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"Attitude to Death"
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The study of dying : from autonomy to transformation
\"What is it really like to die? Though our understanding about the biology of dying is complex and incomplete, greater complexity and diversity can be found in the study of what human beings encounter socially, psychologically and spiritually during the experience. Contributors from disciplines as diverse as social and behavioural studies, medicine, demography, history, philosophy, art, literature, popular culture and religion examine the process of dying through the lens of both animal and human studies. Despite common fears to the contrary, dying is not simply an awful journey of illness and decline; cultural influences, social circumstances, personal choice and the search for meaning are all crucial in shaping personal experiences. This intriguing volume will be of interest to clinicians, professionals, academics and students of death, dying and end-of-life care, and anyone curious about the human confrontation with mortality\"--p. [4] of cover.
BOOK
Dying in America
For patients and their loved ones, no care decisions are more profound than those made near the end of life. Unfortunately, the experience of dying in the United States is often characterized by fragmented care, inadequate treatment of distressing symptoms, frequent transitions among care settings, and enormous care responsibilities for families. According to this report, the current health care system of rendering more intensive services than are necessary and desired by patients, and the lack of coordination among programs increases risks to patients and creates avoidable burdens on them and their families. Dying in America is a study of the current state of health care for persons of all ages who are nearing the end of life.
Death is not a strictly medical event. Ideally, health care for those nearing the end of life harmonizes with social, psychological, and spiritual support. All people with advanced illnesses who may be approaching the end of life are entitled to access to high-quality, compassionate, evidence-based care, consistent with their wishes.
Dying in America evaluates strategies to integrate care into a person- and family-centered, team-based framework, and makes recommendations to create a system that coordinates care and supports and respects the choices of patients and their families. The findings and recommendations of this report will address the needs of patients and their families and assist policy makers, clinicians and their educational and credentialing bodies, leaders of health care delivery and financing organizations, researchers, public and private funders, religious and community leaders, advocates of better care, journalists, and the public to provide the best care possible for people nearing the end of life.
eBook
Nursing Professionals’ Attitudes, Strategies, and Care Practices Towards Death: A Systematic Review of Qualitative Studies
Purpose
To explore the attitude of nursing professionals towards death.
Design
Systematic qualitative review methods were used.
Methods
A search was conducted in the PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and CUIDEN databases. This study included 17 articles.
Findings
Thirteen categories emerged, which were grouped into three themes: meanings and feelings during the dying process; coping strategies in the face of death; and the importance of training, experience, and providing a dignified death. In the different accounts of the participants, it was found that death had a large negative emotional impact on them, that the participants complained about the lack of previous training in the care of dying patients, and that avoiding these complex situations was one of the strategies most commonly used by professionals to face the death of a patient.
Conclusions
The lack of training in the basic care of terminally ill patients, as well as today’s preconceived negative idea about death, both cause health professionals to experience situations of great stress and frustration resulting, on many occasions, in resorting to avoidance of these situations, thus preventing dying with dignity.
Clinical Relevance
In this article, we explore the consequences of this process for nursing professionals, common coping strategies, and possible areas for improvement, such as the need for the training of nursing professionals in the care of terminally ill patients and their families.
Journal Article
On death & dying : what the dying have to teach doctors, nurses, clergy & their own families
The five stages of grief, first formulated in this hugely influential work, are now part of our common understanding of loss. Ideal for all those with an interest in bereavement, this classic text is reissued with a new introduction looking at its influence on contemporary thought and practice.
Book
The effect of sleep quality on attitudes toward death in breast cancer survivors
Purpose
The aim of this study was to determine the levels of sleep quality and attitudes toward death among breast cancer survivors and to examine the impact of sleep quality on attitudes toward death.
Methods
This descriptive and correlational study was conducted with 117 patients who had been treated for breast cancer in radiation oncology. Data were collected using a Demographic Information Form, the Pittsburgh Sleep Quality Index, and the Death Attitude Profile-Revised Scale.
Results
The mean score for sleep quality among breast cancer survivors was 15.17 ± 3.96, while the mean score for the Death Attitude Profile-Revised was 137.65 ± 30.74. Sleep quality was associated with marital status, place of residence, perception of economic status, presence of social support, time since diagnosis, body mass index, and other factors (
p
< 0.05). Attitudes toward death were associated with age, educational level, occupation, place of residence, perception of economic status, comorbidity, histopathological stage, chemotherapy status, type of breast surgery, and other factors (
p
< 0.05). Additionally, a moderately positive correlation was found between sleep quality and attitudes toward death among women undergoing breast cancer treatment (
r
= 0.368,
p
< 0.001). It was determined that patients’ sleep quality, education status, and comorbidity had a significant effect on attitudes toward death and the variables explained 29.4% of the variance (
R
2
= 0.294) (
p
< 0.001).
Conclusion
This study shows that there is a significant relationship between sleep quality and attitudes toward death in cancer patients and that sleep quality affects attitudes toward death. In addition, when evaluating the sleep quality and attitudes toward death of women treated for breast cancer, taking into account their sociodemographic characteristics and treatment characteristics may contribute positively to the recovery process and quality of life.
Graphical Abstract
Journal Article
Effects of a “silent mentor” initiation ceremony and dissection on medical students’ humanity and learning
Objectives
Many medical schools in Taiwan have adopted a dignified “silent mentor” initiation ceremony to strengthen student’s medical humanity and increase their learning attitudes. This ceremony consists of introductions of the body donor’s conduct and deeds, wreath-laying, and a tea party. However, few empirical studies have examined the influences of the ceremony and dissection on medical humanity. This study explored if the initiation ceremony and the course can help students care more about others, develop more positive attitudes toward death, improve learning effectiveness in the course, and decrease negative emotions the first time they see a cadaver.
Methods
The Attitudes Towards Death and Love and Care subscales of the life attitude inventory, Learning Effectiveness of Gross Anatomy Laboratory Scale (LEGALS), and Emotional Reactions Towards Cadavers Scale were adopted to examine differences before (T1) and after (T2) medical students attended an initiation ceremony at a university in northern Taiwan. Whether these effects lasted to the end of the semester (T3) was also tested.
Results
After the ceremony, students’ attitudes towards death increased, negative emotions towards cadavers decreased, but love and care and the LEGALS did not significantly change. Data from T3 showed a similar pattern, but high-level emotions (e.g., being respected, cherished, and grateful) and the LEGALS were significantly higher than those at T1.
Discussion
The initiation ceremony, which showed a body donor’s deeds and attitudes toward life and death when they were alive, could help medical students gain more mature attitudes towards death and decreased negative emotions. Learning between T2 and T3 might have caused significant changes in high-level emotions and the LEGALS at T3. Arranging reflective writing with guided discussion by a teacher before and after the ceremony is highly recommended.
Journal Article
Priorities of a “good death” according to cancer patients, their family caregivers, physicians, and the general population: a nationwide survey
PurposeUnderstanding the concept of a “good death” is crucial to end-of-life care, but our current understanding of what constitutes a good death is insufficient. Here, we investigated the components of a good death that are important to the general population, cancer patients, their families, and physicians.MethodsWe conducted a stratified nationwide cross-sectional survey of cancer patients and their families from 12 hospitals, physicians from 12 hospitals and the Korean Medical Association, and the general population, investigating their attitudes toward 10 good-death components.FindingsThree components—“not be a burden to the family,” “presence of family,” and “resolve unfinished business”—were considered the most important components by more than 2/3 of each of the three groups, and an additional three components—“freedom from pain,” “feel that life was meaningful,” and “at peace with God”—were considered important by all but the physicians group. Physicians considered “feel life was meaningful,” “presence of family,” and “not be a burden to family” as the core components of a good death, with “freedom from pain” as an additional component. “Treatment choices’ followed, “finances in order,” “mentally aware,” and “die at home” were found to be the least important components among all four groups.ConclusionWhile families strongly agreed that “presence of family” and “not be a burden to family” were important to a good death, the importance of other factors differed between the groups. Health care providers should attempt to discern each patient’s view of a good death.
Journal Article