The Mediating Role of Knowledge of Advance Directives in the Relationship between Good Death Perception and Attitudes toward Withdrawl of Life-Sustaining Treatment among Nursing Students

Objectives This study examines the mediating effect of knowledge of advance directives in the relationship between good death perception and attitude toward withdrawal of life-sustaining treatment among nursing students. Methods In this study correlational study, 167 nursing students from two nursing colleges completed questionnaires of a good death perception, a knowledge toward advance directives, and an attitude toward withdrawal of life-sustaining treatment. Data were analyzed Spearman correlational coefficients, three-step regression analysis, and Hayes Process Macro analysis. Results Good death perception was correlated with the knowledge of advance directives (r=.180, p=.020) and the attitude of withdrawing life-sustaining treatment (r=.213, p=.006). Good death perception influenced the knowledge of advance directives and attitude toward withdrawal of life-sustaining treatment (B=0.22, p=.015; B=0.03, p=.009). Knowledge of advance directives mediated the relationship between Good death perception and attitude of withdrawing life-sustaining treatment (B=.039, LLCI=.006, ULCI=.084). Conclusions Learning strategies aiming to enhance attitude toward withdrawal of life-sustaining treatment require successful good death perception to boost knowledge of advance directives among nursing students.