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KMID : 0350919760010000117
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Journal of Nursing Science
1976 Volume.1 No. 0 p.117 ~ p.146
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Attitudes of Nursing Student and Nurses towards Death and the Dying Patient
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전산초/Chun, San Cho
김조자/최옥신/유지수/전경애/Kim, Cho Ja/Choi, Ok Shin/Yoo, Ji Soo/Chun, Kyung Ai
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Abstract
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A nurse sometimes is in., the position of caring for a patient who is seriously ill and facing impending death. In caring for a person who is robbed of all hope of maintaining life, the nurse in charge must make every effort to ensure the person a peaceful span of remaining life in which they may keep their, consciousness in peace, painlessness and solemnity In order to care for persons who are dying a nurse should first solve his or her own conflicts about death, and be aware of their own concepts of death and dying.
The purpose of this study was: (1) to deter However to determine nurses attitudes towards death (2) to discover nurses attitudes towards dying patients death was a (3) and to discern factors which, may influence these attitudes.
From September 1 through September 31,1974, 290 graduate nurses(working in 3 hospitals attached to 3 medical colleges in Seoul) and 210 junior and senior nursing students (enrolled in 3 nursing colleges attached to their own hospitals also in Seoul) were given a questionnaire designed to provide information about their attitudes towards death and dying. Completed questionnaire were received from 240 the graduate nurses and from 177 of the nursing students. The total number of respondents participating in the study was 417.
Analysis of the data should be the following;
In response to the question regarding the meaning of death, 35.0% of the total respondents replied affirmatively saying it would be an “eternal repose”. 63.0% responded negatively saying death would be a “void”. The data seems to indicate that the majority of nurses held a negative view of death.
However 54.2% of the total number of nurses also felt death was a part of life.
There was no remarkable difference between the graduate nurses and the nursing students in their attitudes.
This view of death as a part of life, appeared to enable the nurses to accept death more compliantly, and is an important factor in considering nursing educational practices.
2.Of the total respondents, 89.7% said that they had been motivated to think seriously about death by "the death of a patient". Only 3.4% of the, respondents said they had thought about death as a result of "a lecture on death". These responses indicate that many nurses had no mental preparation regarding death before caring for critical patients. In such a situation, it can be assumed that the nurse may naturally try to avoid the threat of death rather than help the patient. Including causes on death early in students course of study would seem to be indicated.
3. Only 12.4% of the nursing students and 7.9%, of the graduate nurses approved of autopsis to determine the cause of death. Also, only 33.9%, of the nursing students and 30.5 %/ of the graduate nurses approved of organ transplants. This shows a clear aversion towards motivation of the body following death.
A higher percentage of those who believe in God approved of organ transplants (35.7%) than did those who had no religion (23.4 %) . This was statistically significant. (x2=10.1146, d.f.=3, p <0. 05) No other statistically significant differences were shown for other variables.
4. Of the total respondents, 83.7% had had the experience of caring for hopeless patients. Though man has a natural inclination to avoid hardship, 74. 1 % said that they wanted to care for patients who were dying. This may indicate that these nurses have formed a philosophy of their own which enables them to care for dying patients.
5. In response to questions about sufferings experienced by hopeless patients, 62.7 of the students and 73.3 % of the graduate nurses felt that suffering was a part of the dying process rather than death itself. Being suffering 70.0 % of the total respondents felt that mental suffering was more Unbearable than physical suffering. Whine 17.0 % felt physical suffering more unbearable. The nursing students felt that mental suffering was far more unbearable Than did the graduate nurses this difference in attitude was statistically significant.(X2=18.1102, D.F. =4, p<0.05)
6. In response to the question of whether or not the terminally ill patient should be informed of his condition, 38.4% of the students replied that they would inform the patient of the "fact itself", while 36.7% of the graduate nurses said they would inform the patient of the "serious ness of the disease only". However, when the nurses were asked if they would want to be told "the fact", if they were in a critical condition, 65. 5 % of the students and 52.9% of the graduate nurses replied affirmatively. This shows a discrepancy with their replies about informing patients of the fact of death.
7. In response to the medical treatment for hopeless cases, 51.4% of the students and 62. 1 % of the nurses felt that "reasonable treatments only should be tried for the patient." 17.9% of the graduate nurses said they should "do their best to the end while 19.8% of the students responded in their manner. This difference was statistically significant (x2=7.3864, d.f.=2, p <0.05).
It would seem that the students might tend to be seem that the students might tend to be more active in caring for dying patients.
The students who had had no experience showed a lower percentage of response (12.7 % ) to "do their best to the end" than did the graduate nurses who had had experience (20. %). This was a statistically significant difference. (x²=7.8022, d.f.=2, p<0.05)
8. Of the total respondents, 73.4 % felt psychological factors affected their attitudes towards death and dying while 26.6 felt they did not; 70.7 % of the nurses felt religion affected their attitude while 29.3% felt it did not; 63.3% felt that environment affected their attitude and 36.7% felt it did not. Religion did not appear to play a more important part in affecting attitudes than did psychological and environmental influences.
The major recommendation of the study is that courses on death and dying should be included in the nursing curriculum, in order to help nurses clarify their own attitudes. These courses should be offered early in the curriculum before the nurse has to are for dying patient.
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