Nursing students' perceptions of a good death: A mixed method study

Background: Social aging tendencies and increasing chronic disease burdens draw people's attention to the concept of a good death. Objective: This study investigated how Chinese nursing students perceive a good death. Design: A mixed quantitative and qualitative design. Participants and setting: Four hundred and ninety-three nursing students from one mainland China university and one Macao SAR university participated in the study. Methods: The Good Death Inventory (Chinese version) was used to collect quantitative data. Qualitative data was collected through semi-structured interviews. Four hundred seventy-two questionnaires were collected, and 21 participants were interviewed. Quantitative and qualitative data were analyzed through statistics and thematic analysis, respectively. Results: Chinese nursing students gained an average score of 3.76 ± 0.39 in GDI-C. Students from mainland China, female, and with senior grades scored higher in the GDI-C (p < 0.05). Students' good death perception comprised four themes: positive psychological status, no physical suffering, open and supportive social surroundings, and spiritual/religious perfection. Mainland China and Macao students showed high consistency in their ranking of good death dimensions. The first five rankings in GDI-C were domains of being respected as an individual, dying in a favorite place, preparation for death, good relationships with family/medical staff, and environmental comfort. The last five rankings in GDI-C were domains of religious and spiritual comfort, independence, unawareness of death, pride and beauty, and not being a burden to others. Conclusion: Chinese nursing students had a moderate degree of good death perception, characterized by the emphasis on social domains. Nursing students from mainland China and Macao SAR shared a similar perception of a good death in the Chinese context. More hospice care opportunities should be provided to students to train their empathy. Educators should guide students to apply principles of respect/dignity and open communication in the nursing practice.