Attitudes toward death in nursing staff: the role of resilience

Background: Nurses frequently care for patients at the end of life, yet many lack adequate preparation to manage the associated emotional challenges. Attitudes toward death influence both the quality of end-of-life care and nurses´ own psychological well-being. Although resilience has been identifie...

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Autores: Arribas García, Silvia, Petkari, Eleni, Jaureguizar Alboniga-Mayor, Joana, Sánchez Gutiérrez, Teresa, Morales, Isabel, Doval, Sandra
Tipo de recurso: artículo
Fecha de publicación:2026
País:España
Institución:Universidad del País Vasco
Repositorio:Addi. Archivo Digital para la Docencia y la Investigación
OAI Identifier:oai:dnet:addi________::1aad48b0df46321cf7eb6fd572245628
Acceso en línea:http://hdl.handle.net/10810/79575
Access Level:acceso abierto
Palabra clave:attitude to death
nurses
psychological resilience
palliative care units
end-of-life care
death education
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spelling Attitudes toward death in nursing staff: the role of resilienceArribas García, SilviaPetkari, EleniJaureguizar Alboniga-Mayor, JoanaSánchez Gutiérrez, TeresaMorales, IsabelDoval, Sandraattitude to deathnursespsychological resiliencepalliative care unitsend-of-life caredeath educationBackground: Nurses frequently care for patients at the end of life, yet many lack adequate preparation to manage the associated emotional challenges. Attitudes toward death influence both the quality of end-of-life care and nurses´ own psychological well-being. Although resilience has been identified as a potential protective factor, its role in shaping attitudes toward death among nursing professionals remains insufficiently explored. This study examinedthe role of resilience in attitudes toward death and analyzed personal and occupational factors associated with these attitudes prior to the COVID-19 pandemic. Methods: This observational cross-sectional study included 742 nursing professionals working in Intensive Care, Palliative Care and Oncology units across seven public hospitals in Spain. Participants completed the Death AttitudeProfile-Revised, the Connor-Davidson Resilience Scale and an ad-hoc questionnaire assessing sociodemographicand professional variables between June 2018 and April 2019. Multivariate analyses of variance, correlation analyses, mediation and moderation analyses, and principal component analysis were conducted. Results: Neutral-Acceptance was the most predominant attitude toward death (M = 5.68, SD = 0.90), followed by Fearof-Death (M = 3.70, SD = 1.39) and Death-Avoidance (M = 3.53, SD = 1.59). Attitudes toward death were significantlyassociated with professional category, age, prior training in death and bereavement, healthcare setting, and resilience (all p<.05). Resilience correlated positively with Neutral-Acceptance and negatively with Fear-of-Death and Death-Avoidance. Mediation analyses showed that resilience fully mediated the relationships between several professional factors and key death attitudes, with suppression effects observed in some models. Conclusions: Resilience and prior training in death and dying appear to play an important role in shaping nurses´ attitudes toward death. Integrating resilience-enhancing strategies and structured death education into both academic curricula and continuing professional training may contribute to nurses´ emotional well-being and to the quality of end-of-life care.Springer Nature202620262026info:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10810/79575reponame:Addi. Archivo Digital para la Docencia y la Investigacióninstname:Universidad del País VascoIngléshttps://link.springer.com/article/10.1186/s12904-026-02062-8info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-nd/4.0/his article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licenseoai:dnet:addi________::1aad48b0df46321cf7eb6fd5722456282026-06-18T09:23:17Z
dc.title.none.fl_str_mv Attitudes toward death in nursing staff: the role of resilience
title Attitudes toward death in nursing staff: the role of resilience
spellingShingle Attitudes toward death in nursing staff: the role of resilience
Arribas García, Silvia
attitude to death
nurses
psychological resilience
palliative care units
end-of-life care
death education
title_short Attitudes toward death in nursing staff: the role of resilience
title_full Attitudes toward death in nursing staff: the role of resilience
title_fullStr Attitudes toward death in nursing staff: the role of resilience
title_full_unstemmed Attitudes toward death in nursing staff: the role of resilience
title_sort Attitudes toward death in nursing staff: the role of resilience
dc.creator.none.fl_str_mv Arribas García, Silvia
Petkari, Eleni
Jaureguizar Alboniga-Mayor, Joana
Sánchez Gutiérrez, Teresa
Morales, Isabel
Doval, Sandra
author Arribas García, Silvia
author_facet Arribas García, Silvia
Petkari, Eleni
Jaureguizar Alboniga-Mayor, Joana
Sánchez Gutiérrez, Teresa
Morales, Isabel
Doval, Sandra
author_role author
author2 Petkari, Eleni
Jaureguizar Alboniga-Mayor, Joana
Sánchez Gutiérrez, Teresa
Morales, Isabel
Doval, Sandra
author2_role author
author
author
author
author
dc.subject.none.fl_str_mv attitude to death
nurses
psychological resilience
palliative care units
end-of-life care
death education
topic attitude to death
nurses
psychological resilience
palliative care units
end-of-life care
death education
description Background: Nurses frequently care for patients at the end of life, yet many lack adequate preparation to manage the associated emotional challenges. Attitudes toward death influence both the quality of end-of-life care and nurses´ own psychological well-being. Although resilience has been identified as a potential protective factor, its role in shaping attitudes toward death among nursing professionals remains insufficiently explored. This study examinedthe role of resilience in attitudes toward death and analyzed personal and occupational factors associated with these attitudes prior to the COVID-19 pandemic. Methods: This observational cross-sectional study included 742 nursing professionals working in Intensive Care, Palliative Care and Oncology units across seven public hospitals in Spain. Participants completed the Death AttitudeProfile-Revised, the Connor-Davidson Resilience Scale and an ad-hoc questionnaire assessing sociodemographicand professional variables between June 2018 and April 2019. Multivariate analyses of variance, correlation analyses, mediation and moderation analyses, and principal component analysis were conducted. Results: Neutral-Acceptance was the most predominant attitude toward death (M = 5.68, SD = 0.90), followed by Fearof-Death (M = 3.70, SD = 1.39) and Death-Avoidance (M = 3.53, SD = 1.59). Attitudes toward death were significantlyassociated with professional category, age, prior training in death and bereavement, healthcare setting, and resilience (all p<.05). Resilience correlated positively with Neutral-Acceptance and negatively with Fear-of-Death and Death-Avoidance. Mediation analyses showed that resilience fully mediated the relationships between several professional factors and key death attitudes, with suppression effects observed in some models. Conclusions: Resilience and prior training in death and dying appear to play an important role in shaping nurses´ attitudes toward death. Integrating resilience-enhancing strategies and structured death education into both academic curricula and continuing professional training may contribute to nurses´ emotional well-being and to the quality of end-of-life care.
publishDate 2026
dc.date.none.fl_str_mv 2026
2026
2026
dc.type.none.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv http://hdl.handle.net/10810/79575
url http://hdl.handle.net/10810/79575
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv https://link.springer.com/article/10.1186/s12904-026-02062-8
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-nd/4.0/
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Springer Nature
publisher.none.fl_str_mv Springer Nature
dc.source.none.fl_str_mv reponame:Addi. Archivo Digital para la Docencia y la Investigación
instname:Universidad del País Vasco
instname_str Universidad del País Vasco
reponame_str Addi. Archivo Digital para la Docencia y la Investigación
collection Addi. Archivo Digital para la Docencia y la Investigación
repository.name.fl_str_mv
repository.mail.fl_str_mv
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