Examination of the relationship between thanatophobia and resilience levels of nurses working in intensive care and palliative care units.

BACKGROUND: Nurses in critical care and palliative care units care for patients suffering from severe pain and suffering and at high mortality risk. For this reason, nurses working in these units should be psychologically resilient. However, nurses who are constantly exposed to the death process face the risk of thanatophobia. The aim of this study is to examine the relationship between thanatophobia levels and the psychological resilience of nurses working in intensive care and palliative care units. METHODS: The sample of this descriptive and cross-sectional study included 158 nurses working in intensive care and palliative care units. Personal information form for nurses, Thanatophobia Scale and Psychological Resilience Scale for Adults were used. Data were collected through an online questionnaire in the study. Percentage calculations, mean measurements, Kruskal Wallis test and Mann Whitney U test were used in the statistical evaluation of the data. RESULTS: The mean of thanatophobia scale and psychological resilience scale was found 31.74 ± 10.08 and 108.34 ± 7.12, respectively. There was a statistically significant difference between the tanatophobia total scale score and age, receiving training on psychological resilience (p < 0.05). A statistically significant difference was found between perseption of self, family cohesion and perception of future and the status of receiving training on psychological resilience (p < 0.05). A statistically negative significant correlation was determined between the thanatophobia scale and the psychological resilience scale total scores. CONCLUSIONS: As a result, it was determined that as the thanatophobia of the nurses increased, their psychological resilience decreased. This situation may negatively affect nurses working in critical departments to provide quality health care to patients. Establishing and maintaining training programs to reduce thanatophobia and increase psychological resilience of nurses working in intensive care and palliative care units will ensure that nurses provide quality health care to the patient and reduce the physiological and psychological wear of nurses.

The Relationship Between the Levels of Thanatophobia and the Attitudes Towards the Care of Dying Patients Among Student Nurses.

This study aims to examine the relationship between the levels of thanatophobia and the attitudes towards the care of dying patients among student nurses. It is descriptive, cross-sectional, and correlational. 140 student nurses studying at the faculty of health sciences of one foundation university participated in it. We collected research data using 'Defining Features of a Student Nurse Form', 'Frommelt Attitude Toward the Care of the Dying Scale', and 'Thanatophobia Scale'. 17.1% of student nurses were deeply affected by death in the last year and 38.6% stated that a patient they cared for died during their internship. The thanatophobia scale scores of student nurses who chose their profession willingly were higher on a statistically meaningful level than those participants who did not choose their profession willingly. We found a statistically significant (p < .05) difference between the FATCOD scale scores of interns and their gender, family type, having been affected by death, and willingness to care for dying patients. We suggest that nursing students should more often provide care to dying patients before graduation.

Death anxiety among advanced cancer patients: a cross-sectional survey.

PURPOSE: This study aimed to investigate death anxiety in advanced cancer patients and identify associated factors in the context of Chinese culture. METHODS: Participants (N = 270) with advanced cancer in a tertiary cancer hospital completed anonymous questionnaire surveys. Measures included the Chinese version of a Likert-type Templer-Death Anxiety Scale, Rosenberg's Self-esteem Scale, Medical Coping Modes Questionnaire, the Social Support Rating Scale, and Connor-Davidson Resilience Scale. Data were analyzed in SPSS using descriptive statistics, Student's t test, Pearson correlation test, and linear regression. RESULTS: Respondents returned 252 (93.33%) of the 270 questionnaires. The total CL-TDAS score was 39.56 ± 10.20. The top three items were "I fear dying a painful death" (3.59 ± 1.41), "I often think about how shortly life really is" (3.11 ± 1.33), and "1 am not particularly afraid of getting cancer" (3.09 ± 1.35). Associated factors of death anxiety (R2 = .333, F = 15.756, p < .001) were the medical coping mode (resignation, confronce), self-esteem, the participants' adult children, the patient-primary caregivers' relationship, resilience, and the level of activity of daily living. CONCLUSIONS: Our results demonstrate high levels of death anxiety in advanced cancer patients. Generally, patients with adult children, high self-esteem and resilience had low death anxiety. Conversely, patients with low levels of activity of daily living and high coping mode (resignation, confrontation) reported high death anxiety. We determined that associated factors contributed to reduce death anxiety. Social interventions are recommended to improve the end-of-life transition for patients and caregivers.

The Relationship Between Thanatophobia Levels and Attitudes Towards Caregiver Roles Among Nurses in the COVID-19 Period.

The current study aimed to determine the relationship between fear of death and their caregiver roles in nurses during the COVID-19. The research data were collected with the personal information form, the Thanatophobia scale, the Scale of Nurses' Attitudes to Their Caregiver Roles (SNACR), the Google Questionnaire Form. Of the nurses participating in the study, 16.1% were diagnosed with COVID-19. The current study found statistically significant differences among the thanatophobia mean scores of the groups composed according to the variables; age, gender, marital status, job position, voluntarily choosing the profession, satisfaction with the department, having had a COVID-19 diagnosis, personal assessments about their own COVID-19 knowledge, and evaluating the COVID-19 disease as fatal. In addition, there were statistically significant differences among the SNACR mean scores of the groups according to their evaluations about gender, income level, working experience as a nurse, being diagnosed with COVID-19, and their COVID-19 knowledge. The current study found no correlation between the nurses' Thanatophobia scale score and SNACR score.

The Effect of Emergency Nurses' Psychological Resilience on Their Thanatophobic Behaviors: A Cross-Sectional Study.

PURPOSE: This study analyzed the effect of emergency nurses' psychological resilience on their thanatophobic behaviors. METHODS: The research was conducted with 156 emergency nurses. In the data collection process, the Socio-Demographic Information Form, the Brief Resilience Scale, and the Thanatophobia Scale were used. RESULTS: It was found that emergency nurses had medium-level psychological resilience and high-level thanatophobia. Besides, it was discerned that there was a moderate negative relationship between psychological resilience and thanatophobia (r:-.643, p: 0.000). Lastly, as per the simple linear regression analysis, it was identified that the predictor variable of psychological resilience accounted for 40.9% of the variance in the predicted variable of thanatophobia (R2:.409, p: 0.000). PRACTICE IMPLICATIONS: Emergency nurses, who are faced with many negative situations, need to have a high level of psychological resilience in order to get out of the mental state brought by negative conditions as soon as possible, and it is recommended to carry out applications to increase psychological resilience.

The Validity and Reliability of the Thanatophobia Scale-Turkish Form: A Psychometric Study Among Nurses.

Purpose: To examine the validity and reliability of the Thanatophobia Scale-Turkish Form among nurses. Design and methods: This methodological study included 154 nurses. Content and construct validity, item analysis, confirmatory factor analysis, and internal consistency were used to evaluate the data. Findings: The content validity index of the scale was 0.91. Item-total score correlation values varied between 0.453 and 0.718. As a result of the confirmatory factor analyses, one factor was confirmed. Cronbach's alpha internal consistency coefficient was 0.854. Practice Implications: Thanatophobia Scale-Turkish Form is a valid and reliable tool used to evaluate the fear of death among nurses.

Gender difference about death anxiety among older adults: Structural Equation Model.

BACKGROUND: Older adults may be more prone to death anxiety than their younger counterparts. This study explores factors affecting death anxiety based on gender differences. METHODS: In this correlational study, 450 older adults referred to the health centres in the city of Bukan, Iran were recruited by using a randomised sampling method. Next, data were collected about the demographic questionnaire, anxiety about ageing, death anxiety, mental well-being, perceived social support, and quality of life questionnaire. The Spearman correlation coefficient was used to determine the correlation between variables, and the predictors of death anxiety were evaluated using quintile regression. Relationship between death anxiety and other variables was evaluated by the Structural Equation Model (SEM). The study was approved by the Tabriz University of Medical Sciences Ethics Committee (Ethics Code: IR.TBZMED.REC.1397.304). RESULTS: The results showed that death anxiety in men had a significant relationship with the level of literacy (P = 0.047), body self-imaging (P = 0.031), and perceived social activity (P = 0.033). Among women, death anxiety had a significant relationship with physical activity (P = 0.007) and perceived social activity (P = 0.002). Additionally, quintile regression analysis was calculated: among men, anxiety about ageing was related to death anxiety (ß = 0.182, P = 0.05), while in women, only perceived social support was associated to death anxiety (ß = -0.376, P = 0.05). Finally, according to SEM, a significantly different level of predictability of mental well-being was found for death anxiety among older men and women. CONCLUSION: Understanding the gender differences about death anxiety by the healthcare system might be useful in controlling and reducing a variety of concerns among elders who experience high levels of anxiety of death.

Death anxiety among emergency care workers.

Death anxiety, or 'thanatophobia', is a state in which people experience negative emotional reactions in recognition of their own mortality. Emergency and unscheduled healthcare workers, such as emergency nurses and paramedics, are constantly reminded of death and therefore of their own mortality, and this makes them susceptible to death anxiety. This article introduces the concept of death anxiety, and highlights the need for staff, employers and universities to recognise its signs and symptoms. It also suggests some interventions that could prevent the debilitating effects of death anxiety, to improve staff's mental health and the care they provide to patients.

Thanatophobia (Death Anxiety) in the Elderly: The Problem of the Child's Inability to Assess Their Own Parent's Death Anxiety State.

Thanatophobia is omnipresent in our lives. Research has shown separate but connected constructs: fear of death or fear of the dying process. The influences on death anxiety are varied including religiosity, gender, psychological state, and age. It is often assumed by the children of the elderly that the fear of death is prevalent in their parents. Daily the medical staff encounters the presence of death anxiety: from family members or the staff itself. In order to understand this phenomenon, a three-tier study was conducted on non-terminal elderly inpatients in an acute geriatric care ward. The study showed that the elderly had low levels of anxiety (scoring 4/15 on Templer's Death Anxiety Scale) but their children scored higher for themselves (6.9/15) and for their parents (8.9/15). A regression model showed that only the presence of generalized anxiety and religiosity of parent had an effect explaining 33.6% of the variance. Death anxiety of death is usually absent in the elderly but rather they fear the dying process. On the other hand, their children do fear death, which they extrapolate onto their parents. This causes conflicts since the children prevent disclosure of relevant medical information to their parents. This has to be addressed by the staff when dealing with family members, to allow open and honest communication with their patients. The staff need to explain to the family that the elderly are not afraid of death but of the suffering from the dying process.

How death anxiety impacts nurses' caring for patients at the end of life: a review of literature.

Nurses are frequently exposed to dying patients and death in the course of their work. This experience makes individuals conscious of their own mortality, often giving rise to anxiety and unease. Nurses who have a strong anxiety about death may be less comfortable providing nursing care for patients at the end of their life. This paper explores the literature on death anxiety and nurses' attitudes to determine whether fear of death impacts on nurses' caring for dying patients. Fifteen quantitative studies published between 1990 and 2012 exploring nurses' own attitudes towards death were critically reviewed. Three key themes identified were: i). nurses' level of death anxiety; ii). death anxiety and attitudes towards caring for the dying, and iii). death education was necessary for such emotional work. Based on quantitative surveys using valid instruments, results suggested that the level of death anxiety of nurses working in hospitals in general, oncology, renal, hospice care or in community services was not high. Some studies showed an inverse association between nurses' attitude towards death and their attitude towards caring for dying patients. Younger nurses consistently reported stronger fear of death and more negative attitudes towards end-of-life patient care. Nurses need to be aware of their own beliefs. Studies from several countries showed that a worksite death education program could reduce death anxiety. This offers potential for improving nurses' caring for patients at the end of their life.