The impact of death attitudes on death education needs among medical and nursing students

Background: Medical and nursing students will play an essential role in delivering palliative care in the future. Death education is important in preparing them for future palliative care, however, little is known about students education needs and how death attitudes affect such needs in Mainland China.Objectives: The purpose of this survey was to investigate the death education needs of medical and nursing students and to evaluate the impact of death attitudes on death education needs. Design: Multi-center, cross-sectional survey.Settings: Fourteen medical and nursing colleges & universities in Hunan, Sichuan, Liaoning, Guangdong, Shandong, and Shanxi provinces in China. Participants: The sample included 1044 medical and nursing students from six provinces. Methods: In this multi-center cross-sectional study, all data were collected through an online questionnaire that included demographic information and questions on death-related experiences. In addition, the Death Attitude Profile-Revised and the Death Education Needs Scale were used to evaluate students' death attitudes and death education needs , respectively. Results: The students had a mean death education needs score of 38.85 +/- 7.25 (range: 10-50), yet only 20.9 % of them had received palliative care-related training. Being female (B:3.869, 95 % CI:2.849-4.889), fear of death (B:0.119, 95 % CI:0.005-0.232), and neutral acceptance (B:0.787, 95 % CI:0.638-0.936) were associated with higher death education needs, while death avoidance (B: -0.226, 95 % CI: -0.368 - -0.083), approach acceptance (B: -0.126, 95 % CI: -0.215 - -0.036), and escape acceptance (B: -0.198, 95 % CI: -0.322 -0.073) were associated with lower death education needs.Conclusions: The high level of death education needs and low training rate in palliative care among medical and nursing students in mainland China indicates a gap that needs to be addressed. Students' death education needs were affected by gender and death attitudes, which provides implications for the future development of palliative care training models.