A Descriptive Study To Assess The Perception On Death And Dying Among Nursing Students In Selected Colleges Of Nursing In Udupi District, Karnataka State

Introduction

Student nurses are involved in caring for patients who are dying or who have been told they have a terminal illness and are faced with the process of dying. Students encounter these patients in hospitals, nursing homes, at home or in hospice care settings. Nurses are the healthcare providers that are most often with individuals at the end of their lives. Nurses should be knowledgeable about end-of-life care. Studies show that, only 0.41% of nurses are certified in palliative care. Nursing students often have a difficult time coping with the stress that comes with caring for those who are dying. Student nurses need to be prepared to take an active role in caring for patients who are dying or have been told they have a terminal illness. Students are in clinical settings where they may encounter death and dying. The purpose of this study is to understand the nursing student's perception in caring for dying patients and their families. The researcher seeks to gain an understanding of nursing students' (1) thoughts about caring for dying patients and their families, (2) feelings about caring for dying patient and their families, and (3) communication with dying patients and their families. The objectives of the study were to assess nursing students perception on death and dying and to identify the perception on death and dying among nursing students of different levels.

Materials and Methods

A survey approach was adopted with a descriptive design and was conducted in selected Colleges of Nursing in Udupi district, Karnataka. Tool 1: Demographic Proforma and Tool 2: Semi- structured questionnaire on perception on death and dying (section A: Regarding thoughts, section B: Regarding feelings and section C: Regarding challenges) were developed by the researcher and were validated by three experts in the field of nursing. Pretesting was done among 5 samples to determine the clarity of items. Pilot study was conducted among 20 samples. Non-probability convenient sampling technique was used to select the samples. Sampling criteria were those who are willing to participate in the study and who are undergoing B.Sc or PBB.Sc or M.Sc nursing programme. Main study was conducted in selected Colleges of Nursing in Udupi district, Karnataka state among 210 nursing students. The obtained data were analyzed based on the objectives and the hypothesis by using descriptive statistics with the help of SPSS version 16.

Results

Analysis is done by using descriptive statistics. Data is organized under the following headings.

• Section 1: Description of sample characteristics.

• Section 2: Description of nursing students' perception on death and dying

• Section 3: Description of perception on death and dying among nursing students of different levels.

Section1 : Sample characteristics

Table 1: Frequency and Percentage distribution of sample characteristics (n=210)

Section 2: Description of nursing students perception on death and dying

Fig 1: Thoughts perceived by nursing students on death and dying (n=210)

The data presented in Fig 1 shows that while caring dying patients and their families, 66.6% perceived thoughts regarding the physical, emotional, spiritual care given to patients who were dying and 77.6% regarding their family or friends. 57.1% perceived thoughts regarding their sufferings, death as a relief from suffering and there was a relief felt for the patient when they are no longer dealing with the illness or pain. 88% perceived thoughts about a realization that, death is a part of life, 29.5% perceived thoughts about the survival and 42.8% perceived that being able to care for dying patients as a privilege and it is an opportunity to work with those who are going through the dying process.

Fig 2: Feelings perceived by nursing students on death and dying (n=210)

The data presented in Fig 2 shows that, 40.5% nursing students had physiological symptoms like nausea, muscle tension, headache , 53.8% had fear, 68.5% developed compassion, 86.6% had sadness and 46.2% developed anxiety while caring for dying patients and their families.

Fig 3: Challenges perceived by nursing students on death and dying (n=210)

The data presented in Fig 3 shows that, 67.1% of nursing students unaware about how to communicate with unresponsive patient, 61.9% expressed they had language barrier and 71.4% developed problems related to severe emotions while caring dying patients and their families.

Section 3: Description of perception on death and dying among nursing students of different levels.

The data presented in Table 2 shows that while caring dying patients and their families, majority of fourth year B.Sc nursing students had perceived thoughts regarding the physical, emotional, spiritual care given to patients who were dying. Majority of M.Sc nursing students had perceived thoughts regarding their family or friends. Majority of fourth year B.Sc nursing students had perceived thoughts regarding their sufferings, death as a relief from suffering and there was a relief felt for the patient when they are no longer dealing with the illness or pain. Majority of M.Sc nursing students had perceived thoughts about a realization that, death is a part of life. Majority of first year B.Sc nursing students had perceived thoughts about the survival and Majority of PBB.Sc nursing students perceived that being able to care for dying patients as a privilege and it is an opportunity to work with those who are going through the dying process. Majority of first year B.Sc nursing students had physiological symptoms like nausea, muscle tension, headache; fear, sadness and anxiety while caring for dying patients and their families. Majority of first year B.Sc nursing students were unaware about how to communicate with unresponsive patient, expressed they had language barrier and developed problems related to severe emotions while caring dying patients and their families.

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Fig. 1

Thoughts perceived by nursing students on death and dying (n=210)

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Fig. 2

Feelings perceived by nursing students on death and dying (n=210)

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Fig. 3

Challenges perceived by nursing students on death and dying (n=210)

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Discussion

Conclusion

Understanding students' perceptions of death and dying can help educators prepare students for these situations by using the research available to plan better ways to teach students about the needs (physical, spiritual, emotional and social) of the dying/terminal patient and their family. There is a great need to educate students about death and dying, cultural competence, communication skills and coping with emotional stress.