Nurses’ Bereavement Needs and Attitudes Towards Patient Death: A Qualitative Descriptive Study of Nurses in a Dialysis Unit

Abstract

SUMMARY Background Dialysis nurses have a unique relationship with their patients and often require bereavement support should a patient death occur. This study was conducted in 2014 and aimed to explore the attitudes of dialysis nurses to death and dying and to identify suitable bereavement strategies following a death of a patient. Methods A purposeful, convenience sample of all nurses employed in the dialysis service completed a demographic profile and The Death Attitudes Profile Revisited (DAP_R) survey. Results There were 52 responses to the survey (98% response rate). The mean age of the participants was 45 years ± 8.0 years; 87% had >10 years nursing experience. Nurses suggest that debriefing and the use of a counsellor would support them in their grieving process while new graduate nurses appear to require extra support following a patient death. Analysis of the death attitude profile‐revised (DAP‐R) showed significant relationships between fear of death/death avoidance as well as fear of death/neutral acceptance. Spirituality and religion correlate strongly with ‘Approach Acceptance’ in this study group. Forty‐four percent people who ‘approach acceptance’ of death can be explained by the strength of religious beliefs. Conclusions Many dialysis nurses appear to have strong religious or spiritual belief systems and this contributes to their acceptance of death, although there also appears to be a degree of death avoidance. The study has highlighted the need to provide adequate bereavement support for dialysis nurses.

Correlates of perceived death competence: What role does meaning-in-life and quality-of-life play?

“…There is limited empirical knowledge about 21 st century community attitudes towards death and dying (Cox et al, 2013;Collins, McLachlan, & Philip, 2017). In Australia, studies have generally been small and focused on death attitudes of health professionals or patients (Halliday & Boughton, 2008;Hack et al, 2010;Peters et al, 2013;Tranter, Josland, & Turner, 2016;Collins et al, 2017), although two studies have examined death fear/anxiety in samples of Australian university students (Bath, 2010;Davis, Deane, & Lyons, 2016). Similarly, previous research worldwide has focused predominantly on death attitudes in relation to anxiety and fear, with calls for a broader focus including strengths-based death competencies and coping skills (Robbins, 1994;Neimeyer, Moser, & Wittkowski, 2003;Wass, 2004).…”

Translation and Cultural Adaptation of Death Attitude Profile Revised (Dap-R) for Use in Brazil

“…10,18,23 Thus, the DAP-R stands out for analyzing the construct from the positive (acceptance) and negative (fear, anxiety and avoid thinking or talking about death) constructs, and is one of the most psychometrically sound measures for assessing attitudes to death in the world. [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Thus, it is justified to perform the crosscultural adaptation of the scale in order to be able to conduct future studies that may allow comparisons between attitudes towards death in Brazil with other countries.…”

“…10 One of the most widely used instruments in international research to successfully measure attitudes towards death is Death Attitude Profile Revised (DAP-R). 6,[8][9][10][11] This Canadian instrument is distinguished for being a multidimensional measure that evaluates a broad set of attitudes, based on Kubler-Ross's conceptual analysis for death acceptance as the last stage of the dying process. 12 This model has inspiration and an existentialist orientation and understands that both fear and death acceptance are inseparable and are related to the search for meaning in life.…”

Dutch Healthcare Professionals Experiences of Assisted Dying: A Constructivist Qualitative Study Conducted in a Chronic Disease Care Centre and Hospice.

“…Psychological impacts related to natural deaths are reported (43,44,45), but studies focused on the impact of assisted deaths on professionals are lacking. Impacts of natural deaths may be heightened by close relationships (43,44) and, in this study, participants developed close bonds with assisted dying patients and their families. These developed over the weeks, or sometimes months, of assessment.…”

“…Practically, some professionals found post-death debriefing sessions helpful and there is evidence, related to natural deaths, that such discussions can support staff (44). Structured debriefing has also been shown to aid the development of nurses' clinical reasoning skills (46).…”