Neutral Acceptance Research Articles

When we Talk about Neutral Acceptance... and When We Talk About the Fear of Death of Others...

When we Talk about Neutral Acceptance... and When We Talk About the Fear of Death of Others...

The Relationship Between Death and Do Not Resuscitation Attitudes Among Intensive Care Nurses.

This study aimed to determine the relationship between death and DNR attitudes among ICNs. This descriptive-analytical study was performed on 156 ICNs in 2018. All nurses were enrolled in the study; data collection instruments included Death Attitude Profile-Revised (DAP-R) and the DNR attitude questionnaires. The mean scores of DAP-R and DNR items were 150.89/ ± 23.59 and 91.82 ± 11.41, respectively. There was a significant relationship between death attitude and DNR attitude Famong ICNs. All dimensions of DAP-R significantly predicted attitude toward DNR (P < 0.05). Among those, "neutral acceptance" (1.17 [95% CI (0.68--1.65)] was the strongest predictor and "death avoidance" was the weakest predictor (0.36 [95% CI (0.09--0.62)]. There was a significant relationship between the ICNs' work experience and attitude toward DNR (p = 0.03). The findings can be used in formulation of the national guideline for DNR order.

A comparative study of death anxiety and death attitudes in Han and Tibetan ethnic groups

This study compared the responses of 380 Han and 315 Tibetan respondents regarding their attitudes about death and factors influencing those attitudes using the Death Anxiety Scale and Death Attitude Profile-Revised. The results show that Tibetan respondents expressed more death anxiety, fear of death, death avoidance, and escape acceptance than the Han participants, while Han participants showed more neutral acceptance than the Tibetan participants. There was a significant interaction between age and gender around Approaching Death. In addition, the death attitudes of Han and Tibetan participants were influenced by religious beliefs, funeral experiences, and the way their families talked about death.

Fear of Death and Death Acceptance Among Bereaved Adults: Associations With Prolonged Grief.

This study aimed to analyze fear of death and neutral acceptance of death after a significant loss and their associations with prolonged grief. The sample of the study included 239 bereaved participants. Time since the loss ranged from 6 to 72 months. We found that neutral acceptance of death was associated with older age, a natural cause of death, and the ability to find meaning in the death of a close one. Fear of death was negatively associated with the frequency of practicing religion. We found that fear of death but not neutral acceptance was significantly associated with prolonged grief symptoms.

Death Attitudes, Palliative Care Self-efficacy, and Attitudes Toward Care of the Dying Among Hospice Nurses.

Previous research has linked death attitudes, palliative care self-efficacy, and attitudes toward care of the dying among nursing students and other nursing samples, but not among hospice nurses. The purpose of this study was to investigate these relationships among hospice nurses (N = 90). More positive attitudes toward care of the dying were associated with lower fear of death and death avoidance as well as higher neutral acceptance and escape acceptance, but not with approach acceptance. More positive attitudes toward care of the dying was associated with perceived capability to answer end-of-life concerns, but not with perceived capability to respond to end-of-life symptoms. Clinical interventions seeking to improve attitudes toward care of the dying among hospice nurses may be most effective by targeting death attitudes and improving self-efficacy in the area of discussing end-of-life concerns with patients.

Investigation of Nursing Students’ Attitudes Towards Death and Their Perceptions of Spirituality and Spiritual Care

Nurses are responsible for meeting the care needs of dying patients and their families, including their physical, psychological, emotional and spiritual assessment and care. The aim of this descriptive study was to investigate nursing students' attitudes towards death and their perceptions of spirituality and spiritual care. The study sample consisted of 237 second-, third- and fourth-grade nursing students. Data were collected using a "Personal Information Form", the "Spirituality and Spiritual Care Rating Scale (SSCRS)" and "Death Attitude Profile-Revised (DAP-R)". Number, percentage, mean, standard deviation and Spearman's correlation analysis were used for analysis. Participants stated that they had witnessed death before (73.8%), that spiritual care of dying patients and their families should be given special importance (93.7%) and that they feel incompetent in providing spiritual care (86.1%). Participants had a mean SSCRS score of 3.45 ± 0.43. They had the highest and lowest scores on the DAP-R subscales of "fear of death" (4.48 ± 0.83) and neutral acceptance (3.71 ± 1.21), respectively, indicating that they have a high fear of death and above average perceptions of spirituality and spiritual care. It is recommended that different teaching methods be integrated into the curriculum to help nursing students develop more positive attitudes towards death and improve their perceptions of spiritual care.

Investigation of attitudes toward death and hospice care in nursing students before internship

Objective To investigate nursing students' attitudes toward death and hospice care before they start clinical practice, analyze the correlation between the two attitudes and compare their differences in junior and regular nursing college students. Methods A cross-sectional study was adopted to investigate the attitudes toward death and hospice care in 232 senior nursing students at school. Instruments included the Chinese version of the Death Attitude Profile-Revised (DAP-R) and the Chinese version of the Frommelt Attitude Toward Care of the Dying Scale-Form B (FATCOD-B). Pearson correlation analysis and independent t-test were used to analyze the data. Results The mean scores of the 5 dimensions of death attitude were neutral acceptance (4.10±0.43), fear of death (2.76±0.66), death avoidance (2.73±0.74), approach acceptance (2.61±0.58), and escape acceptance (2.48±0.75), respectively. The total score of hospice care attitude was (107.63±8.45), which was negatively correlated with fear of death (r=-0.247, P<0.01), death avoidance (r=-0.278, P<0.01), and escape acceptance (r=-0.145, P<0.05) scores and positively correlated with neutral acceptance score (r=0.405, P<0.01). The death avoidance score of regular nursing college students was significantly lower than that of junior nursing college students (t=-2.043, P<0.05), and the hospice care attitude score of regular nursing college students was significantly higher that of junior nursing college students (t=2.639, P<0.01). Conclusion There is a big room to improve nursing students' attitudes toward death and hospice care. Strengthening end-of-life care education is imperative. Key words: Hospice care; Death attitude; Education; Nursing; Students

Okay as a neutral acceptance token in German conversation

In German oral discourse, previous research has shown that okay can be used both as a response token (e.g., for agreeing with the previous turn or for claiming a certain degree of understanding) and as a discourse marker (e.g., for closing conversational topics or sequences and/or indicating transitions). This contribution focuses on the use of okay as a response token and how it is connected with the speakers’ interactional state of knowledge (their understanding, their assumptions etc.). The analysis is based on video recorded everyday conversations in German and a sequential, micro-analytic approach (multimodal conversation analysis). The main function of conversational okay in the selected data set is related to indicating the acceptance of prior information. By okay, speakers however claim acceptance of a piece of information that they can’t verify or check. The analysis contrasts different sequences containing okay only with sequences in which change-of-state tokens such as ah and achso co-occur with okay. This illustrates that okay itself does not index prior information as new, and that it is not used for agreeing with or for confirming prior information. Instead it enables the speaker to adopt a kind of neutral, “non-agreeing” position towards a given piece of information.

Examining If Religion Influences Death Attitudes: Mental Health Perspective

Dying is inevitable; however, people respond to the concept of death differently. One’s response varies on his/her attitude towards religion and non-believers. There are five different death attitudes: (a) neutral acceptance which suggest that death is a part of life; (b) approach acceptance which holds a positive attitude towards death because one will have a happy afterlife; (c) escape acceptance wherein death is welcomed and seen as a way out for a life filled with pain, misery, and suffering; (d) fear of death is when a sense of fear is evoked by confrontations with death; (e) and death avoidance is when an individual avoids the topic of death in order to reduce death anxiety (Harding, Flannelly, Weaver, &amp; Costa, 2005; Wong, 2008). While religious believers were able to forgive and found overall improved health; religion increased death anxiety as compared to non-believers. However, religion further helped with coping with the inevitable, death. Many studies found that there is a negative correlation between death anxiety and death acceptance. Despite religion helping one cope, it is also a source of stress for an individual facing death due to questioning their life choices and good deeds. This paper employs meta-analysis of seminal knowledge and statistical analysis to examine if religion influences death attitudes from mental health perspective. Keywords: Religion, Death Attitude, Death Anxiety, Death Fear, Mental Health Perspective

Actitudes de las enfermeras frente a la muerte de los pacientes en una unidad de cuidados intensivos

Introducción: en las unidades de cuidado intensivo (UCI) es frecuente el contacto con la muerte a la que se expone el profesional de enfermería. Este tema ha sido poco estudiado en nuestro país. El objetivo de este estudio fue describir las actitudes hacia la muerte en un grupo de enfermeras que laboraban en una UCI de alta complejidad. Materiales y métodos: estudio descriptivo en el que se incluyeron 17 profesionales de enfermería que trabajan en una unidad de cuidados intensivos de alta complejidad. Se aplicó el perfil revisado de actitudes hacia la muerte. Las variables continuas fueron reportadas como promedio acompañadas de desviación estándar, dado que tenían una distribución normal según la prueba de Shapiro-Wilk y demás pruebas gráficas. Las variables categóricas fueron expresadas como frecuencias absolutas o relativas. Resultados: el promedio general de la escala de actitud hacia la muerte fue 133,53 ± 21,50. La actitud con mayor promedio fue la de aceptación de acercamiento con 48,17 ± 12,64, seguida por la actitud de aceptación neutral con 28,94 ± 4,62 y miedo a la muerte con 23,0 ± 7,42. Existe una correlación moderada y directa entre el promedio general de la escala de actitudes hacia la muerte y los años de trabajo en el servicio, RHO = 0,59, p = 0,016. Conclusiones: dentro de las actitudes hacia la muerte de los participantes del presente estudio, la que más predominó fue la de aceptación de acercamiento. Adicionalmente, se pudo establecer que existe una correlación moderada y directa entre el promedio general de la escala de actitudes hacia la muerte y los años de trabajo en UCI.

Relationships among attitude to death, work engagement and organizational citizenship behaviors in emergency nurses

Objective To investigate the attitude to death, work engagement and organizational citizenship behaviors (OCB) in emergency nurses, and to analyze the relationships among them. Methods Two hundred and fifty-one emergency nurses were investigated with Chinese version of Death Attitude Profile-Revised (DAP-R), the Medical Personnels Work Engagement questionnaire and Medical Staffs, Organizational Citizenship Behavior questionnaire. Results The attitude to death in emergency nurses was relatively positive and the total score of DAP-R was 103.49±14.76.There were significant differences on the score of nursing ages, emergency working years and religious beliefs (F=4.584, 6.159, 5.251, P<0.01). The neutral acceptance to death was positively correlated with the work engagement (r=0.098, P<0.01) , the work engagement was negatively correlated with death avoidance (r=-0.177, P<0.01) .The neutral acceptance to death was positively correlated with the OCB, civic responsibility and responsible behavior (r=0.155, 0.161, 0.202, P<0.05 or 0.01). Conclusion The attitude to death has significant influence on work engagement and OCB in emergency nurses. Nursing administrators should through establishing an effective strategies to improve the positive attitude to death and OCB level. Ultimately, give full play to the role of the emergency department nurse in terminal care and quality of emergency medical care can be improved. Key words: Emergency service, hospital; Nurse; Attitude to death; Work engagement; Organizational citizenship behaviors

German version of the Death Attitudes Profile- Revised (DAP-GR) \u2013 translation and validation of a multidimensional measurement of attitudes towards death

BackgroundIn Germany, only limited data are available on attitudes towards death. Existing measurements are complex and time consuming, and data on psychometric properties are limited. The Death Attitude Profile- Revised (DAP-R) captures attitudes towards dying and death. The measure consists of 32 items, which are assigned to 5 dimensions (Fear of Death, Death Avoidance, Neutral Acceptance, Approach Acceptance, Escape Acceptance). It has been translated and tested in several countries, but no German version exists to date. This study reports the translation of the Death Attitudes Profile-Revised (DAP-R) into German (DAP-GR) using a cross-cultural adaption process methodology and its psychometric assessment.MethodsThe DAP-R was translated following guidelines for cultural adaption. A total of 216 medical students of the Heinrich Heine University Duesseldorf participated in this study. Interrater reliability was investigated by means of Kendall’s W concordance coefficient. The internal consistency of the DAP-GR Scales was assessed with Cronbach’s alpha coefficients. Split-half reliability was estimated using Spearman-Brown coefficients. Convergent validity was measured by Spearman’s correlation coefficient. Content validity was assessed by means of confirmatory factor analysis (CFA). All statistical analyses were performed using SPSS 24 and AMOS 22.ResultsThe items showed fair to good interrater reliability, with W-values ranging from .30 to .79. Internal consistency of the five subscales ranged from .61 (Neutral Acceptance) to .94 (Approach Acceptance). Split-half reliability was good, with a Spearman-Brown-coefficient of .83. The results of CFA slightly diverged from the original scale.ConclusionOur results suggest overall good reliability of the German version of the DAP-R. The DAP-GR promises to be a robust instrument to establish normative data on death attitudes for use in German-speaking countries.

Attitudes towards the dying and death anxiety in acute care nurses - can a workshop make any difference? A mixed-methods evaluation.

In Singapore, the core curriculum for end-of-life (EOL) care used in nurse training courses is limited. Only 45% of nurses indicated familiarity with inpatient palliative care. Nurses who lack skills in palliative care may develop anxiety and negative attitudes towards caring for dying patients. We explored whether a two-day, multimodal EOL care workshop could reduce nurses' death anxiety and improve nurses' skills, knowledge, and attitude towards palliative care. Forty-five nurses participated in the workshop. At baseline before and at six weeks after, a 20-item knowledge-based questionnaire and the Death Attitude Profile-Revised (DAP-R) were administered. Six weeks post-workshop, in-depth interviews were conducted. We employed descriptive statistics, student paired samples t-test and inductive thematic analysis. There was a significant improvement in nurses' knowledge score (p < 0.01) and reduction in their death anxiety score (p < 0.01). Fear of Death (p = 0.025) and Death Avoidance (p = 0.047) sub-scores decreased significantly. However, the remaining domains such as Neutral Acceptance, Approach Acceptance, and Escape Acceptance did not show any significant difference, although Escape Acceptance showed a trend towards a reduced score (p = 0.063). After the workshop, more nurses adopted the Neutral Acceptance stance (76.2%), and none of them fell into the Fear of Death subdomain. Most nurses interviewed reported a positive change in their knowledge, attitudes, and practice even after the workshop. The multimodal palliative care workshop was useful in improving nurses' EOL knowledge and reducing their anxiety towards death. The positive change in nurses' attitudes and practices were noted to be sustained for at least six weeks after the intervention.

Assessing oncology nurses’ attitudes towards death and the prevalence of burnout: A cross-sectional study

Burnout in nursing is a global phenomenon. Caring for dying patients could increase nurses' death anxiety. However, minimal information about oncology nurses' burnout and attitudes towards death in Chinese culture has been reported. This study aims to assess Chinese oncology nurses' burnout, and its relationship with attitudes towards death. A cross-sectional design was used. A total of 279 oncology nurses from a cancer hospital in northern China were recruited using convenience sampling, and completed a survey containing a demographic form, the Death Attitudes Profile Scale and the Maslach Burnout Inventory. Descriptive statistics, independent t-test and one-way ANOVA, Pearson correlation analysis and multiple regression analysis were conducted to analyze data. An average of 73.1%-86.9% of oncology nurses reported moderate to high levels of burnout. Specifically, 48.7%, 45.4% and 65.1% of oncology nurses reported high levels of emotional exhaustion, depersonalization and personal accomplishment, respectively. Multiple regression analysis showed that fear of death, escape acceptance, younger age and participation of death education/training were significantly associated with emotional exhaustion (p < 0.01), accounting for 22.0% of the variance; fear of death, escape acceptance, and neutral acceptance in total explained 17.8% of depersonalization; fear of death, escape acceptance and neutral acceptance accounted for 8.5% of personal accomplishment. Oncology nurses with more positive attitudes towards death experience less burnout. Death education and death related training including discussion of personal attitudes towards death should be part of nursing education programs, which would in turn prevent oncology nurses from burnout.

Automated Cow Manure Tiles Maker

Bricks are widely considered as one of the longest-lasting and strongest building material. Recently it is also used as aesthetic items that are commonly used on gardens and garages. On the other hand, cow manure has given a decent amount of attention in the recent times due to the various applications that may be utilized for the society. This research is a microcontroller-based machine which focuses on cow manure to garage tile conversion to provide an alternative process in the creation of said tiles. It is an applied research designed to utilize electronic and mechanical processes to manipulate the given input to a specific end product. The device’s design starts with two receptacles which are connected to separate grinder, which then inputted materials will be weighted onto a load cell. This in turn will pass through a mixer, which also accepts fluid input from three separate fluid reservoirs filled with differently colored fluids. The mixture then finally comes to a chosen designated molder. The entire process will be controlled by the user through LCD screen to display user options. After the process the device will output a designed and colored garage tile. This device was developed in the hopes of finding an alternative material other than clay and soil from making garden tiles and also in automating and further improving the time for manufacture. The speed of mixing and molding cow manure as well as the compressive strength of the produced tiles were considered and passed under the set standard. The evaluation results based on functionality, reliability, usability, efficiency and maintainability of the Automated Cow Manure Tiles Maker was 3.48 which signify a neutral acceptance of the respondents.

Effect of Emotional State of Nurses Working in Intensive Care on Their Attitudes Toward Death.

The purpose of this study is to investigate the effect of the emotional state of the nurses working in intensive care unit on their attitudes toward death. The study was conducted with the participation of 100 nurses working in intensive care units between July and December 2017. A positive statistically significant correlation was found between the nurses' status of approaching emotions and subscales of Death Attitude Profile (p < .05). It was observed that there was a positive significant correlation between the emotional avoidance scores and neutral acceptance and approach acceptance (r = .281), escape acceptance (r = .335), and fear of death and death avoidance (r = .490) scores (p < .05).

Perceptions, Attitudes, and Teaching about Death and Dying in the Medical School of the Federal University of Acre, Brazil

ABSTRACT Death is one of the major taboos of contemporary Western society and is a forbidden and avoided subject. If in the past it was a public and domestic event, nowadays it is hidden in hospitals crowded with professionals who are unprepared to deal with issues related to the end of life. This unpreparedness is a reflex of excessively technical and non-humanistic training which favors healing over caring. Therefore, it seems medical students are taught to work against death and not with it. In this context, we sought to trace the profile of attitudes towards death of the students graduating from the Medicine course of a public university in Brazil and evaluate how this course has prepared them to deal with issues of death and dying in their perception. We employed quantitative and qualitative methodologies by applying two data collection instruments: a questionnaire to collect sociodemographic and academic data as well as data on the teaching about death, and another to define the profile of attitudes towards death (DAP-R). We analyzed the studied variables descriptively using frequencies and means, and intercorrelated them to infer the hypotheses. We also considered student statements for analysis and discussion of results based on comments on the responses to one of the questionnaires. As results, we observed that the students’ attitude towards death was characterized by a view of death as a natural event of life (neutral acceptance), while their imagination about death was permeated with conflicting feelings; that most students had experienced the death of a patient during the course (75.8%) although most of those received no guidance in these situations (80%); that the humanistic courses concentrated the approaches on death; and that such approaches somewhat contributed to create reflection and develop abilities for managing death. We concluded that teaching about death and dying is still concentrated in few courses of the medical curriculum, mainly in the humanistic ones, and is excessively theoretical, whereas the real experiences with death during the Medicine course are treated with detachment and silence when they could be better utilized for teaching and learning about the end of life.

Wisdom as the mediator in the relationships between religious meaning system and attitude toward death among older adults

The objective of the present research was to investigate whether wisdom is a mediator in the association between the religious meaning system and the attitude toward death in the period of late adulthood. The study included 315 persons aged 60–75. Three measures were used: Religious Meaning System Scale (RMSS), Three-Dimensional Wisdom Scale (3D-WS), Death Attitude Profile-Revised (DAP-R). The analyses allowed for a partial verification of the hypothesis that wisdom is a mediator in the relationship between the explicit religious meaning system and the multidimensional attitude toward death in late adulthood. It was confirmed that the relationship of the religious meaning system with fear of death, death avoidance, neutral acceptance, escape acceptance and approach acceptance is mediated by at least one (cognitive, reflective and/or affective) of the dimensions considered in the study.

Karakteristik Fisikokimia dan Sensori Permen Jelly Kulit Buah Kopi dengan Penambahan Gelatin dan Sari Lemon

In the field of food, coffee waste begins to be developed by processing it as a beverage product. The skin of coffee fruit can also be processed as a food product, one of which is jelly candy. This study aims to study jelly candy making with the addition of gelatin as a gelling agent and the addition of lemon juice to produce coffee fruit skin jelly candy that has physicochemical and sensory characteristics that meet SNI quality requirements. The design used was factorial Completely Randomized Design consisting of 2 (two) factors. Factor I concentration of gelatin (G) and Factor II is the concentration of lemon water (L). Factor I consists of 4 levels, namely G1 = 10%, G2 = 15%, G3 = 20% and G4 = 25%, while factor II consists of 3 levels, namely L1 = 5%, L2 = 10% and L3 = 15%. Each treatment was repeated 2 times to obtain 24 experimental units.The concentration of gelatin and the concentration of lemon have a very significant effect on water content and pH value. The concentration of lemon has a significant effect on the value of hedonic organoleptic taste. Both interactions have a very significant effect on the value of organoleptic hedonic texture. The results of the analysis of coffee fruit peel jelly candy have an average moisture content of 21.25%, 0.95% ash content, pH 4.53, sensory hedonic color (3.50 neutral reception), aroma (3.48 neutral acceptance), taste (3.50 neutral acceptance), texture (3.59 likes reception).The results showed that 10% gelatin concentration and 10% lemon concentration (G1L2) were the best treatments obtained through the ranking test. The jelly candy produced has 21.32% moisture content characteristics, 1.55% ash content, pH 4.71, 14.09% antioxidant activity, 3.03 mg / 100g vitamin C levels, 3.55 sensory colors (likes) , aroma 3.45 (neutral), taste 3.48 (neutral) and texture 3.43 (neutral).

Psychometric Properties of the Revised Death Attitude Profile in a Greek Sample of Nurses.

This study aimed to examine the psychometric properties of the Revised Death Attitude Profile (DAP-R) in a sample of Greek nurses and nursing students. A convenience sample (n = 934) was used from six National Health System hospitals, and two University Schools of Nursing in central and northern Greece completed the Greek version of the DAP-R (Gr-DAP-R). Principal component analysis with varimax rotation revealed a six-factor solution, including approach acceptance, death avoidance, escape acceptance, neutral acceptance, fear of death, and after death concerns. The internal consistency for each of the subscales ranged from 0.64 to 0.88. Intercorrelations between the Gr-DAP-R subscales supported the relative independence of death attitudes dimensions. The Gr-DAP-R can be used as a research and clinical tool in assessing death attitudes among Greek nurses.