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Effectiveness of death education program by methods of didactic, experiential, and 8A model on the reduction of death distress among nurses

Authors: Mahboubeh Dadfar, Ali Asghar Asgharnejad Farid, David Lester, Mohammad Kazem Atef Vahid and Behrooz Birashk

Int J Med Res Health Sci.60-71 | pdf PDF Full Text

Death distress includes death anxiety, death depression, and death obsession. There are different approaches to
death education program include didactic, experiential, and 8A model. Death distress of nurses can have an impact
on their mental, physical, general health aspects, and the quality of care that they provide during the terminal stages
of a patient’s life. Aim of this study was comparison of effectiveness of death education program by methods of
didactic, experiential, and 8A model on the reduction of death distress among nurses. The study was a quasiexperimental
method with four-group pretest/posttest design. The participants were 42 nurses in four groups (12
didactic, 10 experiential, 10 8A model, and 10 controls). The groups were selected randomly from different wards of
the Khatom-Al-Anbia General Hospital in Tehran city, and they matched with together for demographic variables.
The nurses completed Death Concern Scale (DCS), Collett-Lester Fear of Death Scale (CLFDS), Death Anxiety
Scale (DAS), Death Obsession Scale (DOS) and Death Depression Scale (DDS), before and after intervention.
Death education programs were held by 36-hours 6 workshops weekly. Data were analyzed through χ²,t-test, One-
Way ANCOVA, and One-Way ANOVA using SPSS/WIN 16.0 program. On the DAS, DOS and DDS scores more
increased in control group in posttest compared to didactic and experiential approaches and 8A model. But these
differences were no significant statistically. The most Eta (Effect size) was on the DOS (14%), and the DDS (11%),
respectively. On the Scale of Death Education Program Evaluation (SDEPE), there was a significant difference
between didactic approach and 8A model. The nurses evaluated 8A model more useful compared to didactic
approach. In the present study self-report scales was used; sample was small; education was not trained by
teamwork of death education, it was trained only by one educator and the study had no follow-up phase so there is
difficulty in generalizing results. Based on the results, it is apparent that the death education programs have some
affirmative impacts on the death distress of nurses. Our study paved the way for the establishment of a similar
program in the hospitals and community in the future and the use of the program was expected to improve the
quality of the palliative nursing services, end of life care as well as the satisfaction of the patients and their families.
Key Words: Death Education, Didactic, Experiential, 8A Model, Death Distress, Nurses

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