Acceptance Of Death Research Articles

Death acceptance among Lodha older adults: their perceptions of ‘good death’ during the COVID-19 pandemic

ABSTRACT A ‘good death’, one that is natural and involves lesser suffering and distress, is elusive in the present time. Indiscriminate uses of life-sustaining medical technologies in present times only lead older people and their families to frantically search for ‘good death’. On the other hand, there is little information on ageing and dying in folk and indigenous societies. In response to the huge information deficit, this article attempts to explore perceptions about death in old-age among Lodhas, a Mundari-speaking tribal community of eastern India. Interacting with only living 15 elderly members in a hamlet let us know their beliefs like, 1. Death being inevitable, they do not seek medical interventions to postpone it; 2. Close connection with nature till death brings peace; 3. No compromise with personal autonomy; and 4. Filial piety in moments of dying. The study theorises their indigenous beliefs are keys to ageing and dying well in the Lodha community. Hopefully, the insights from the ethnic group will be a lesson for modern societies to overcome death anxiety in old-age.

Gender Perspective on Neutral Acceptance of Death: A Study of Nepalese Youth

Background & Objective: This study explores gender differences in the neutral acceptance of death among Nepalese youth. Neutral acceptance is defined as the recognition of death as a natural and inevitable part of life without judgment or strong emotions. Methods: A cross-sectional, explanatory quantitative study was conducted among 196 college students using simple random sampling. Data were collected through the Death Attitude Profile—Revised (DAP-R), specifically focusing on neutral acceptance. The study employed statistical tests such as the Chi-Square test and independent samples t-test to assess gender differences in attitudes toward neutral acceptance. Results: The findings revealed significant gender differences in neutral acceptance of death. Female participants exhibited a higher mean score (M = 4.23) compared to males (M = 3.93). Statistical analysis (p = 0.003) confirmed that females are more likely to adopt a neutral acceptance of death than males. Conclusion & Recommendation: The study concludes that Nepalese females tend to exhibit a higher neutral acceptance of death than males, likely due to cultural and social factors that encourage emotional openness and caregiving roles. These findings suggest the need for further exploration of how gender influences death attitudes and coping mechanisms in Nepalese society. Novelty: This research fills a gap in understanding gender-specific differences in neutral death acceptance, shaped by societal norms and cultural factors. The study provides insights into how male and female perspectives on death vary, offering valuable information for mental health, policy, and cultural discussions around death and gender roles in Nepalese society.

Unmet Spiritual Needs: A Study among Patients with Chronic Illness

Objectives: The conventional healthcare system operates on the ‘physiological man’ and overlooks the ‘spiritual man’. Many studies reported on the unmet spiritual needs of terminally ill patients. Despite spiritual care being a predictor of a positive mindset (meaning making) among patients with terminal illnesses, assessing spiritual needs and providing adequate spiritual care is still a distant phenomenon in the healthcare setting. Materials and Methods: With the help of a spiritual needs questionnaire, we analysed the unmet spiritual needs and preferences of 30 terminally ill patients. Specific attention was given to psychosocial, emotional, existential, religious and acceptance of death. Results: The results show that 72% of terminally ill patients reported a strong desire to have their spiritual needs met. Psychosocial needs scored the highest, while acceptance of dying scored the least. The need to be connected with the family was one of the strongest wishes expressed in the study. Religious needs ranked as the second category of needs. Findings show that the highest needs are intertwined with the patients’ culture. Conclusion: In India, religion and family connections are essential; terminally ill patients expressed the desire that meeting these two aspects makes their lives meaningful even at the end stage. The results warrant a spiritual needs assessment as a deathbed test to make the end–of–life more meaningful.

Embracing mortality: psychological preparation on death in the guidance of stoic philosophy

Humanity's greatest fear is the inevitability of death, the ultimate fate that all strive to evade. This collective dread of mortality stems from its perceived malevolence. Across the ages, from religious rituals promising salvation to scientific efforts to delay death, human attempts to confront mortality vary widely. Yet death remains inescapable, a natural consequence of life. While religious doctrines offer comfort through ideas of an afterlife, and science views death as a biological challenge to be postponed. Conversely, philosophy advocates for an intellectual acceptance of death's inevitability. The Stoic Philosophy, in particular, advocate for the joyful acceptance of death as an integral part of life. This philosophical stance fosters a positive perspective on death, encouraging individuals to live life to its fullest potential. Embracing death with joy entails psychological reassurance and preparatory measures for life's inevitable end. This qualitative study explores psychological preparation for death using primary and secondary data sources. Primary sources include the philosophical texts by Seneca and Marcus Aurelius, specifically "Letters to Lucilius," "On the Shortness of Life," and "Meditations." Secondary data is collected from peer-reviewed journals, books, and reports that contextualize these works within modern psychological frameworks. The primary audience includes individuals preparing for death due to age or illness and those grieving loved ones, offering a pathway to peace and understanding through Stoic wisdom. Moreover, this will be a guidance to those who work with the terminally ill people to get psychological resilience. By embracing death, Stoicism encourages both the dying and the bereaved to find psychological reassurance and encourage all to live a meaningful life in the given time frame.

The Impact of Palliative Care Knowledge and Death Attitudes on Palliative Care Attitudes Among Vocational Nursing Students

This study investigates the relationships between palliative care knowledge, death attitudes, and palliative care attitudes among vocational nursing students, aiming to identify factors that influence their approach to end-of-life care. Through an online survey, data were collected on demographics, palliative care knowledge, death attitudes, and attitudes toward palliative care. Pearson correlation and linear regression analyses revealed that palliative care attitudes were significantly influenced by both knowledge and death attitudes. Specifically, natural acceptance of death positively impacted palliative care attitudes, while escape acceptance and fear of death had negative effects. These findings suggest that fostering natural acceptance of death and addressing death-related fears in educational programs can help improve vocational nursing students' attitudes toward palliative care and enhance their readiness for end-of-life care.

A Study on the Analysis of the Recognition Factors of Good Death for the Elderly: Focusing on Acceptance of death, Death anxiety, Ego integrity

A Study on the Analysis of the Recognition Factors of Good Death for the Elderly: Focusing on Acceptance of death, Death anxiety, Ego integrity

Exploring the Influence of Family Dynamics on Death Attitude among Elderly People: A Comparative Study of Chitwan and Jhapa District, Nepalrict, Nepal

This research examines the impact of living arrangements on death attitudes among elderly individuals in Nepal's Chitwan and Jhapa districts. A cross-sectional survey of 127 participants (79 in elder homes, 48 in their own homes) was conducted and analyzed using SPSS v.20. Significant differences in death attitudes were found based on living arrangements. Elder home residents showed greater acceptance of quick death, less fear, and viewed death more as relief from pain. They preferred dying in religious places, while those in their own homes preferred passing at home. Belief in reincarnation was higher among those living independently. The study reveals that living environments significantly influence elderly individuals' death attitudes, with elder home residents exhibiting more acceptance towards death. These findings suggest a need for tailored end-of-life care and support services that consider living arrangements and cultural contexts, contributing to the discourse on geriatric care in diverse settings.

Family presence during resuscitation: a survey of Japanese physicians’ views

Abstract Aim This study aimed to clarify physicians’ awareness of and attitudes toward family presence during resuscitation (FPDR) and related factors. Subject and methods A web-based questionnaire survey was conducted of 7859 physicians who were members of the Japanese Society of Intensive Care Medicine (survey period: October 12, 2022, to December 31, 2022). Focusing on cardiopulmonary arrest, the survey questioned their awareness and attitudes, with a comparison of exogenous and non-exogenous patients. Results The proportion of respondents who have family present during resuscitation was 100 (25.0%) for exogenous and 105 (29.2%) for non-exogenous. The proportion who believed that the family’s acceptance of death is greater with FPDR was 255 (61.7%) for exogenous and 245 (65.7%) for non-exogenous. The proportion who believed that the family’s acceptance of death is greater with FPDR included a significantly higher number of respondents who had family present than in the proportion who believed that FPDR has no effect. The proportion who believed that the family is emotionally traumatized by FPDR was 251 (60.8%) for exogenous and 217 (58.2%) for non-exogenous. The proportion who believed that families are emotionally traumatized by FPDR included a significantly higher number of respondents who do not have family present than the proportion who believed that FPDR has no effect. Conclusion Various international resuscitation guidelines have recommended FPDR from an early stage to alleviate grief and prevent mental disorders. However, these guidelines are not always followed in Japan.

The Relationship Between Body Image and Meaning of Life Among Women with Breast Cancer in Kerman, Iran

We aimed to examine the relationship between body image and the meaning of life among women with breast cancer. The analytic sample included 142 women with breast cancer, and data were collected using a standardized questionnaire through face-to-face interviews. We used Kolmogorov–Smirnov test, Pearson test, Spearman and Mann–Whitney U test to determine the relationship between the research variables. We found an association between the mean score of body image and the mean score of the meaning of life. As the average score of body image increases, the score of the meaning of life increases (p < 0.05). Findings indicated that the body image score increases by increasing the score of the meaning of life and its dimensions, especially existential vacuum and acceptance of death. Future research and targeted treatments should consider the role of body image in shaping the meaning of life among women with breast cancer.

Critical Care Experience Shapes Respiratory Therapists' Attitudes toward Death: A Survey Study.

Respiratory therapists (RTs) frequently encounter death in their work with critically ill patients. Healthcare providers' attitudes toward death significantly affect their approach to caring for dying patients; however, there is a lack of knowledge on RTs' attitudes toward death. This study examines how the work environment and personal characteristics of RTs influence their attitudes toward death. Utilizing the Death Attitude Profile-Revised-Chinese questionnaire, a cross-sectional survey compared non-critical care RTs (non-CCRTs, N = 86) to critical care RTs (CCRTs, N = 85). Non-CCRTs displayed significantly lower scores in overall acceptance of death compared to CCRTs (p = 0.015) and a tendency to actively avoid thoughts about death (p = 0.005). CCRTs scored higher in "neutral acceptance" (p = 0.015), and non-CCRTs exhibited higher scores on items reflecting a negative attitude toward death. RTs with shorter professional tenures showed heightened fear of death and avoidance tendencies. Perception of life and death education correlated with higher "fear of death" and "death avoidance" scores (p = 0.001). The findings indicate that CCRTs demonstrate a more neutral acceptance of death. Additionally, experience, sex, mental health status, and life-death education exposure significantly influence RTs' attitudes toward death.

Differentiating between romantic and mature love: Revisiting the three caskets.

Freud's paper on the three caskets is revisited. His view that the lead casket represented death is supported by extracts from The Merchant of Venice, in particular the song, "Tell Me Where is Fancy Bred". It is argued that the acceptance of death is a necessary step in the transformation of romantic love to mature love. With experience of reality a disillusion of romantic idealisation becomes possible, but this means that losses have to be accepted and mourned. It is argued that this is made more bearable if an ironic stance enables an acceptance of the pleasures of romance without believing them to be literally true.

Den queer Pontoppidan

AbstractIn this article, we pursue the idea that Pontoppidan’s writing lends itself well to being read with a queer theoretical approach. We focus on Jakobe in Lykke-Per/A Fortunate Man and show how, by virtue of her morbidity, her Jewish otherness, her intelligence, her entrepreneurial initiative and her care for the children of the proletariat, she is an excellent example of Jack Halberstam’s “female masculinity”. In De Dødes Rige/ Realm of the Dead, the author has taken his two main characters out of bourgeois society’s worship of the future in the form of the young child – what Lee Edelman calls “reproductive futurism”. Therein also lies an acceptance of death and the end that departs much from the common worship of progress and future, what Sarah Ensor calls “terminal temporality”. Finally, we point out that there are probably limitations to how queer the author was able to be, a child of his time like anyone else.

‘You Also Have to Let People Go’—Effects of Formative Experiences with Dying and Death on Medical Trainees’ Attitudes

This study investigates the effects of medical students’ and residents’ formative patient death experiences on their understanding of the role of the physician in dealing with dying patients. Analyses revealed a change in attitude, an acceptance of death as ‘part of life’. Thoughtful and comprehensive care, allowing patients to die and enabling them to have a beautiful death, were identified as the physician’s duty. Honesty, well timing and completeness were determined as the guiding principles of communication. The importance of distancing and keeping in control to practice the medical profession was stressed. The burdensome nature of making therapeutic decisions was emphasized.

The Associations of Perceived Self-Efficacy with Emotional Intelligence, Personality, Resilience, and Attitudes Towards Death among Midwives.

Midwives' self-efficacy can significantly affect the provided care and, therefore, maternal and neonatal outcomes. The aim of the present study was to investigate associations of perceived self-efficacy with emotional intelligence, personality, resilience, and attitudes towards death among midwives in Greece. From 2020 to 2022, a total of 348 midwives were recruited in this descriptive cross-sectional study. The participants were employed as independent professionals, in public hospitals or regional health authorities. Data collection involved five research instruments: the General Self-Efficacy Scale (GSES), the Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF), the Eysenck Personality Questionnaire (EPQ), the Connor-Davidson Resilience scale (CD-RISC), and the Death Attitude Profile-Revised (DAP-R) scale. The mean score for the GSES was 29.1 (SD = 4.2), suggesting a moderately elevated level of self-efficacy among midwives. The results revealed that higher scores on the GSES were significantly associated with higher scores on the Extraversion subscale (p < 0.001) and lower scores on the Neuroticism (p < 0.001) and Lie (p = 0.002) subscales of the EPQ. Additionally, high self-efficacy was significantly correlated with high emotional intelligence (p < 0.001), high neutral acceptance of death (p = 0.009), and high resilience (p < 0.001). These findings highlight the relationship between the self-efficacy of Greek midwives and various psychological factors, as well as the multifaceted nature of self-efficacy and its importance for midwives' psychological well-being and professional functioning.

#1686 How do older people with advanced kidney disease and their family members approach kidney treatment decision-making? A qualitative study

Abstract Background and Aims Chronic kidney disease (CKD) is common in the UK, especially amongst frail older people with multiple health problems. The survival benefit of kidney replacement therapy (KRT) for such patients is uncertain and the burdens significant, meaning patients make difficult decisions between planning for dialysis or opting for conservative kidney management (CKM). People close to individuals with advanced CKD are known to play an important role in treatment decision-making, but data exploring their perspectives are limited. This qualitative study aimed to explore older, comorbid patients’ and family members’ understanding of and views regarding treatment decision-making. Method In-depth interviews were conducted in person in 2018-2019 among older patients with advanced CKD (&amp;gt;80 years old or &amp;gt;65 with evidence of frailty or comorbidity) and least one family member (partner/spouse/child/grandchild) per patient. Interviews used open-ended questioning, supported by a topic guide based on patient input and the literature. Transcripts were analysed using inductive thematic analysis and constant comparison to identify concepts and meanings from participants’ views and reported experiences. Codes and interviews were discussed and compared among study investigators, with consideration of wider meaning, alongside reorganisation and recoding, and thematic development. Results Ten patients and 12 family members (6 spouses/partners, 5 adult children and 1 adult grandchild) were interviewed. Four themes were identified: (1) “whose decision is it anyway?”; (2) “facing uncertainty”; (3) “on death and dying” and (4) “caring and being cared for”. “Whose decision is it anyway?” speaks to perceived nuances around the ownership of decisions about kidney therapy. While some interviewees described the decision belonging solely to the patient, others described varying degrees of collaboration with and persuasion from family members (particularly partners/spouses). Clinician influence was also described by patients and family members. “Facing uncertainty” captures patients’ and their family members’ view that decisions are contingent upon largely uncertain future circumstances. “On death and dying” describes the pivotal role in treatment decision-making of patients’ and family members’ sense of life completion and feelings about death and dying. KRT was perceived as life-prolonging, while an acceptance of death and dying was seen to be important for consideration of CKM. “Caring and being cared for” elucidates the importance of caring roles between patients and their family members for decisions about the future, including the specific effect of loving relationships on the value patients and their family members assign to living. Conclusion We found both patients and family members influence treatment decisions, which they tend to view as flexible in the face of uncertainty. The desire to prolong important family relationships was a motivator for favouring KRT, in light of an understanding of KRT as life-prolonging. Kidney services should recognise the significance of family relationships to older patients’ treatment decision-making. Clinicians must ensure that patients and family members understand the implications of treatment choice for quality-of-life, prognosis, and end-of-life care. This is likely to include understanding which family members or close ones are important, involving these people in decision-making and recognising that changes in family situations may necessitate re-visiting previous decisions.

Determining the Effect of Psychological Resilience on Death, the Fear of Death, and Death Acceptance in Nursing Students in Turkey.

This study will investigate the effects of psychological resilience on death, fear of death and acceptance of death in nursing students. This study was descriptive and cross-sectional. The sample of the study consisted of 270 students who voluntarily participated. The data were collected using a descriptive characteristics questionnaire, the resilience scale for adults (RSA) and the multidimensional orientation to death and dying inventory MODDI-F. A positive and significant correlation was found between the Acceptance Subscale, RSA and MODDI-F subscale scores. Nursing students' attitudes towards death and dying are affected by their psychological resilience. Psychological resilience should be increased because nursing students are candida for future caregivers. For this reason, within the scope of the findings of the study, it is recommended that during the theoretical and practical nursing education process, students should be reinforced by conducting studies on the dying patient through educational teaching methods such as role play and case presentations. In addition, ıt is thought that an interview or focus group on nursing students' psychological resilience and attitudes towards death can provide a more comprehensive source of information on the subject.

남성 독거노인의 죽음 불안과 수용에 관한 웰다잉 집단미술치료 질적 사례연구

In the second half of life, as people get older, they are more frequently exposed to the death of acquaintances, and some of the older adults have very intensive anxiety about death. In particular, the anxiety tends to be severe in older men who are living alone in poor health and in poverty. Accordingly, this study was conducted in the context of examining the specific background of the death anxiety among older men living alone and helping them to accept their death as a natural phenomenon. The participants in this study were four older men who were members of a senior welfare center located in Seoul, and all of them had lived alone for at least 20 years. A group art therapy program based on acceptance and commitment therapy was conducted on them once a week for 10 weeks. The researcher attempted to have interaction verbally with them related to life or death while helping and/or intervening in their work activities in each session, and had in-depth interviews with each of them after the program ended twice. Through within-case and cross-case analyses of the verbal interaction and in-depth interviews conducted in each session, sub-themes and themes corresponding to two categories of death anxiety and acceptance were derived. As a result, 29 sub-themes were derived from the within-case analyses of the death anxiety category, and they were integrated into 5 themes through cross-case comparisons. The five themes were ‘death recognized in childhood’, ‘death to come soon’, ‘despair and fear of death’, ‘sleepless nights due to death anxiety’, and ‘wishing for a painless death’. Meanwhile, for the category of death acceptance, 22 sub-themes were derived from within-case analyses and integrated them into 4 themes through the cross-case comparisons. The four themes were ‘a new life in the face of death’, ‘a peaceful zone in the storm of death’, ‘composure toward death’, and ‘a valuable gift gained from the program’. In addition, older men living alone not only reduced their anxiety about death but also developed an attitude of naturally accepting death as a part of life while participating in the program of this study. Although the findings of this study were derived from a program conducted on a small group, they are significant in terms of their effectiveness in preventing suicide. In other words, it can be said that the well-dying art therapy program would lower the risk of suicide by providing opportunities for communicating about life and death to vulnerable older people who are at high risk of suicide due to illness or poverty.

When Meaningful Movies Invite Fear Transcendence: An Extended Terror Management Account of the Function of Death in Movies

Meaningful movies can serve as an anxiety buffer against the fear of death, unless death plays a central role in the movie. This invites the question what happens when death is central to a movie storyline. The present research introduces and tests the so-called fear transcendence route, a second terror management route in which meaningful movies about death invite viewers to virtually confront and transcend their fear of death. Two experiments ( N = 206; N = 401) tested three preconditions for fear transcendence, that is, (1) death is salient in real life; (2) death is central to the storyline, and (3) the movie projects a specific meaning to death. We assessed effects on fear transcendence, operationalized as decreased fear of death; decreased death avoidance; increased death acceptance. Especially older viewers became less avoidant and more accepting of death when the preconditions for fear transcendence were met. Meaningful movies about death can thus evoke fear transcendence.

Cross-Cultural Comparison of Older Adults' Emotional Responses Toward Death: A Pilot Study.

The current study reports preliminary findings from a pilot sample that sought to compare the emotional responses of older adults toward death in Egyptian and Spanish cultures. A cohort of 90 eligible older adults from Egypt and Spain were recruited using a cross-sectional descriptive design. Egyptian participants recorded a significantly higher score in approaching acceptance of death compared to their Spanish counterparts (mean = 21.57, SD = 9.4 and mean = 13.51, SD = 7.11, respectively). Post-hoc test showed there were differences in levels of valence (F[1,86] = 23.88, p < 0.001), indicating that older adults in Spain perceived such images as more unpleasant compared to Egyptian older adults. A significant difference related to death attitude profile scale was noted between Egyptian and Spanish older adults. Egyptian and Spanish older adults demonstrated different attitudes toward death in addition to differences in death anxiety and depression. This preliminary study validates the importance of developing effective nursing strategies to lessen anxiety and fear about death. [Research in Gerontological Nursing, 17(3), 112-120.].

Influencing Factors on Death Acceptance Among Thai Older Persons

ABSTRACT Objectives This study aimed to investigate both the direct and indirect effects of various factors on the acceptance of death. Methods This cross-sectional study included 800 older Buddhist persons in Thailand, who were recruited through a multistage sampling method. Data were collected using six questionnaires and analyzed through path analysis using the MPlus program. Results Death anxiety was the main factor influencing death acceptance, with death anxiety exerting a negative direct effect on death acceptance. Buddhist beliefs about death demonstrated both a positive direct effect on death acceptance and a positive indirect effect on death acceptance through Buddhist practices. Furthermore, Buddhist practices exhibited a positive direct effect on death acceptance, while social support also showed a positive direct effect on death acceptance. Conclusions This study highlights the significant direct and indirect effects on death acceptance among older Thai Buddhists. Clinical implications Buddhist-aligned interventions may be more effective and readily embraced by Thai older persons. For those who are receptive, nurses can foster death acceptance by developing interventions that reduce death anxiety and promote Buddhist beliefs about death, Buddhist practices, and social support.