Death exposure, death attitude, death anxiety and burnout in nurses

Ferrett, Helen Louise (1999-12)

Thesis (M.A.) -- University of Stellenbosch, 1999.

Thesis

ENGLISH ABSTRACT: This research constituted a pilot study to begin to investigate the experiences of South African nursing professionals who work with dying patients, within an existential-phenomenological theoretical paradigm. The specific purposes were to describe the profile of the sample with regard to the variables of death exposure, death attitude, death anxiety and burnout, to establish whether these variables were related, and whether the groups differed with regard to those variables. The sample (N=114) consisted of three groups of nurses. The first group included hospice nurses, who work in high mortality-exposure, death-certainty, palliative-focus contexts. The second group consisted of private hospital intensive care (lCU) nurses, who worked in moderately high mortality-exposure, death-possibility, curative-focus contexts. The third group comprised first-year university nursing students, who work in a low mortality-exposure, death-unlikely, academic-focus context. Death exposure and demographic variables were measured using a demographic questionnaire designed by the researcher. Death attitude, according to existentialist theory, was measured by the Death Attitude Profile - Revised Version (D AP). Death anxiety was measured using the Multidimensional Fear of Death Scale (MFODS), and burnout was measured with the Maslach Burnout Inventory (MBI). Statistical analyses of the data (namely calculation of descriptive statistics, correlation matrices and multiple analyses of variance) were performed using the computer package Statistica. The results showed that numerous aspects of death exposure, death attitude, death fear and burnout are related. In general, the findings indicated positive correlations between death exposure, reduced death anxiety, improved attitude and reduced experiences of emotional exhaustion and depersonalization. The MANOVAs demonstrated that the three groups do not differ significantly with regard to private death exposure or death attitude, but significant differences were found with regard to professional death exposure, death anxiety and burnout. Hospice nurses had experienced the most patient deaths, followed by ICU nurses and then students. Hospice nurses showed significantly less death anxiety than the nursing students. Hospice nurses were also significantly less emotionally exhausted than students, and less depersonalized than ICU nurses as wen as nursing students. The findings suggest that death exposure, in combination with cognitive and emotional resolution of existential anxiety, mitigates against excessive death anxiety, and burnout due to emotional exhaustion and depersonalization, when working with the dying.

AFRIKAANSE OPSOMMING: In hierdie navorsingsprojek is die ervarings van Suid-Afrikaanse verpleegkundiges wat met sterwende pasieme werk, ondersoek. n' Eksistensieel-fenomenologiese paradigma is gebruik. Die spesifieke doe1stellings was om die verpleegkundiges te beskrywe in terme van die volgende veranderlikes: blootstelling aan sterfgevalle, houding teenoor die dood, angs vir die dood, en uitbranding (burnout); ook om vas te stel of die veranderlikes onderling verwant is, en of die onderskeie groupe ten opsigte van hierdie veranderlikes beduidend verskil het. Die deelnemers (N= 114) het bestaan uit drie groupe verpleegkundiges. Die eerste groep het bestaan uit verpleegkundiges verbonde aan die hospice wat in hulle werk baie blootgestel is aan die sterfte van pasiente. Die pasiente was sterwend en verpleegkundiges was daarop ingestel om lyding te verminder. Die tweede groep het bestaan uit verpleegkundiges verbonde aan 'n privaat hospitaal en wat in hoe intensiewe sorg eenhede gewerk het. Hierdie groep verpleegkundiges het 'n matige blootsteUing aan sterfgevalle gebad. Pasiente kon moontlik sterf, en die doel van mediese behandeling was dikwels om die pasiente te genees. Die derde groep het bestaan uit verplegingstudente in hul eerste studiejaar wat in 'n konteks van opleiding, lae sterfte-risiko en onwaarskynlike pasient sterfte gewerk het. Die deelnemers se vorige blootstelling aan sterftes en demografiese veranderlikes is deur middel van 'n vraelys gemeet wat deur die navorser opgestel is. Die houding teenoor die dood is, volgens die eksistensiele teorie, gemeet met behulp van die Death Attitude Profile - Revised Version (DAP). Die angs vir die dood is gemeet met behulp van die Multidimensional Fear of Death Scale (MFODS), en uitbranding is gemeet met behulp van die Maslach Burnout Inventory (MBI). Die statistiese ontleding van data het beskrywende statistiek, korrelasiematrikse en variansie ontleding ingesluit. Die Statistica rekenarprogram is gebruik. Volgens die resultate van die ondersoek is daar in die algemeen beduidende korrelasie gevind tussen blootstelling aan, houding teenoor, en angs vir die dood, en uitbranding. n' Positiewe verband is gevind tussen 'n hoe blootstelling aan pasietsterfte, verminderde doodsangs, 'n "beter" houding teenor die dood, verminderde ervaring van uitputting en depersonalisasie. Die MANOV As het aangetoon dat die drie groupe nie beduidend verskil het ten opsigte van blootstelling aan persoonlike sterfterverliese nie, en houding teenoor die dood nie. Beduidende verskille is weI gevind tussen die mate van biootstelling aan sterfte van pasiente, angs vir die dood, en uitbranding. Hospice verpleegkundiges het die meeste sterfgevalle hanteer, gevolg deuir die intensiewe sorg verpleegkundiges, en die studentegroep. Hospice verpIeegkundiges het beduidend minder angs vir die dood ervaar as verplegingstudente, Hospice verpleegkundiges het ook minder emosionele uitbranding ondervind as studente, en minder gedepersonaliseer as intensiewe sorg verpleegkundiges. Die resultate dui daarop dat blootstelling aan die dood, in kombinasie met kognitiewe en emosionele resolusie van eksistensiele angs, die verpleegkundige beskerm teen oormatige angs vir pasientsterfte, en ook teen uitbranding wanneer verpleegkuIldiges met sterwende pasiente werk.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/51190
This item appears in the following collections: