Intervention “Dying care” in Patients with Death Anxiety in a Secularised Society

Wednesday, 24 July 2013

Helena Kisvetrová, PhDr, MSc, RN
Department of Nursing, Palacky University Olomouc, Faculty of Health Sciences, Olomouc, Czech Republic

Learning Objective 1: The learner will be able to meet the activities of the intervention Dying care, which are performed by Czech nurses for patients with Death anxiety.

Learning Objective 2: The learner will be able to realise that a secularised society may affect the choice of nursing activities of Dying care in terminally ill patients.

Purpose:  Secularisation is a phenomenon in contemporary consumer society. Death anxiety causes distress in the final stage of life, connected with the fear of pain, process of dying and confrontation with the Unknown. The NIC intervention “Dying care” consists of activities for bio-psycho-social-spiritual support. The aim was to learn which activities are realised by Czech nurses caring for the terminally ill with the nursing diagnosis Death Anxiety and which activities are feasible to be implemented into nursing practice in the Czech secularised society. The study is a part of a larger research focused on death anxiety.

Methods: Quantitative research, structured questionnaire with Likert scales. Respondents: 468 nurses. Workplace: hospice, oncology, geriatrics, long-term care institution, home for the elderly, home care. Length of work experience 15.5 years, SD 10.6 Statistical processing: chi-squared test with Bonferroni correction, Mann-Whitney and Kruskal-Wallis tests.

 Results: These activities were considered the most important: “Monitor pain” (38.9%), “Support the family’s efforts to remain at the bedside” (36.3%) and “Minimize discomfort, when possible” (22.4%). 11.3% responded „Facilitate obtaining spiritual support for patient and family”. In practice, the most common activities were: “Assist with basic care, as needed” (scale average 1.27), “Monitor pain” (1.29) and “Provide frequent rest periods” (1.34). Implementation of these activities was considered feasible in the Czech nursing practice. Depending on the type of workplace (more common with hospice nurses; p<0.05): “Monitor mood changes”, “Facilitate obtaining spiritual support for patient and family” and “Facilitate discussion on funeral arrangements”. Depending on the length of work experience (nurses with longer experience): “Monitor mood changes” (p=0.036) and “Include the family in care decisions and activities, as desired” (0.042). 

 Conclusion: The results suggest the influence of a secularised society on the nursing practice. Activities concerning psycho-social and spiritual dimensions are considered important, but are realised more often by hospice nurses.