The effects of nurses' spiritual well-being and death awareness on end-of-life nursing attitudes in Korea: a cross-sectional study

Purpose: This descriptive survey was conducted to identify the factors influencing nurses’ end-of-life nursing attitudes, particularly focusing on spiritual well-being and death awareness among nurses in internal medicine and surgical departments.Methods: In total, 176 nurses from five medical centers in Korea completed a structured questionnaire. Data were collected on nurses’ general characteristics, end-of-life nursing attitudes, spiritual well-being, and awareness of death. Multiple regression analysis was conducted to examine the factors affecting nurses’ end-of-life nursing attitudes.Results: A significant difference in end-of-life nursing attitudes was observed according to the nursing department. Nurses in the internal medicine sector (wards and intensive care units) demonstrated significantly better end-of-life nursing attitudes than those in the surgical sector (surgical intensive care units). Death awareness exhibited a significant positive association with end-of-life nursing attitudes. The factors influencing nurses’ end-of-life nursing attitudes included a higher level of death awareness, and working in an internal medicine ward as opposed to a surgical intensive care unit.Conclusion: Nurses working in internal medicine wards exhibited higher levels of end-of-life nursing attitudes, indicating the need to develop specialized training programs in end-of-life care for surgical departments. In addition, it is necessary to improve nurses’ death awareness.