la muerte expresadas por un grupo de adultos jóvenes en contexto COVID-19. Los participantes fueron 10 jóvenes residentes en la región de Tarapacá (60% mujeres, 40% hombres) entre 18 a 29 años. La metodología tuvo un enfoque mixto de preponderancia cualitativa y diseño secuencial. En la primera etapa, se administró el Perfil Revisado de Actitudes hacia la muerte [PAM-R] para medir cinco actitudes: Miedo a la muerte; Evitación de la muerte; Aceptación de acercamiento; Aceptación de escape; y Aceptación neutral. Posteriormente, se aplicaron entrevistas semiestructuradas que profundizaron los resultados, mediante la exploración de las percepciones, emociones y pensamientos de los participantes durante la pandemia. Finalmente, se triangularon los datos cuantitativos y cualitativos para obtener una mayor validez. Los resultados señalan a estas actitudes como un fenómeno contextual, cuya expresión depende de diversos elementos personales y del entorno, siendo los más importantes los miedos asociados a familiares. En jóvenes, la muerte fue comprendida como una realidad lejana. Esto influyó en una alta neutralidad y bajo miedo a la muerte propia. El contexto COVID-19 actuó como un factor influyente en las actitudes, particularmente en el miedo al contagio o a la posibilidad de morir. Si bien los jóvenes reconocieron la peligrosidad del virus, sus necesidades emocionales-afectivas se vislumbraron como problemas más urgentes. Por lo tanto, los miedos en contexto COVID-19 no evitaron la exposición al contagio en compañía de amigos. Estas conductas fueron significadas como medidas de autocuidado psicológico, particularmente en jóvenes con Aceptación de Escape.

Abstract This research analyzed the attitudes towards death expressed by a group of young adults in a COVID-19 context. The participants were 10 young residents in the Tarapacá region (60% women, 40% men) between 18 and 29 years old. The methodology had a mixed approach of qualitative preponderance and sequential design. First, the Death Attitude Profile-Revised [DAP-R] was administered to measure five attitudes: Fear of Death, Death Avoidance, Approach Acceptance, Escape Acceptance, and Neutral Acceptance. Subsequently, semi-structured interviews were applied that deepened the results, by exploring the perceptions, emotions and thoughts of the participants during the pandemic. Finally, the quantitative and qualitative data were triangulated to obtain greater validity. The results point to these attitudes as a contextual phenomenon, the expression of which depends on various personal and environmental elements, the most important being the fears associated with family members. In young people, death was understood as a distant reality. This influenced a high neutrality and low fear of own death. The COVID-19 context acted as an influencing factor in attitudes, particularly in fear of contagion or the possibility of dying. Although the young people recognized the dangerousness of the virus, their emotional-affective needs were seen as more urgent problems. Therefore, fears in the COVID-19 context did not prevent exposure to contagion in the company of friends. These behaviors were signified as measures of psychological self-care, particularly in young people with Escape Acceptance.

Resumo Este estudo teve como objetivo analisar as atitudes de um grupo de jovens adultos em relação a morte no contexto de COVID-19. Nela participaram 10 jovens que vivem na região de Tarapacá (60% mulheres, 40% homens) os quais tinham entre 18 e 29 anos. A metodologia da pesquisa teve uma abordagem mista de preponderância qualitativa e desenho de investigação sequencial. Na primeira etapa, foi administrado o Perfil Revisado de Atitudes em Relação a Morte [PAM-R] para medir cinco atitudes: Medo da morte; Evitar a morte; Aceitação de abordagem; Aceitação de fuga; e aceitação neutra. Posteriormente, foram aplicadas entrevistas semi-estruturadas que aprofundaram os resultados, explorando as percepções, emoções e pensamentos dos participantes durante a pandemia. Por fim, os dados quantitativos e qualitativos foram triangulados para obter maior validade. Os resultados apontam essas atitudes como um fenômeno contextual, cuja expressão depende de diversos elementos pessoais e do meio ambiente, sendo o mais importante deles, os medos associados aos parentes. Nos jovens, a morte era entendida como uma realidade distante. Isso influenciou uma alta neutralidade e pouco medo da propia morte. O contexto de COVID-19 atuou como um fator influente nas atitudes, particularmente no medo de contágio ou na possibilidade de morrer. Enquanto os jovens reconheciam o perigo do vírus, suas necessidades emotivas e afetivas eram vistas como problemas mais urgentes. Portanto, os temores no contexto de COVID-19 não impediram a exposição ao contágio na companhia de amigos. Esses comportamentos foram considerados como medidas de autocuidado psicológico, particularmente em jovens com Aceitação da Fuga da morte.

The Relationship Between the Attitudes of Nursing Students Towards Providing Care for a Dying Patient and Their Empathic Tendencies.

This study was planned to determine the relationship between the attitudes of nursing students towards death and dying patients and their empathic tendencies. This study was conducted with a descriptive and correlational design. The research was completed with 176 students. Positive significant relationship found between between the FATCOD and ETS scores. It was observed that a 1-point increase in the Empathic Tendency Scale score caused an increase of 0.502 points in the FATCOD score. It is recommended providing training sessions with simulation applications for nursing students to prepare them for end-of-life care experiences.

Spanish Version of the Death Attitude Profile-Revised. Translation and Validation Into Spanish.

The Death Attitude Profile-Revised (DAP-R) was developed in English-speaking cultures with the aim of measuring attitudes towards death. This measure consists of 32 items, grouped into five factors (Fear of Death, Avoidance of Death, Neutral Acceptance, Approach Acceptance, and Escape Acceptance). The DAP-R was translated and adapted to Spanish (DAP-RSp), and the psychometric properties were analyzed accross a general sample. The face validity was evaluated by 20 experts in palliative care. N = 417 (X = 39.06 years) took part in the validation. DAP-RSp showed adequate internal consistency (Cronbach's alpha ranging from 0.67 for Neutral Acceptance to 0.95 for Escape a Acceptance, and 0.88 for the total), a multitrait scaling analysis and a confirmatory factor analysis reproduced the five dimensions of the original scale. The Spanish version of the DAP-R can be used as a valid scale to assess attitudes towards death in Spanish speaking population.

The Influence of Life-and-Death Views on the Well-Being of Chinese Tujia Ethnic Adolescents.

The purpose of this study was to evaluate how a person's view of life and death might influence various aspects of well-being. Similar studies have been conducted with adolescents in different cultures, but not with Chinese Tujia ethnic adolescents. Tujia adolescents (N = 309) completed the Meaning in Life Questionnaire (MLQ), the Death Attitude Profile (DAP), the Satisfaction with Life Scale (SWLS) and the Happiness Inventory (HI). Results indicated that Chinese Tujia ethnic adolescents maintain a relatively positive life-and-death view and overall well-being. Meaning in life and death attitude both corresponded with overall well-being. A dominance analysis indicated that meaning in life can predict the well-being of a person better than a death attitude. Limitations and future directions are discussed.

Experiences of a Group of Senior Nursing Students with End of Life Care and Death in Turkey.

Nursing students may feel unprepared to manage the care of dying individuals and may experience anxiety and fear related to death and dying. Preparing nursing students for this situation can help them provide quality care to dying patients. This study aimed to examine the end-of-life care values and behaviors and death attitudes of senior nursing students. In examining these variables, the Values and Behaviors of Intensive Care Nurses for End-of-Life Instrument and the Death Attitude Profile-Revised Scale were used. It was found that the students developed positive attitudes and behavior towards end-of-life care, and that they believed death to be a natural part of life and there is life after death. Students who felt that the information they received during their education was partially sufficient were more likely to have negative death attitudes. It can be recommended that teaching strategies in the education of the nursing students be developed.