© Journal of Medicine and Biomedical Sciences, ISSN: 20780273, May, 2010
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1
Lecturer of Adult Care Nursing,
2
Lecturer of Gerontological Nursing,
Faculty of Nursing, Mansoura University &’
(
()*+,#-. to provide quality care at the end of life, nurses must not only possess knowledge and skills to
provide effective endoflife care, but must also develop the attitudes and interpersonal competence to provide
compassionate care. /. this study aimed to assess nurses' attitude toward death and caring for dying patients and
to examine relationships among demographic variables and nurse’s attitudes toward death and caring for dying
patients. /+-. In this study descriptive and correlation design was used. 0/: sample of this study is a
convenient sample of 197 nurses from Oncology Center and medical and surgical departments in Mansoura University
Hospital. Two tools were used to collect data. /#0/. the main results yielded that, the majority of subjects (58.9 %)
has fair attitude level and there is no statistically significant relationship between nurse's age, years of experience,
work place, and the total score of FATCOD scale. On the others hand, there is a statistical significant relationship
between nurses educational level and number of deaths attended by the nurse and their total score of FATCOD scale.
-)#/-/. this study concluded that nurses with higher education and repeated attendance of deaths had a more
positive attitude toward care of dying patients. )-0-. An introduction of end of life care concept in
undergraduate curriculum may improve nurses' readiness and attitude toward care of dying patients.
1" 2,/. nursing, care, Dying patients, Mansoura University hospitals
Dying is the final portion of the life cycle for all of us. Providing excellent, humane care to patients near the end
of life, when curative means are either no longer possible or, no longer desired by the patient, is an essential part of
nursing and medicine. The American Geriatrics Society (AGS) recognizes that most people near the end of life want to
live as fully as they can. They want their health care providers to honor their wishes and goals and to help them
maintain their dignity and independence while relieving symptoms and maximizing comfort
(1)
. To provide quality care
at the end of life, nurses must not only possess the knowledge and skills to provide effective endoflife care, but must
also develop the attitudes and interpersonal competence to provide compassionate care
(2)
.
With cancer being a disease that predominantly affects adults and an aging population, the absolute numbers
of patients being diagnosed with cancer will continue to increase. Although many treatments are successful and
patients go on to live their expected life spans, many other therapies fail and these patients will not survive
(3)
. Nurses
working in oncology departments routinely encounter patients whose illness progresses despite aggressive efforts to
extend life. While there have been important advances in cancer care over the past several decades, and recent
remarkable progress in treating a few specific neoplasms, approximately half of all patients diagnosed with cancer will
eventually die as a consequence of their illness or related complications. Caring for people as they die is therefore, an
integral part of oncology nursing practice
(4)
. In addition caring for the elderly dying patient presents particular
challenges because co morbid medical conditions and disabilities increase susceptibility to complications and add to
the symptom burden
(5)
.
Nurses often care for patients in all stages of disease, from diagnosis to death or survivorship. A nurse's
caseload in a shift can consist of patients in varying phases of illness, presenting a challenge to nurses who must
constantly adjust to the different needs of each patient and their families. The attitudes of nurses toward death and
dying patients may influence the care nurses are able to provide
(6)
. although a systematic investigation of the variables
that are important in providing effective care for the dying has not been conducted, the variables of death anxiety and
attitudes toward death and dying have been identified within the clinical literature as being significant. Nurses who are
anxious in relation to death and have negative attitudes toward death are described as retreating from dying patients
and therefore unable to provide effective care
(7)
.
Ideal positive attitudes to care of the dying are defined as flexibility in interpersonal relations, desire for open
communication about critical issues, and psychological mindedness in relation to patients and families of dying
patients. Caring for an individual with a terminal illness requires great ski11 and understanding on the part of nurses
(8)
.
The characteristics of the nurse as a person are critical in the establishment of nurses attitudes towards care of the
dying patients. How nurses feel about caring for persons with a terminal illness will depend, to a large extent, on the
nurses' feelings and ideas about death and dying, their religious convictions, and their philosophies of death and life
(9)
.
Lev (1986)
(10)
refers to attitudes as a pattern of views reflecting cumulative prior perceptions and experiences
which includes cognitive, affective and behavioral components. The cognitive component adopts the premise of a
human's need for balance, symmetry or reduced dissonance. In striving to achieve consistency attitudes may undergo
change. The second aspect of attitudes is the affective component. Positive or negative tendencies toward the object