Effects of Death Anxiety and Perceived End-of-Life Care Competencies on Fear of Terminal Care among Clinical Nurses

Abstract

Purpose: The aim of this study was to examine the effects of death anxiety and perceived end-of-life care competencies on the fear of terminal care among clinical nurses. Methods: This correlational study was conducted from June to July 2021. The study included 149 clinical nurses employed at a tertiary hospital and seven other hospitals. The measurement tools used in this study were the Thanatophobia Scale (Cronbach’s α=0.87), the Death Anxiety Scale (Cronbach’s α=0.80), and the Scale of End-of-life Care Competencies (Cronbach’s α=0.94). These instruments were chosen to assess the levels of fear of terminal care, death-related anxiety, and competencies in end-of-life care. Results: The mean score for fear of terminal care was 3.32±1.32. Differences in fear of terminal care were observed based on the working unit, position, number of patients requiring terminal care, and ex- perience with end-of-life care education. Fear of terminal care was significantly positively correlated with death anxiety and significantly negatively correlated with end-of-life care competencies. In multiple regression analysis, the factors influencing fear of terminal care were attitudes toward end-of-life care competencies (β=-0.39, P＜0.001), death anxiety (β=0.24, P＜0.001), knowledge of end-of-life care competencies (β=-0.22, P=0.005), and behaviors related to end-of-life care competencies (β=-0.16, P=0.021). These factors explained 64.6% of the total variance (F=25.54, P＜0.001). Conclusion: This study suggests that developing nurses’ end-of-life care competencies and reducing death anxiety are cru- cial for managing the fear of terminal care. Therefore, providing end-of-life care education and psychological support programs is important.