Terminal Care and Death Through the Eyes of Turkish Nursing Students: A Qualitative Research Study

Abstract

Aim: This study was aimed to determine the thoughts and feelings of nursing students emerging during the provision of care to terminally ill patients.
Material and Method: It is a qualitative study. The study population consisted of 12 students who volunteered to participate in the study. Data were collected using a semi-structured interview form and focus group interview technique. Descriptive and content analysis techniques were used for the data analyses.
Results: The study found out that the majority of the students defined death as a “sad ending” and “loss”. Some students stated that they kept an attitude of acceptance, while others stated that they experienced intense feelings of fear when they encountered death. The students stated that they generally felt sorry for the patient, felt ineffective, and experienced an intensification of their fears of death when providing care for terminally ill patients. Furthermore, all of the students said that terminal care should aim to “minimize pain and provide an abundance of resources”.
Conclusion: This study shows that nursing students need to get more education about terminal care and that further qualitative studies should be conducted to investigate the feelings of nursing students from various aspects.

Keywords

• nursing
• student
• terminal care
• death

Türk Hemşirelik Öğrencilerinin Gözünden Yaşam Sonu Bakım ve Ölüm: Bir Kalitatif Araştırma

Öz

Amaç: Araştırma, terminal dönem hastalarına bakım veren hemşirelik öğrencilerinin bakım sırasında yaşadıkları duygular ve ölüm hakkındaki düşüncelerini belirlemek amacıyla planlanmıştır.
Materyal ve Metot: Araştırma nitel desende tasarlanmıştır. Araştırma grubunu, çalışmaya katılmaya gönüllü olan 12 öğrenci oluşturmaktadır. Veriler yarı yapılandırılmış görüşme formu ve odak grup görüşmesi tekniği ile toplanmıştır. Verilerin analizinde, betimsel analiz ve içerik analizi tekniği kullanılmıştır.
Bulgular: Araştırmada, öğrencilerin büyük çoğunluğu ölümü “Hüzün verici bir son ve kayıp” olarak tanımlamıştır. İlk defa ölümle karşılaştıklarında bazı öğrenciler kabullenici bir tutum sergilediğini, bazıları ise korku duygusunu yoğun olarak yaşadıklarını ifade etmişlerdir. Öğrenciler, terminal dönem hastalarına bakım verirken genellikle hasta için üzüldüklerini, çersizlik hissettiklerini ve kendi adlarına da ölüm korkularının arttığını belirtmişlerdir. Ayrıca öğrencilerin tamamı, terminal dönem bakımın amacının, “az ağrı ve refah içinde ölüm” şeklinde olması gerektiğini söylemiştir.
Sonuç: Bu araştırma, hemşirelik öğrencilerinin terminal dönem bakımı konusunda daha fazla eğitime ihtiyaçları olduğunu ve bu konuda öğrencilerin duygularının farklı boyutlarıyla da ele alındığı nitel çalışmaların artırılması gerektiğini göstermektedir.

Kaynakça

1. 1. Kübler-Ross E. On death and dying (Büyükal B, Translation Editor). Istanbul: Boyner Holding Publications; (Original study publication date 1969).1997.
2. 2. Öz F. Basic concepts in healthcare. Publisher: Image Domestic and Foreign Trade (İmaj İç ve Dış Ticaret) Ankara. 2004.
3. 3. Eues SK. End-of-life care: improving quality of life at the end of life. Prof Case Manag. 2007;12(6):339-44. doi:10.1097/01.PCAMA.0000300408.00325.1c
4. 4. Sahin M, Demirkiran F, Adana, F. Nursing Students’ Death Anxiety, Influencing Factors and Request of Caring For Dying People. Journal of Psychiatric Nursing. 2016; 7(3):135–141. doi: 10.5505/phd.2016.66588
5. 5. Uysal N, Ceylan E, Koc A. Nursing Students' Attitudes on Care of Dying Individuals. Gumushane University Journal of Health Sciences. 2019; 8(1): 98- 105.
6. 6. Birol, L. Patient Care In Terminal Period. Editor: Nuran Akdemir, Leman Birol. Internal Diseases and Nursing Care. 1st edition. Publisher: Vehbi Koc Foundation SANERC. Publication No. 2, Istanbul, 210. 2003.
7. 7. Bilge A, Cam, O. Therapeutic approach of the psychiatric nurse to the terminally ill patient and his/her relatives. Journal of Ege University Faculty of Nursing. 2004; 20:127–36.
8. 8. Inci F, Oz F. Palliative care and death anxiety. Current approaches in Psychiatry. 2012; 4:178–87.

9. 9. Özer Z, Yıldırım D, Bölüktaş P. Attitudes of Nursing Students Towards Death. Journal of Economics and Social Research. 2015; 2(4): 1-13. doi: 10.10.2014/05.01.2015
10. 10. Xu F, Huang K, Wang Y, Xu Y, Ma L, Cao Y. A Questionnaire Study on the Attitude towards Death of the Nursing Interns in Eight Teaching Hospitals in Jiangsu, China. BioMed Research International. 2019; 1-8. https://doi.org/10.1155/2019/3107692
11. 11. Üstükuş A. Investigation of the effects of nurses' death anxiety on their approach to deadly patient. Cukuova university Health Science Institute Master Thesis. 2019.Adana-Turkey.
12. 12. Youssef HA. Nursing students' perception of dying and their contextualizing end of life and palliative care in nursing curriculum at Taif University. European Journal of Academic Essays. 2016; 3(5): 193-199.
13. 13. Cokluk O, Yilmaz K, Oguz EA Qualitative Interview Method: Focus Group Interview. The Journal of Theoretical Educational Science. 2011; 4(1):95-107.
14. 14. Kartal H, BalantekinY, Bilgin A, Soyucok M. Factors Affecting Bullying in Home and School Life: A Mixed Method Research. Journal of Qualitative Research in Education. 2019;7 (1): 50-85. doi:10.14689/issn.2148-2624.1.7c1s.3m.
15. 15. Isik E, Fadiloglu O, Demir YA Study of the Reliability and Validity of the Turkish Version of Death Attitude Profile in the Nurse Population.Turkish Journal of Research & Development in Nursing. 2009: 11(2): 28-43.
16. 16. Koku F, Ates M. Nurses' Experiences and Attitudes Towards Death in Improving the Quality of Terminall Ill Patient Care. Journal of Health and Nursing Management. 2016: 2, 3: 99-104. 17. Yilmaz E, Vermisli S. Attitudes of intensive care unit nurses toward death and provision of care to terminally ill patients. Celal Bayar University Journal of the Institute of Health Sciences. 2015: 2, 2, 41-46.
17. 18. Erdogan S, Nahcivan N, Esin N. Research in Nursing (First Edition). Nobel Tıp Kitabevleri Tic.Ltd.Şti.,150-155, İstanbul. 2014.
18. 19. Koc Z, Saglam Z. Determining the Emotions and Opinions of Nursing Students Related to End-Of-Life Care and Death State. Journal of Cumhuriyet University The School of Nursing. 2008 12: 13-21.
19. 20. Kurz M, Hayes E. End of life issues action: Impact of education. Int J Nurs Educ Scholarsh. 2006; 3:18.
20. 21. Tarhan F, Arı F. The Meanıng Unıversıty Students Gıve To Death And Death Anxıety Levels Accordıng To Theır Department. Yüzüncü Yıl University, Faculty of Education Journal. 2006; 2: 44-55.
21. 22. Bilge A, Embel N, Kaya FG. Attitudes of health professional students to death and the relationship between death anxiety and the variables affecting them. J Psy Nurs. 2013; 4: 119-124.
22. 23. Kumar S, Chris E, Pais M, et al. Nursing students' perceived attitudes towards death: a cross-sectional survey. Indian Journal of Forensic Medicine & Pathology. 2013; 7 (1): 5-15.
23. 24. Inci F, Oz F. Effects of death education on nurses' death anxiety, depression regarding death, and attitudes towards the dying patient. Anatolian Journal of Psychiatry. 2009;10: 253-260.
24. 25. Taşdemir G, Gök F. Bir sağlık yüksekokulu’nda okuyan öğrencilerin ölüm kaygılarının belirlenmesi. International Journal of Human Sciences [Online]. 2012; (9): 303-317.
25. 26. Ay F, Gencturk N. Midwifery Student’s Opinions Related to Death, Terminal Period and Palliative Care: Focus Group Study. Florence Nightingale Journal of Nursing. 2013; 21 (3): 164-171.
26. 27. Cavdar I. Care of the cancer patient in the terminal period. Turkish Journal of Oncology. 2011;26 (3): 142-147.
27. 28. Gurkan A, Gumus AB, Dodak H. The Opinions of Nursing Students about Issues of Terminal Stage Patients: The Investigation in the Context of Nursing Interventions, Patient Rights and Ethical Issue. M. Ü. Journal of Nursing Science and Art. 2011; 4 (1): 2-12.