Análisis de las actitudes, aptitudes y creencias en la profesión enfermera, sobre el final de la vida y su cuidado
Authors:   , Osés Zubiri María , Casas Fernández de Tejerina Juan Manuel 
Published: May 2023

Introduction: Nursing assists patients in all stages of life, from the diagnosis of a disease to its cure or death. The end-of-life care environment represents a challenge for nursing professionals, who must constantly adapt both socially and culturally to the different needs that may arise in patients and their families. Objective: To analyse the attitudes, aptitudes and beliefs about the end of life and its care, in a group of nursing professionals from Navarra (Spain) and Valdivia (Chile), through the different periods and scenarios of their work activity (specialized care and primary care), and according to the different socio-demographic variables because they are described (age, gender, marital status, religion and perception of technical and emotional competences). Methodology: Cross-sectional descriptive study, which has used an accidental non-probabilistic sampling in two samples of nursing professionals. Various previously standardized and validated questionnaires have been used, such as the Death Attitude Revised Profile scale (DAP-R), Bugen's Coping with Death scale, Frommelt's Attitudes Towards Care of dying patients scale (FATCOD-B) and reduced Post-Critical Beliefs scale (S-PCB) by Duriez, Soenens and Hutsebaut. Results: Nursing professionals from Navarra showed higher levels of attitude of fear towards death compared to those from Valdivia (p<0.021), which were differentiated by higher attitudes of rapprochement (p<0.000) and escape (p<0.008). Similarly, the participants from Navarra obtained a less favourable score in coping with death in general terms (p<0.019), as well as less aptitude for caring for the dying patient and their family according to the FATCOD-B scale (p<0.020). In addition, nursing professionals from Valdivia show significantly more transcendental religious positions than nursing professionals from Navarra (S-PCB) (p<0.000), turning out to be more orthodox (p<0.000) and with a position closer to the second naivete (0.000), compared to other positions such as relativism (0.011) and external criticism (0.000). In all the dimensions of the scales, significant differences were found in items of analysis around death according to age, cultural and religious context, and previous experiences of death, as well as in the emotional perception and technique of caring for end-of-life patients and coping with their death. In this way, older age, greater previous experience in funeral ceremonies in childhood, the fact of professing a religion, or having a high self-perception about technical management in nursing care at the end of life, are aspects that encourage the nursing professional, an adequate construction on the concept of death, as well as a coherent and flexible provision of palliative care during the end-of-life process. Conclusions: Nursing personnel, based on sociodemographic factors and their experiences, both personal and cultural, elaborate in a diverse way a series of attitudes, aptitudes and beliefs about death and its process, which intervene in the conformation of nursing care at the end of life, whether at community and hospital level. The skills that are developed in this regard, both emotional and practical, facilitate the care of terminally ill persons and their families, and therefore, their approach is necessary among the health collective. Consequently, the present study recommends intervening in the avoidant attitudes of nursing professionals towards death and coping with it, and considering the acquisition of positive attitudes, as well as specific skills to the context of end-of-life care, which facilitate their development. In this sense, it is suggested to encourage the number of nursing training programs in palliative and end-of-life care, both at the undergraduate and postgraduate levels.