Skip to main content

Advertisement

SpringerLink
Log in

Factors associated with death anxiety and nurses’ preparedness to care for the dying patients with COVID-19

  • Published:
Current Psychology Aims and scope Submit manuscript

Abstract

Death is the most traumatic life experience among humans. Nurses' caring for dying patients increases their death anxiety, especially during pandemics. This study examined factors associated with nurses' death anxiety and preparedness to care for dying patients diagnosed with COVID-19 in Jordan.

A cross-sectional correlation study recruited 400 nurses from six hospitals with specialized COVID-19 units in Jordan. Nurses have moderate levels of death anxiety and preparedness to care for the dying. Furthermore, the result revealed statistically significant differences in death anxiety levels and nurses’ readiness to care for dying patients according to their demographic and professional characteristics.

As nurses’ death anxiety is negatively associated with their preparedness to care for dying patients, implementing adequate assessment of nurses' death anxiety to encourage early intervention through counseling and organizing training programs to improve their preparedness to care for the dying is highly recommended.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

  • Abu Hasheesh, M., AboZeid, A., El-Said, G., & Alhujaili, A. (2013). Nurses’ characteristics and their Attitudes toward Death and Caring for Dying Patients in a Public Hospital in Jordan. Health Science Journal, 7(4), 384–395.

    Google Scholar 

  • Adegoke, O., & Ajuluchukwu, J. N. (2019). Demographic characteristics and causes of death for persons brought in dead to emergency department of tertiary health facility in South-West Nigeria. Nigerian Postgraduate Medical Journal, 26(1), 45–52.

    Article  PubMed  Google Scholar 

  • Afshar, P., Javadian, H., Sadeghmoghaddam, L., & Farhadi, A. (2021). Relationship between death anxiety and Mental Health of Nurses Working in Bushehr Persian Gulf Martyrs Hospital at the Time of Coronavirus Virus. Quaternary Journal of Nursing Management, 10(2), 68–75.

    Google Scholar 

  • Al Qadire, M. Jordanian Student Nurses’ Attitudes towards the Care of Dying Patients. (2020), OMEGA—Journal of Death and Dying, 1–13. https://doi.org/10.1177/0030222820971077.

  • Alwidyan, M., Oteir, A., Mohammad, A., & Williams, B. (2021), Are healthcare professionals in Jordan willing to work and provide care for COVID-19 patients? Australasian Journal of Paramedicine, 18, https://doi.org/10.33151/ajp.18.924 .

  • Barrett, C. (2013) Death Anxiety. In: Encyclopedia of Behavioral Medicine, edn. Edited by Gellman MD, Turner JR. New York, NY: Springer New York, 541–542.

  • Bibi, A., & Khalid, M. A. (2020). Death anxiety, perceived social support, and demographic correlates of patients with breast cancer in Pakistan. Death Studies, 44(12), 787–792. https://doi.org/10.1080/07481187.2019.1614108

    Article  PubMed  Google Scholar 

  • Brady, M. (2015). Death anxiety among emergency care workers. Emergency Nurse, 23(4), 32–37. https://doi.org/10.7748/en.23.4.32.e1448

    Article  PubMed  Google Scholar 

  • Buttler, R., Monsalve, M., Thomas, G. W., Herman, T., Segre, A. M., Polgreen, P. M., & Suneja, M. (2018). Estimating time physicians and other healthcare workers spend with patients in an intensive care unit using a sensor network. The American Journal of Medicine, 131(8), 972.e9-972.e15. https://doi.org/10.1016/j.amjmed.2018.03.015

    Article  Google Scholar 

  • Chang, H. T., Lin, M. H., Kuo, W. H. (2021), Primary care staff’s willingness to participate in compassionate community network and palliative care and the barriers they face: a mixed methods study. BMJ open, 11(9), https://doi.org/10.1136/bmjopen-2020-046961.

  • Chew, N. W., Lee, G. K., Tan, B. Y., Jing, M., Goh, Y., Ngiam, N. J., ... & Sharma, V. K. (2020). A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak. Brain, behavior, and immunity, 88, 559–565.

  • Choi, J., Gu, M., & Oh, S. (2022). Relationship between End-of-Life Care Stress, Death Anxiety, and Self-Efficacy of Clinical Nurses in South Korea. International Journal of Environmental Research and Public Health, 19(3), 1082. https://doi.org/10.3390/ijerph19031082

    Article  PubMed  PubMed Central  Google Scholar 

  • Coffey, A., McCarthy, M. G., & Weathers, E. (2016). Nurses’ Knowledge of Advance Directives and Perceived Confidence in End-of-Life Care: A Cross Sectional Study in Five Countries. International Journal of Nursing Practice, 22(3), 247–257. https://doi.org/10.1111/ijn.12417

    Article  PubMed  PubMed Central  Google Scholar 

  • Collett, L. J., & Lester, D. (1969). The Fear of Death and the Fear of Dying. Journal of Psychology: Interdisciplinary and Applied, 72(2), 179–181. https://doi.org/10.1080/00223980.1969.10543496

    Article  PubMed  Google Scholar 

  • Emaliyawati, E., Ibrahim, K., & Trisyani, Y. (2021). Determinants of nurse preparedness in disaster management: A cross-sectional study among the community health nurses in coastal areas. Open Access Emergency Medicine: OAEM, 13, 373–379. https://doi.org/10.2147/OAEM.S323168

    Article  PubMed  PubMed Central  Google Scholar 

  • Farajzadeh, M., GhaneiGheshlagh, R., & Beiramijam, M. (2017). Preparedness of nurses for crises and disasters in imam Khomeini and social security hospitals of Saqqez. Health in Emergencies and Disasters Quarterly, 3(1), 57–63.

    Article  Google Scholar 

  • Farhadi, A., Javadian, H., & Afshar, P. (2021). Prediction of Mental Health by Religious Orientation and the Mediating Role of Death Anxiety Among Nurses in the Covid-19 Pandemic. Research Square. https://doi.org/10.21203/rs.3.rs-620594/v1

    Article  Google Scholar 

  • Farmani, H. A., Mirhfez, R. S., & Kavosi, A. (2018). Dataset on the Nurses’ Knowledge, Attitude and Practice towards Palliative Care. Data in Brief, 22, 319–325. https://doi.org/10.1016/j.dib.2018.11.133

    Article  PubMed  PubMed Central  Google Scholar 

  • Fernandez, R., Lord, H., & Halcomb, E. (2020). Implications for COVID-19: A systematic review of nurses’ experiences of working in acute care hospital settings during a respiratory pandemic. International Journal of Nursing Studies, 111, 103637. https://doi.org/10.1016/j.ijnurstu.2020.103637

    Article  PubMed  PubMed Central  Google Scholar 

  • Forte, G., Favieri, F., & Tambelli, R. (2020). COVID-19 pandemic in the Italian population: Validation of a post-traumatic stress disorder questionnaire and prevalence of PTSD symptomatology. International Journal of Environmental Research and Public Health, 17(11), 4151. https://doi.org/10.3390/ijerph17114151

    Article  PubMed  PubMed Central  Google Scholar 

  • Galehdar, N., Toulabi, T., & Kamran, A. (2020). Exploring nurses’ perception of taking care of patients with coronavirus disease (COVID-19): A qualitative study. Nursing Open, 8(1), 171–179. https://doi.org/10.1002/nop2.616

    Article  PubMed  PubMed Central  Google Scholar 

  • Gazi, M., Rashid, H. U., & Mr, A. (2021). Readiness of nurses to provide nursing care for COVID-19 patients at COVID dedicated hospitals in Dhaka, Bangladesh. Bangladesh Medical Research Council Bulletin, 46, 161–167. https://doi.org/10.3329/bmrcb.v46i3.52250

    Article  Google Scholar 

  • Gillan, P. C., van der Riet, P. J., & Jeong, S. (2014). End of life care education, past and present: A review of the literature. Nurse Education Today, 34(3), 331–342.

    Article  PubMed  Google Scholar 

  • Halliday, L. E., & Boughton, M. A. (2008). The moderating effect of death experience on death anxiety: Implications for nursing education. Journal of Hospice & Palliative Nursing, 10(2), 76–82.

    Article  Google Scholar 

  • Ho, C. S., Chee, C. Y., & Ho, R. C. (2020). Mental health strategies to combat the psychological impact of COVID-19 beyond paranoia and panic. Annals of the Academy of Medicine, Singapore, 49(1), 1–3.

    Google Scholar 

  • Huang, L. C., Tung, H. J., & Lin, P. C. (2019). Associations among Knowledge, Attitudes, and Practices toward Palliative Care Consultation Service in Healthcare Staffs: A Cross-Sectional Study. PLoS ONE. https://doi.org/10.1371/journal.pone.0223754

    Article  PubMed  PubMed Central  Google Scholar 

  • Karabağ Aydın, A., & Fidan, H. (2022). The Effect of Nurses’ Death Anxiety on Life Satisfaction During the COVID-19 Pandemic in Turkey. Journal of Religion and Health, 61(1), 811–826.

    Article  PubMed  Google Scholar 

  • Kudubes, A. A., Akıl, Z. K., Bektas, M. & Bektas, A. (2019), Nurses’ attitudes towards death and their effects on spirituality and spiritual care. Journal of Religion and Health, 1–9. https://doi.org/10.1007/s10943-019-00927-2.

  • Labrague, L. J., & De Los Santos, J. A. A. (2020). COVID-19 anxiety among front-line nurses: Predictive role of organisational support, personal resilience and social support. Journal of Nursing Management, 28(7), 1653–1661. https://doi.org/10.1111/jonm.13121

    Article  PubMed  PubMed Central  Google Scholar 

  • Labrague, L. J., & McEnroe-Petitte, D. M. (2018). Job stress in new nurses during the transition period: An integrative review. International Nursing Review, 65(4), 491–504.

    Article  PubMed  Google Scholar 

  • Lai, J., Ma, S., & Wang, Y. (2020). Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Network Open, 3(3), e203976.

    Article  PubMed  PubMed Central  Google Scholar 

  • Landeros-Olvera, E., Mondragon-Sanchez, E. J., & Pérez-Noriega, E. (2020). Validation of Collett-Lester Fear of Death Scale in a Mexican University Nursing student. MedUNAB, 23(1), 23–34.

    Google Scholar 

  • Lázaro-Pérez, C., Martínez-López, J. Á., Gómez-Galán, J., & López-Meneses, E. (2020). Anxiety about the risk of death of their patients in health professionals in Spain: Analysis at the peak of the COVID-19 pandemic. International Journal of Environmental Research and Public Health, 17(16), 5938.

    Article  PubMed  PubMed Central  Google Scholar 

  • Le, X. T. T., Nguyen, Q. T., Onyango, B., Nguyen, Q. N., Pham, Q. T., Ta, N. T. K., ... & Ho, C. S. (2021). Perception toward exposure risk of COVID-19 among health workers in Vietnam: Status and correlated factors. Frontiers in public health, 9, 589317.

  • Lee, K. A., Brennan, W. C., & Meterko, M. (2015). Organization of Nursing and Quality of Care for Veterans at the End of Life. Journal Pain Symptom Manage, 49(3), 570–577. https://doi.org/10.1016/j.jpainsymman.2014.07.002

    Article  Google Scholar 

  • Lee, S. A., Jobe, M. C., Mathis, A. A., & Gibbons, J. A. (2020). Incremental validity of coronaphobia: Coronavirus anxiety explains depression, generalized anxiety, and death anxiety. Journal of Anxiety Disorders, 74, 102268.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lester, D. (1990). The collett-lester fear of death scale: The original version and a revision. Death Studies, 14(5), 451–468. https://doi.org/10.1080/07481189008252385

    Article  Google Scholar 

  • Lester, D., & Abdel-Khalek, A. (2003). The Collett-Lester Fear of Death Scale. Death Studies, 27, 81–85. https://doi.org/10.1080/07481180390136946

    Article  PubMed  Google Scholar 

  • Lund, C., Breen, A., & Flisher, A. J. (2010). Poverty and common mental disorders in low and middle income countries: A systematic review. Social Science & Medicine, 71(3), 517–528.

    Article  Google Scholar 

  • Mallon, A., Hasson, F., & Casson, K. (2021). Young adults understanding and readiness to engage with palliative care: Extending the reach of palliative care through a public health approach: A qualitative study. BMC Palliative Care, 20(1), 1–13. https://doi.org/10.1186/s12904-021-00808-0

    Article  Google Scholar 

  • Mateo, J. D., Carlos, M. A., & Chua, W. R. V. (2020). You’ll get used to it: A lived experience of Filipino nurses in dealing with death and dying patient. Enfermería Clínica, 30(107–112), 955–959. https://doi.org/10.1188/08.ONF.955-959

    Article  Google Scholar 

  • Menzies, R. E., Zuccala, M., Sharpe, L., & Dar-Nimrod, I. (2018). The effects of psychosocial interventions on death anxiety: A meta-analysis and systematic review of randomised controlled trials. Journal of Anxiety Disorders, 59, 64–73.

    Article  PubMed  Google Scholar 

  • Mokhtari, R., Moayedi, S., & Golitaleb, M. (2020). COVID-19 pandemic and health anxiety among nurses of intensive care units. International Journal of Mental Health Nursing, 29(6), 1275.

    Article  PubMed  PubMed Central  Google Scholar 

  • Mondragón-Sánchez, E. J., Cordero, E. A. T., Espinoza, M. D. L. M., & Landeros-Olvera, E. A. (2015). A comparison of the level of fear of death among students and nursing professionals in Mexico. Revista Latino-Americana De Enfermagem, 23(2), 323–328. https://doi.org/10.1111/inm.12800

    Article  PubMed  PubMed Central  Google Scholar 

  • Naeem, F., Irfan, M., & Javed, A. (2020). Coping with COVID-19: Urgent need for building resilience through cognitive behaviour therapy. Khyber Medical University Journal, 12(1), 1–3.

    Google Scholar 

  • Neto, M. L. R., Almeida, H. G., & Esmeraldo, J. D. (2020). When health professionals look death in the eye: The mental health of professionals who deal daily with the 2019 coronavirus outbreak. Psychiatry Research, 288, 112972.

    Article  PubMed  PubMed Central  Google Scholar 

  • Nia, H. S., Lehto, R. H., Ebadi, A., & Peyrovi, H. (2016). Death anxiety among nurses and health care professionals: A review article. International Journal of Community-Based Nursing and Midwifery, 4(1), 2–10.

    PubMed  PubMed Central  Google Scholar 

  • Nienaber, K., & Goedereis, E. (2015). Death anxiety and education: A comparison among undergraduate and graduate students. Death Studies, 39(8), 483–490. https://doi.org/10.1080/07481187.2015.1047057

    Article  PubMed  Google Scholar 

  • Othman, E. H., Khalaf, I. A., Alosta, M. R., Abualruz, H., & Zeilani, R. (2022). Death and Dying Through the Lens of Jordanian Muslim Patients and Caregivers. OMEGA-Journal of Death and Dying, 00302228221133505.

  • Pappa, S., Ntella, V., & Giannakas, T. (2020). Prevalence of Depression, Anxiety, and Insomnia Among Healthcare Workers During the COVID-19 Pandemic: A systematic review and meta-analysis. Brain, Behavior, and İmmunity, 88, 901–907. https://doi.org/10.1016/j.bbi.2020.05.026

    Article  PubMed  PubMed Central  Google Scholar 

  • Peters, L., Cant, R., & Payne, S. (2013). How Death Anxiety Impacts Nurses’ Caring for Patients at the End of Life: A Review of the Literature. The Open Nursing Journal, 7, 14–21. https://doi.org/10.2174/1874434601307010014

    Article  PubMed  PubMed Central  Google Scholar 

  • Pokpalagon, P. (2005). Knowledge, attitude, and caring behavior for end of life patients among professional nurses in governmental hospital, Bangkok, Unpublished master’s thesis, Mahidol University, Bangkok, Thailand.

  • Pratumwan, R., & Unipun, J. (1995). The relationship between selected factors and competencies of professional nurses in caring the dying patients. Journal of Nursing Science Chulalongkorn University, 4(2), 51–67.

    Google Scholar 

  • Reid, C., Jones, L., Hurst, C., & Anderson, D. (2018). Examining relationships between socio-demographics and self-efficacy among registered nurses in Australia. Collegian, 25(1), 57–63.

    Article  Google Scholar 

  • Sánchez-Anguita Muñoz, Á., Pulido López, M. F., & Conde Vieitez, J. (2018). Self-efficacy and anxiety in female hospital healthcare workers. Ansiedad y Estrés, 24(2–3), 1134–7937. https://doi.org/10.1016/J.ANYES.2018.08.002

    Article  Google Scholar 

  • Subih, M., Al-Amer, R., & Malak, M. Z. (2022). Knowledge of Critical Care Nurses About End-of-life Care Towards Terminal Illnesses: Levels and Correlating Factors. The Journal of Health Care Organization, Provision, and Financing, 59(1–9), 00469580221080036.

    PubMed  Google Scholar 

  • Tamrakar, P., Pant, S. B., and Acharya, S. P. (2021), Anxiety and Depression Among Nurses in COVID and non‐COVID Intensive Care Units. Nursing in Critical Care.

  • Todaro-Franceschi, V. (2013). Critical Care Nurses’ Perceptions of Preparedness and Ability to Care for the Dying and Their Professional Quality of Life. Dimensions of Critical Care Nursing, 32(4), 184–190. https://doi.org/10.1097/DCC.0b013e31829980af

    Article  PubMed  Google Scholar 

  • Van Riesenbeck, I., Boerner, K., & Barooah, A. (2015). Preparedness for Resident Death in Long-term Care: The Experience of Front-line Staff. Journal of Pain and Symptom Management, 50(1), 9–16. https://doi.org/10.1016/j.jpainsymman.2015.02.008

    Article  PubMed  PubMed Central  Google Scholar 

  • Wolf, A. L., Delao, M. A., & Perhats, C. (2015). Exploring the Management of Death: Emergency Nurses’ Perceptions of Challenges and Facilitators in the Provision of End-of-Life Care in the Emergency Department. Journal of Emergency Nursing, 41(5), e23–e33. https://doi.org/10.1016/j.jen.2015.05.018

    Article  PubMed  Google Scholar 

  • World Health Organization. Novel Coronavirus (2019-nCoV), Situation Report -1. 2020. World Health Organization, (2007) mental health definition.

  • World Health Organization, (2020). WHO Coronavirus (COVID-19) dashboard. https://covid19.who.int

  • Wu, B., Zhao, Y., & Xu, D. (2020). Factors associated with nurses’ willingness to participate in care of patients with COVID-19: A survey in China. Journal of Nursing Management, 28(7), 1704–1712. https://doi.org/10.1111/jonm.13126

    Article  PubMed  PubMed Central  Google Scholar 

  • Xia, L., & Kongsuwan, W. (2020). Factors relating to nurses’ end-of-life care. Journal of Biosciences and Medicines, 8(6), 189–200.

    Article  Google Scholar 

  • Xu, F., Huang, K., and Wang, Y. (2019), A Questionnaire Study on the Attitude Towards the Death of the Nursing Interns in Eight Teaching Hospitals in Jiangsu, China. BioMed Research International, 3107692. https://doi.org/10.1155/2019/3107692 .

  • Yurtseven, Ş, & Arslan, S. (2021). Anxiety levels of university hospital nurses during the Covid-19 pandemic. Perspectives in Psychiatric Care, 57(4), 1558–1565. https://doi.org/10.1111/ppc.12719

    Article  PubMed  PubMed Central  Google Scholar 

  • Zhang, M. W., & Ho, R. (2017). Moodle: The cost effective solution for internet cognitive behavioral therapy (I-CBT) interventions. Technology and Health Care, 25(1), 163–165.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. King Hussein Cancer Canter, Amman, Jordan

    Shifa’ Ayed Alrafati

  2. School of Nursing, The University of Jordan, Amman, Jordan

    Ruqayya Zeilani

  3. Faculty of Nursing, Applied Science Private University, Amman, Jordan

    Elham H. Othman

Authors
  1. Shifa’ Ayed Alrafati
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ruqayya Zeilani
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Elham H. Othman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ruqayya Zeilani.

Ethics declarations

Ethical approval statement

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of The University of Jordan.

Informed consent

Informed consent was obtained from all individual participants included in the study

Competing interest

The authors have no competing interests to declare that are relevant to the content of this article.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Alrafati, S.A., Zeilani, R. & Othman, E.H. Factors associated with death anxiety and nurses’ preparedness to care for the dying patients with COVID-19. Curr Psychol 43, 6464–6474 (2024). https://doi.org/10.1007/s12144-023-04758-z

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12144-023-04758-z

Keywords

Search

Navigation