Effects of Death Anxiety and Perceived End-of-Life Care Competencies on Fear of Terminal Care among Clinical Nurses

Purpose The aim of this study was to examine the effects of death anxiety and perceived end-of-life care competencies on the fear of terminal care among clinical nurses. Methods This correlational study was conducted from June to July 2021. The study included 149 clinical nurses employed at a tertiary hospital and seven other hospitals. The measurement tools used in this study were the Thanatophobia Scale (Cronbach’s α=0.87), the Death Anxiety Scale (Cronbach’s α=0.80), and the Scale of End-of-life Care Competencies (Cronbach’s α=0.94). These instruments were chosen to assess the levels of fear of terminal care, death-related anxiety, and competencies in end-of-life care. Results The mean score for fear of terminal care was 3.32±1.32. Differences in fear of terminal care were observed based on the working unit, position, number of patients requiring terminal care, and experience with end-of-life care education. Fear of terminal care was significantly positively correlated with death anxiety and significantly negatively correlated with end-of-life care competencies. In multiple regression analysis, the factors influencing fear of terminal care were attitudes toward end-of-life care competencies (β=-0.39, P<0.001), death anxiety (β=0.24, P<0.001), knowledge of end-of-life care competencies (β=-0.22, P=0.005), and behaviors related to end-of-life care competencies (β=-0.16, P=0.021). These factors explained 64.6% of the total variance (F=25.54, P<0.001). Conclusion This study suggests that developing nurses’ end-of-life care competencies and reducing death anxiety are crucial for managing the fear of terminal care. Therefore, providing end-of-life care education and psychological support programs is important.