Qualitative Study on the Cognition Status of Organ Donors’ Family Members to Advance Care Planning / 中国医学伦理学

Discussing the cognition, attitude and influencing factors of the family members of organ donors towards advance care planning (ACP) to provide a basis for the further promotion of ACP in the field of organ donation. Using qualitative research methods, 8 family members of organ donors were selected purposefully for semi-structured interviews, and the 7-step of Colaizzi was used to analyze and summarize the themes of the interview data. The results showed that the cognition status of the family members of organ donors of ACP could be summarized into 3 themes: problems faced by ACP implementation, positive recognition of the implementation of ACP, factors affecting the promotion of ACP. Organ donors’ family members are unfamiliar with the concept of ACP and have unclear cognition, but think that the implementation of ACP is of positive significance. It is suggested to further strengthen the publicity of ACP, medical autonomy, death education, so as to promote the development of ACP and improve the willing to donate organ.

Construction of a "4M" death education intervention program for advanced cancer caregivers based on the theory of knowledge, belief and practice / 中国实用护理杂志

Objective:To construct a death education intervention program for advanced cancer caregivers to improve the reference for death education for advanced cancer caregivers.Methods:Content analysis, semi-structured interview, Delphi expert consultation method were used to develop a preliminary death education program based on the theory of knowledge, belief, and behavior. From April to May 2022, fifteen experts from palliative care, life and death education, oncology nursing, psychological nursing and other related fields were selected for two rounds of expert consultation, and the contents of the program were revised and improved through preliminary experiments.Results:After two rounds of expert consultation, the results showed that the expert opinions tend to be unanimous. The authoritative coefficient of experts was 0.87, and the Kendall coordination coefficients of feasibility, validity and scientificity of the two rounds of consultation were 0.181, 0.303, 0.363 and 0.249, 0.355, 0.366, respectively (both P<0.05). The preliminary experiments revised and improved the intervention frequency and content, and finally formed a death education intervention program for advanced cancer caregivers which included four-stage progressive death themes: made an appointment with death, made a discussion on death, made an embrace with death and made friends with death. Conclusions:The process of constructing a death education program for advanced cancer caregivers is scientific, and the content is feasible, valid, and scientific. In addition, it is of great significance to promote death education in palliative care.

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.

Analysis on Hospice Care Cognition Status and Influencing Factors among High School Students in Guangzhou / 中国医学伦理学

【Objective:】 To investigate the cognition, attitude and influencing factors of hospice care among high school students in Guangzhou, and to provide basis for improving the understanding level of hospice care and death education among adolescents. 【Methods:】 A total of 226 questionnaires were collected by convenient sampling and questionnaire survey. The questionnaire covered two parts: basic information of the respondents, cognition and attitude towards hospice care (including four dimensions: basic knowledge of hospice care, knowledge of pain control, attitude and thought of hospice care, and attitude towards hospice care education). Excel software was used to preliminary screen, preprocess and establish database of data. SPSS21.0 was used for statistical analysis. T-test and ANOVA were used for difference analysis, multiple linear regression was used for correlation analysis. 【Results:】 High school students had a basic understanding of hospice care. Among the four dimensions of basic knowledge of hospice care, knowledge of pain control, attitude and thought of hospice care, and attitude towards hospice care education, the cognition of "knowledge of pain control" dimension was the weakest link, and the entry of "attitude and thought of hospice care" had the highest score, which was the strong cognitive link. 【Conclusion:】 The main influencing factors of high school students’ cognition of hospice care were family structure, family residence and whether they have understood hospice care. This paper recommended that schools should add medical humanities education courses related to hospice and death education, and cooperate with hospice care centers to carry out hospice care experience practices. It was also suggested that relevant departments or organizations should make full use of mainstream media, such as online media and WeChat public accounts, to strengthen the popularity and popularization of hospice care education and science popularization from multiple channels and aspects, and improve the level and quality of hospice care education for young people.

The Influence of Death Education on Medical Students' Attitudes towards End-of-Life Care: A Preliminary Study / 의학교육논단

End-of-life care competencies have been perceived as important and essential, so it has been suggested that end-of-life care be studied in undergraduate medical education. However, end-of-life care curriculum has mostly focused on acquisition of knowledge and skills rather than attitudes. Therefore, we aimed to explore whether education about death affects medical students' attitudes towards care for dying patients and perception of death anxiety, meaning in life, and self-esteem. A total of 15 first- or second-year medical students were surveyed with questionnaires before and after completing a 6-week death education course. Paired data analysis showed that participants' attitudes towards caring for terminally ill patients and their caregivers improved significantly (t=−2.84, p=0.013) with an effect size of 0.73. In contrast, no significant changes were found in death anxiety, meaning in life, or self-esteem. All participants agreed that formal teaching about death and dying must be encouraged in medical schools. Our results suggest that death education may positively influence attitudes towards end-of-life care. Although replication with larger samples is necessary, this preliminary finding may support the importance of developmentally appropriate end-of-life care education in medical schools.

A percepção de residentes multiprofissionais da área da saúde sobre o processo de morte / Healthcare multiprofessional residents' perception towards the dying process / Percepción de residentes multiprofesionales de la área de salud acerca del proceso de muerte

A morte e o processo de morrer estão constantemente na rotina dos profissionais de saúde, porém, estes nem sempre estão preparados para lidar com estas questões. O objetivo do estudo é verificar a percepção dos profissionais residentes da área da saúde sobre a morte. Trata-se de uma pesquisa descritiva exploratória de abordagem quantitativa, realizada com 129 residentes em um hospital terciário, e contemplou nove profissões, com predominância feminina e idade média de 25anos (desvio padrão de 2,1 anos). Foi aplicada a Escala de Avaliação do Perfil de Atitudes Acerca da Morte (EAPAM). A maioria dos participantes (63%) apresentou aceitação neutra em relação à morte, seguido de aceitação religiosa (16%). Em terceiro lugar está o medo da morte (11%). Por último, o evitamento e a aceitação de escape tiveram resultado similar (5% cada). O perfil de atitude do profissional em relação à morte pode contribuir com o desenvolvimento da Síndrome de Burnout, prejudicando sua saúde e qualidade do serviço prestado.

Death and the dying process are constantly in the health professionals' routine, though they are not always prepared to deal with those issues. The objective of this study is to check the healthcare resident professionals' perception of death. It is a descriptive exploratory research with quantitative approach made with 129 residents in a tertiary hospital, and it covered nine professions, with female predominance and average age of 25 (standard deviation of 2.1 years). The Death Attitude Profile Revised (DAP-R) was the instrument used. Most participants (63%) had neutral acceptance of death, followed by religious acceptance (16%). In third place is the fear of death (11%). At last, the avoiding of death and the escape acceptance had similar results (5% each). The professional's attitude profile toward death can contribute to the development of the Burnout Syndrome, which is harmful for their health and for the quality of the service done.

La muerte y proceso de morir están constantemente en la rutina de profesionales de salud, pero no siempre están listos para hacer frente a esas cuestiones. El objetivo del estudio es verificar la percepción de profesionales residentes del área de salud sobre la muerte. Se trata de una investigación descriptiva exploratoria con abordaje cuantitativa, efectuada con 129 residentes de hospital terciario, e incluyó nueve profesiones, con predominio del sexo femenino y edad media de 25 años (desviación estándar de 2,1 años). Se aplicó la Escala de Evaluación del Perfil de Actitudes sobre la Muerte. La mayoría de los participantes (63%) tuvieron una aceptación neutra en relación a la muerte, seguido de aceptación religiosa (16%). En tercer lugar encuentra-se el miedo (11%). Por último, evitación y aceptación del escape obtuvieron resultado similar (5% cada uno). El perfil de actitud del profesional en relación a la muerte puede contribuir al desarrollo del Síndrome de Burnout, perjudicando su salud y calidad del servicio prestado.

Grief Experience of Cancer Patients' Family Members:A Qualitative Study / 中国医学伦理学

Objective:To explore the grief experience offamily members after the cancer patients die .Meth-ods:Using the qualitative research , 14 bereaved family members were selected and interviewed deeply .Results:The grief experience of the bereaved family members included life retrospect , lack of social support , uncertainty to the future, social with drawal and peaceful acceptance .Conclusion:The grief experience is common in bereaved family members and grief should be concerned during the whole process of hospice care .Providing the bereaved family members with holistic support and death education can help them get through grief and return to the society .

Analysis and Countermeasures of Medical Student' s Cognition of Death / 中国医学伦理学

Objective: To understand the cognition of death among medical students and put forward some countermeasures .Methods:Stratified sampling was used to select 730 medical students in Fujian .A self -de-signed cognition of death questionnaire and Fear of Death Scale ( FODS) were adopted to conduct the survey .Re-sults:The general cognition of death among medical students was normal (84.8%).Fear of death, either towards themselves or their families , was significantly different in participants ' gender (χ2 =29 .552 , P<0 .001 ) , major (χ2 =6.343,P=0.042), and grade (χ2 =13.979, P=0.030).Thinking of death towards themselves was signif-icantly different in participants' living places (χ2 =10.110, P=0.006), bereavement experience (χ2 =7.353, P=0 .025 ) , religion (χ2 =16 .307 , P=0 .003 ) .Meanwhile , statistical significances were found in the thinking of death towards their families among different bereavement experience (χ2 =14.962, P=0.001) and religion (χ2 =12.359, P=0.015).Grade and religion greatly affected the attitudes towards death of families , while bereavement experience and grade had the great impact on the attitudes towards death of respondent themselves .In the fear of death for participant themselves and their families , gender made the biggest difference .Conclusion: Medical students have a high level of death anxiety .Medical universities and colleges should strengthen death education in medical students and improve its course system in the future .

Grief Experience of Cancer Patients' Family Members:A Qualitative Study / 中国医学伦理学

Objective:To explore the grief experience offamily members after the cancer patients die .Meth-ods:Using the qualitative research , 14 bereaved family members were selected and interviewed deeply .Results:The grief experience of the bereaved family members included life retrospect , lack of social support , uncertainty to the future, social with drawal and peaceful acceptance .Conclusion:The grief experience is common in bereaved family members and grief should be concerned during the whole process of hospice care .Providing the bereaved family members with holistic support and death education can help them get through grief and return to the society .

Analysis and Countermeasures of Medical Student' s Cognition of Death / 中国医学伦理学

Objective: To understand the cognition of death among medical students and put forward some countermeasures .Methods:Stratified sampling was used to select 730 medical students in Fujian .A self -de-signed cognition of death questionnaire and Fear of Death Scale ( FODS) were adopted to conduct the survey .Re-sults:The general cognition of death among medical students was normal (84.8%).Fear of death, either towards themselves or their families , was significantly different in participants ' gender (χ2 =29 .552 , P<0 .001 ) , major (χ2 =6.343,P=0.042), and grade (χ2 =13.979, P=0.030).Thinking of death towards themselves was signif-icantly different in participants' living places (χ2 =10.110, P=0.006), bereavement experience (χ2 =7.353, P=0 .025 ) , religion (χ2 =16 .307 , P=0 .003 ) .Meanwhile , statistical significances were found in the thinking of death towards their families among different bereavement experience (χ2 =14.962, P=0.001) and religion (χ2 =12.359, P=0.015).Grade and religion greatly affected the attitudes towards death of families , while bereavement experience and grade had the great impact on the attitudes towards death of respondent themselves .In the fear of death for participant themselves and their families , gender made the biggest difference .Conclusion: Medical students have a high level of death anxiety .Medical universities and colleges should strengthen death education in medical students and improve its course system in the future .

The integration research of death education and resilience cultivation on nursing students / 中国实用护理杂志

Objective Our aim was to study the influence of integration courses combining the death education and resilience cultivation on nursing students.Methods 290 nursing students were randomly divided into the control group and the intervention group with 145 students in each group.The students in the intervention group was provided with the integration courses for 20 class hours based on the curricula of the control group.The influence on the resilience,death anxiety,feeling of sense of life,coping style of students was observed.Results Measurement results showed that the students of two groups had no differences in the four aspects before education,but after education the two groups students showed significant difference,including the average score of resilience and death anxiety,total score of feeling of sense of life as well as the dimensions score of life goals and life value t value was 5.703,3.294,3.649,4.130 and 2.129,P ＜ 0.05.In addition,the mean effectiveness of positive coping styles,problem solving and seeking social support of the two groups showed significant difference too,and all the difference had statistical sense,t value was 1.992,1.977 and 3.344,P ＜ 0.05.Conclusions The integration course can reduce death anxiety as well as improve the resilience of nursing students.

Falando de morte e da finitude no ambiente escolar: um estudo à luz do sentido da vida / Speaking of death and finiteness in a school environment: a study in light of the meaning of life / Hablando de muerte y de la finitud en el ambiente escolar: un estudio a la luz del sentido de la vida

O presente estudo teve como objetivo identificar as concepções da morte e suas repercussões para o sentido da vida entre os adolescentes. Para tanto, foi efetuada uma pesquisa-ação para abordar o tema da finitude partindo da concepção de Viktor Frankl sobre o sentido da vida e da morte. Contou-se com a participação de 17 estudantes do terceiro ano do ensino médio, a maioria do sexo feminino (52,9%), com idade média de 17 anos e amplitude de 15 a 24 anos. Os resultados foram obtidos por meio de cinco intervenções em sala de aula. Cada intervenção teve a duração média de 45 minutos, constituindo-se de questionamentos acerca da morte, do morrer e do sentido da vida. Em seguida, as respostas dos participantes foram submetidas a uma análise de conteúdo. No que se refere às representações da morte, emergiram três categorias: pensamentos, sentimentos e crenças. Sobre a compreensão do sentido da vida, os adolescentes responderam em duas direções: os sentidos subjetivos e sentidos objetivos. Quando refletiram sobre a própria morte, as suas respostas foram classificadas em termos de três categorias valorativas: vivenciais, atitudinais e criativos. No que se refere à pergunta “Como seria a vida se ninguém morresse?”, foram observados os seguintes tipos de argumentos: valorização da vida, corrigir erros do passado, resposta tautológica, resposta religiosa e dialética vida-morte. Os resultados mostraram a importância de tratar sobre o tema da finitude no âmbito escolar...

The present study aimed to identify the conceptions of death and its implications for the meaning of life among adolescents. To that end, we performed an action-research to address the issue of finiteness starting from the Viktor Frankl conception about the meaning of life and death. We counted with the participation of 17 third year students in high school, the majority of them females (52.9%) with mean age 17 years, ranging from 15 to 24 years old. The results were obtained through five interventions in the classroom. Each intervention lasted on average 45 minutes, being constituted by the questions about death, dying and the meaning of life. Then, the participants' responses were subjected to content analysis. With respect to representations of death, three categories were revealed: thoughts, feelings and beliefs. About the understanding the meaning of life, the adolescents responded in two directions: the subjective and objective senses. When reflected on their own death, their answers were classified in terms of three evaluative categories: experiential, attitudinal and creative. With regard to the question “How would life be if nobody died”, the following types of arguments were observed: valuing life, correcting past mistakes, tautological answer, religious response and life-death dialectic. The results showed the importance of dealing with the subject of finitude in schools...

El presente estudio tuvo como objetivo identificar las concepciones de la muerte y sus repercusiones para el sentido de la vida entre los adolescentes. Para tanto, fue efectuada una pesquisaacción para abordar el tema de la finitud partiendo de la concepción de Viktor Frankl sobre el sentido de la vida y de la muerte. Se contó con la participación de 17 estudiantes de tercer año de enseñanza media, la mayoría del sexo femenino (52,9%), con edad media de 17 años y amplitud de 15 a 24 años. Los resultados fueron obtenidos por medio de cinco intervenciones en clase. Cada intervención tuvo la duración media de 45 minutos, siendo constituida de cuestionamientos acerca de la muerte, del hecho de morir y del sentido de la vida. A continuación, las respuestas de los participantes fueron sometidas a un análisis de contenido. En lo que se refiere a las representaciones de la muerte, emergieron tres categorías: pensamientos, sentimientos y creencias. Sobre la comprensión del sentido de la vida, los adolescentes respondieron en dos direcciones: los sentidos subjetivos y sentidos objetivos. Cuando reflexionaron sobre la propia muerte, sus respuestas fueron clasificadas en términos de tres categorías valorativas: vivenciales, actitudinales y creativas. En lo que se refiere a la pregunta “¿Cómo sería la vida si nadie muriese?”, fueron observados los siguientes tipos de argumentos: valorización de la vida, corregir errores del pasado, respuesta tautológica, respuesta religiosa y dialéctica vida-muerte. Los resultados mostraron la importancia de tratar sobre el tema de la finitud en el ámbito escolar...

Death Education for Medical Personnel Utilizing Cinema / 대한소화기학회지

Death and dying is an ultimate process that every human being must experience. However, in these days we do not like to think or discuss about death and dying. Actually, hatred and denial is the usual feeling when we encounter death and dying. Dying is more than a biological occurrence. It is a human, social, and spiritual event, but the spiritual dimension of patients is too often neglected. Whether death is viewed as a "wall" or as a "door" can have significantly important consequences for how we live our lives. Near death experience is one of the excellent evidences to prove that there should be spiritual component being separated from the human physical body when we experience death. People have called it soul, spirit, or nonlocal consciousness. Caregivers need to recognize and acknowledge the spiritual component of patient care. Learning about death and dying helps us encounter death in ways that are meaningful for our own lives. Among the several learning tools, utilizing cinema with its audio and visual components can be one of the most powerful learning tools in death education.

Research status on death education / 中华医学教育探索杂志

Death education that began in the western countries,starting with the rise of thanatolography,is the important content of modern education which can not be ignored.This paper summarized the definition,content,subjects and course of death education by reviewing the literatures,aiming to provide some reference for the death education at present in our country.

Desenvolvimento da Tanatologia: estudos sobre a morte e o morrer: [revisão] / Desarrollo de la Tanatología: estudios sobre la muerte y el morir: [revisar] / Development of Thanatology: studies about death and dying: [review]

Este artigo discute os principais temas e pesquisas na área da Tanatologia, estudos sobre a morte e o morrer. São apresentados os autores pioneiros que escreveram as primeiras obras de sistematização da Tanatologia entre os quais: Herman Feifel, Robert Kastenbaum e Elizabeth Kübler-Ross, e os principais temas de estudo: luto, violência e guerra, a morte e a TV, cuidados a pacientes gravemente enfermos, além da formação de profissionais da área de saúde e educação para lidar com pessoas vivendo situações de perdas e morte. São feitas propostas de estudos para o futuro desenvolvimento da Tanatologia em nosso país.

This study discusses the main themes and research related to Thanatology, studies of death and dying. The pioneer experts who wrote the early works that systematize the area are presented: Herman Feifel, Robert Kastenbaum and Elizabeth Kübler-Ross, as well as the main themes of study: bereavement, violence and war, death and TV, palliative care, training of health and education professionals to deal with people experiencing loss and death. Further studies to develop Thanatology in Brazil are proposed.

Este artículo discutí los temas principales, las investigaciones en el área de la Tanatología y estudios sobre la muerte y el morir. Son presentados los autores pioneros que escribieron las primeras obras sistematizadas de la Tanatología, entre los cuales: Herman Feifel, Robert Kastenbaum y Elizabeth Kübler-Ross. Se presentan también las áreas principales de estudios como: el duelo; la violencia; la guerra; la muerte y la televisión; los cuidados a los pacientes gravemente enfermos y la formación de profesionales del ámbito de la salud y de la educación para trabajar con personas que están viviendo situaciones de pérdida y muerte. También son realizadas propuestas de estudios para el futuro desarrollo de la Tanatología en nuestro país.

Survey on the influence of nursing major students'thanatopsis and values to hospice care / 中华医学教育探索杂志

Objective To search the status quo of students'thanatopsis in order to push focused education on terminal care to the nursing major students.Metheds To distribute home-made questionnaire to 268 nursing students.Results students who cannot talk about death normally account for 21.3 percent;who never considered death or unnecessary to consider death account for 12.9 percent of the total;who considered a lot account for 10 percent;who cannot handle terminally ill account for 74.3 percent;and who prefer self-suicide when suffered defeat account for 4.9 percent.Conclusion Nursing students have insufficient ideas of death,and they need to think deeply about the meaning of death and to nurture a positive outlook on death in order to get a correct terminal care education.

Survey of Curriculum in the Medical Humanities at Japanese Medical Schools. A Comparative Study between an Initial Survey in 1988 and a Second Survey in 1994 / 医学教育

This report provides information on curriculum in the medical humanities in Japanese medical schools. We sent a questionnaire to the same eighty medical schools in 1988 for the first survey, and again in 1994 for the second survey.<BR>Seventy-eight medical schools (98%) responded in the first survey, and all eighty medical schools (100%) responded in the second survey. A curriculum in medical humanities was offered at 67 medical schools (86%) in the 1st survey, and at 71 medical schools (89%) in the 2nd survey. Courses in medical humanities were required subjects in 63 medical schools (91%) in the 1st survey, and in 62 medical schools (87%) in the 2nd survey. These courses were taught in the 1st grade at 47 % of schools in the 1st survey and at 60% of schools in the 2nd survey. Total teaching time was 30hours in 33% of schools in the 1st survey and in 36% of schools in the 2nd survey. Subjects included in the medical humanities course included death, communication between doctors and patients, the bioethics of birth, organ transplantation, the history of medicine, and early exposure in the hospital. According to our survey the teaching of medical humanities has become popular at the new national medical schools. At present, it is one of the most important courses in medical education.

Experience of the Application of Modern Nursing Ethics to Hospice Care / 中国医学伦理学

Clinical treatment shows little significance for some terminal tumor in practice,in which case hospice care seems to be particularly important.During the application of modern nursing ethics to hospice care,some aspects should be bared in mind,including trying to meet the demand of patients and their family members,showing enough respect for their right to choose,and appropriately instructing death education.Meanwhile,communication and cooperation with other medical staff should also be stressed during hospice care.

Remark on Death Education from the point of Medical Personnel's Duty / 中国医学伦理学

Through analyzing medical personnel's duty under Bio-psycho-social Medical Mode, this paper states that medical personnel's duty should be emphasized not only on preventing and curing diseases, but also on solving patients' psychological problems.Therefore it states that death education, first, to medical professionals themselves,second,to the patients and their family,is very important,at last it also inquires into the mode of death education.