Abstract

BackgroundThe denial of death in Western society deprives young people of the tools to derive meaning from experiences of death and dying. Literature shows that death education may allow them to become familiar with this topic without causing negative effects. This article describes the effects of a death education course with adolescents, wherein participants were given the opportunity to meet palliative doctors and palliative psychologists at school and in a hospice, where they were able to converse with the families of the dying.MethodsThis study used mixed methods and included an evaluation of a death education intervention with longitudinal follow-up of outcomes. The course involved 87 secondary school students (experimental group) aged between 16 and 20 years. We also recruited a control group of 76 similarly-aged students to observe differences. The variables we examined were: alexithymia, representation of death, value attributed to life and spirituality. These were measured with the following instruments: the Toronto Alexithymia Scale-20, the Testoni Death Representation Scale, the Personal Meaning Profile and the Spiritual Orientation Inventory, respectively. To better understand how the students perceived the experience, we asked the experimental group to answer some open-ended questions. Their answers were analysed through thematic analysis.ResultsThe study showed that death education and the hospice experience did not produce negative effects, but rather allowed students to decrease alexithymia, improving their ability to recognise and express emotions. Thematic analysis revealed that all participants perceived the experience as very positive.ConclusionsOur findings affirm that death education programs can be successfully implemented in high schools, and that they can usefully involve local hospices and palliative care professionals, especially physicians and psychologists.

Highlights

  • The denial of death in Western society deprives young people of the tools to derive meaning from experiences of death and dying

  • The only significant result pertains to the spirituality dimension, which was higher among participants in the Death Education (DE) group than among those in the No Death Education (NoDE) group

  • We found that psychometric scores generally remained stable over time – namely those relating to ontological representations of death, personal meaning attributed to life and spirituality

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Summary

Introduction

The denial of death in Western society deprives young people of the tools to derive meaning from experiences of death and dying. The representation of death in adolescence is halfway between the magical thinking of childhood and the complex ideation of adulthood [9, 10], and it is characterised by the maturation of abstract cognitive thinking skills, which open up existential questions about life and the afterlife and enable reflection on the meaning of death This is the period in which personal opinions on religion develop in parallel with trust or estrangement from one’s childhood faith, and in which one begins to search for their own spirituality and transcendent truth [7, 11,12,13]. Several studies have shown that it is important to stimulate this dimension in adolescence because it protects against depressive symptoms and other mental health risks [15,16,17] and improves resilience when dealing with negative life events [18,19,20]

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