Death Self-efficacy, Attitudes Toward Death and Burnout Among Oncology Nurses A Multicenter Cross-sectional Study

Background To effectively care for dying patients, nurses need to possess death self-efficacy-the state of having both a range of skills and capabilities to provide care to dying patients and confidence in one's ability to do so. A paucity of death self-efficacy may lead to burnout. Objectives The aims of this study are to clarify oncology nurses' death self-efficacy and to explore its relationships with attitudes toward death and burnout. Methods A cross-sectional study was performed in 7 cancer hospitals across mainland China between June and July 2019. Oncology nurses completed an online survey consisting of the Death Self-efficacy Scale, Death Attitude Profile-Revised Scale, and Maslach Burnout Inventory. Results The 755 oncology nurses completing the survey reported low death self-efficacy and high levels of burnout. Those who had more years of clinical experience, had the highest professional rank, talked death quite often, and have received palliative care trainings, doing no shift work, scored higher on death self-efficacy. Death self-efficacy was positively correlated with positive attitudes toward death and negatively correlated with levels of burnout. The multiple regression analysis showed that death self-efficacy and attitudes toward death were independent, significant predictors of oncology nurses' burnout. Conclusions Chinese oncology nurses are not well prepared to care for dying cancer patients and cope with death-related issues. Implications for Practice Improvement in death self-efficacy among oncology nurses is necessary, especially for those who are young, are unmarried, are doing shift work, and never received palliative care training. Enhanced death self-efficacy may be realized through self-reflective practice and palliative care education.