Nursing Students’ Attitudes towards Caring for Dying Patients

DOI: https://doi.org/10.14710/nmjn.v8i1.17270

Article Metrics: (Click on the Metric tab below to see the detail)

Article Info
Published: 06-06-2018
Section: Articles
Fulltext PDF Tell your colleagues Email the author

Background: Dying is a normal human phenomenon that requires a holistic care approach. Nurses’ attitudes towards the care for dying patients need to be explored, understood, and analyzed to improve the quality of care in palliative setting, including in nursing students.
Purpose: This study explored the nursing students’ attitude and its relationship with the students’ demographic profile in caring for the dying patients in Indonesia.
Methods
: This study used a quantitative descriptive cross-sectional research design.  The samples were 192 nursing students from Universitas Jember, Indonesia, who were recruited by using simple random sampling. Data were collected using the Frommelt Attitudes towards the Care of the Dying Care Form B Indonesian version (FATCOD-BI). The reliability test of FATCOD-BI showed a Cronbach’s alpha of 0.68, and the result of validity test using correlation coefficient showed the range of -0.278 to 0.544. Data were analyzed using frequency distribution, and mean differences test using t-test and One-Way Analysis of Variance (ANOVA).
Results
: Results showed that the mean of nursing students’ attitudes in caring for dying patients was 93.83±5.96 (range 30-120). Gender and training experiences had no relationship with students’ attitudes in caring for dying patients (p=0.22 and p=0.943). There was a relationship between the experiences and student academic level and the students’ attitudes in caring for dying patients (p=0.023 and p=0.036). The students’ experiences and academic level become a primary factor in the attitudes toward caring for dying patients.
Conclusion
: Findings revealed that student nurses’ attitudes in caring for dying patients was in low category and there was no significant relationship between gender and training experience and students’ attitudes towards caring for the dying patients. In contrast, experiences in caring for dying patients and academic level were associated with students’ attitudes. Further studies in the development of curriculum on dying patient care emphasizing on socio-demographic status are recommended.

Keywords

Attitudes; caring; dying patients; nursing students

  1. Muhamad Zulfatul A'la  Orcid Sinta
    Emergency and Critical Care Nursing Department, School of Nursing, Universitas Jember, Indonesia
  2. Baskoro Setioputro 
    Emergency and Critical Care Nursing Department, School of Nursing, Universitas Jember, Indonesia
  3. Dicky Endrian Kurniawan  Sinta
    Fundamental and Management Nursing Department, School of Nursing, Universitas Jember, Indonesia
  1. A’la, M. Z. (2016). The Frommelt Attitudes toward Care Of The Dying Care Form B (FATCOD- B) Indonesia version: measurement validity using factor analysis in nursing students. Nurseline Journal, 1(1), 73–82. Retrieved from jurnal.unej.ac.id/index.php/NLJ/article/view/3832
  2. Abu-El-Noor, N. I., & Abu-El-Noor, M. K. (2015). Attitude of Palestinian nursing students toward caring for dying patients. Journal of Holistic Nursing, 34(2), 193-9.
  3. Abu Hasheesh, M. O., Al-Sayed AboZeid, S., Goda El-Said, S., & Alhujaili, A. D. (2013). Nurses’ characteristics and their attitudes toward death and caring for dying patients in a public hospital in Jordan. Health Science Journal, 7(4), 384–394.
  4. Arslan, D., Akca, N. K., Simsek, N., & Zorba, P. (2014). Student nurses ’ attitudes toward dying patients in Central Anatolia. International Journal of Nursing Knowledge, 25(3), 183–188.
  5. Barrere, C. C., Durkin, A., & Lacoursiere, S. (2008). The influence of end-of-life education on attitudes of nursing students. International Journal of Nursing Education Scholarship, 5(1), 1-18. https://doi.org/10.2202/1548-923X.1494
  6. Beck, I., Tornquist, A., Brostrom, L., & Edberg, A. K. (2012). Having to focus on doing rather than being-Nurse assistants’ experience of palliative care in municipal residential care settings. International Journal of Nursing Studies, 49(4), 455–464. https://doi.org/10.1016/j.ijnurstu.2011.10.016
  7. Colley, S. L. (2016). Senior Nursing students’ perceptions of caring for patients at the end of life. Journal of Nursing Education, 55(5). https://doi.org/10.3928/01484834-20160414-07
  8. De Witt Jansen, B., Weckmann, M., Nguyen, C. M., Parsons, C., & Hughes, C. M. (2013). A cross-national cross-sectional survey of the attitudes and perceived competence of final-year medicine, nursing and pharmacy students in relation to end-of-life care in dementia. Palliative Medicine, 27(9), 847–54. https://doi.org/10.1177/0269216313483661
  9. Dobbins, E. H. (2011). The impact of end-of-life curriculum content on the attitudes of associate degree nursing students toward death and care of the dying. Teaching and Learning in Nursing, 6(4), 159–166. https://doi.org/10.1016/j.teln.2011.04.002
  10. Dunn, K. S., Otten, C., & Stephens, E. (2005). Nursing experience and the care of dying patients. Oncology Nursing Forum, 32(1), 97–104. https://doi.org/10.1188/05.ONF.97-104
  11. Edo-Gual, M., Tomás-Sábado, J., Gómez-Benito, J., Monforte-Royo, C., & Aradilla-Herrero, A. (2017). Spanish Adaptation of the Frommelt Attitude Toward Care of the Dying Scale (FATCOD-S) in nursing undergraduates. OMEGA - Journal of Death and Dying, 1–23. https://doi.org/10.1177/0030222816688294
  12. Faul, F., Erdfelder, E., Lang, A.-G., & Buchner, A. (2007). G*Power: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2), 175–191. https://doi.org/10.3758/BF03193146
  13. Frommelt, K. H. M. (2003). Attitudes toward care of the terminally ill : an educational intervention. American Journal of Hospice & Palliative Care, 20(1), 13–22.
  14. Gallagher, A., Bousso, R. S., McCarthy, J., Kohlen, H., Andrews, T., Paganini, M. C., … Padilha, K. G. (2015). Negotiated reorienting: a grounded theory of nurses’ end-of-life decision-making in the intensive care unit. International Journal of Nursing Studies, 52(4), 794–803. https://doi.org/10.1016/j.ijnurstu.2014.12.003
  15. Gillan, P. C., van der Riet, P. J., Jeong, S., Riet, P. J. Van Der, & Jeong, S. (2014). End of life care education, past and present: a review of the literature. Nurse Education Today, 34(3), 331–42. https://doi.org/10.1016/j.nedt.2013.06.009
  16. Grubb, C., & Arthur, A. (2016). Student nurses’ experience of and attitudes towards care of the dying: a cross-sectional study. Palliative Medicine, 30(1), 83–8. https://doi.org/10.1177/0269216315616762
  17. Henoch, I., Browall, M., C, M. J., Danielson, E., Udo, C., A, J. S., … Strang, S. (2014). The Swedish version of the Frommelt Attitude Toward Care of the Dying scale : aspects of validity and factors influencing nurses ’ and nursing students ’ attitudes . Cancer Nurs, 37(1), 1–2. https://doi.org/10.1097/NCC.0b013e318279106b.Full
  18. Higgs, C. (2010). The Palliative care Handbook: Advice on clinical Management (7th ed.). Sanford: Hierographics Ltd.
  19. Iranmanesh, S., Axelsson, K., Häggström, T., & Sävenstedt, S. (2010). Caring for dying people: attitudes among Iranian and Swedish nursing students. Indian Journal of Palliative Care, 16(3), 147–53. https://doi.org/10.4103/0973-1075.73643
  20. Iranmanesh, S., Savenstedt, S., & Abbaszadeh, A. (2008). Student nurses’ attitudes towards death and dying in south-east Iran. International Journal of Palliative Nursing, 14(5), 214–9. https://doi.org/10.12968/ijpn.2008.14.5.29488
  21. Jeffers, S. (2014). Nurse faculty perceptions of end-of-life education in the clinical setting: a phenomenological perspective. Nurse Education in Practice, 14(5), 455–60. https://doi.org/10.1016/j.nepr.2014.03.009
  22. Lange, M., Thom, B., & Kline, N. E. (2008). Assessing nurses’ attitudes toward death and caring for dying patients in a comprehensive cancer center. Oncology Nursing Forum, 35(6), 955–959. https://doi.org/10.1188/08.ONF.955-959
  23. Lynn, M. (2003). The impact of a palliative care educational component on attitudes toward care of the dying in undergraduate nursing students. Journal of Professional Nursing, 19(5), 305-312.
  24. Macleod, R., Vella-Brincat, J., & Macleod, A. . (2012). The Palliative Care Handbook (10th ed.). Wellington: Hospice New Zealand.
  25. Minister of Health The Republic of Indonesia. (2012). Gambaran penyakit tidak menular di rumah sakit di Indonesia Tahun 2009 dan 2010[The description of non-communicable diseases in hospital in Indonesia on 2009 and 2010]. Buletin Jendela Data Dan Informasi Kesehatan, 2 (2012), 1–48.
  26. Mutto, E. M., Cantoni, M. N., Rabhansl, M. M., & Villar, M. J. (2012). A perspective of end-of-life care education in undergraduate medical and nursing students in Buenos Aires, Argentina. Journal of Palliative Medicine, 15(1), 93–98. https://doi.org/10.1089/jpm.2011.0238
  27. Nakai, Y., Miyashita, M., & Sasahara, T. (2006). Factor structure and reliability of the Japanese version of the Frommelt Attitudes Toward Care of the Dying Scale (FATCOD-B-J) [in Japanese]. Jpn J Cancer Nurs, 11(6), 723–729.
  28. Ramadas, S. (2013). Bereavement leading to death. Asian Journal of Psychiatry, 6(2), 184–185.
  29. Rochmawati, E., Wiechula, R., & Cameron, K. (2016). Current status of palliative care services in Indonesia: a literature review. International Nursing Review, 63(2), 180–190. https://doi.org/10.1111/inr.12236
  30. Smeltzer, S., & Bare, B. (2010). Brunner & Suddarth’s Textbook of Medical-surgical Nursing. Lippincott Williams & Wilkins.
  31. Sudore, R. L., Casarett, D., Smith, D., Richardson, D. M., & Ersek, M. (2014). Family involvement at the end-of-life and receipt of quality care. Journal of Pain and Symptom Management, 48(6), 1108–1116. https://doi.org/10.1016/j.jpainsymman.2014.04.001
  32. Todaro-Franceschi, V., & Spellmann, M. (2012). End of life care pedagogy, death attitudes, and knowing participation in change. Journal of Nursing Education and Practice, 3(2), 120–125. https://doi.org/10.5430/jnep.v3n2p120
  33. Wallace, M., Grossman, S., Campbell, S., Robert, T., Lange, J., & Shea, J. (2009). Integration of end-of-life care content in undergraduate nursing curricula: Student knowledge and perceptions. Journal of Professional Nursing : Official Journal of the American Association of Colleges of Nursing, 25(1), 50–6. https://doi.org/10.1016/j.profnurs.2008.08.003
  34. Wang, L., Li, Y., Yan, W., & Li, G. (2016). Development and psychometric testing Chinese version of the Frommelt Attitude Toward Care of the Dying Scale, Form B in nurses and nursing students, Journal of Cancer Education, 31(1), 123–130. https://doi.org/10.1007/s13187-015-0810-7