Wen Ying, Zhang Qun-Xiang, Liu Yang, He Xiao-Hua, Gong You-Wen
Department of Nursing, Changde Hospital, Xiangya School of Medicine, Central South University, The First People's Hospital of Changde City, Changde 415000, Hunan Province, China.
School of Nursing, University of South China, Hengyang 421001, Hunan Province, China.
World J Psychiatry. 2025 Jul 19;15(7):107416. doi: 10.5498/wjp.v15.i7.107416.
Death anxiety (DA) is a prevalent psychological challenge among oncology nurses that affects their emotional well-being and professional competence in coping with death-related situations. Death-related attitudes and resilience are critical factors that may mediate the relationship between DA and coping with death competence (CDC). However, few studies have examined the chain-mediating effect of these factors among Chinese oncology nurses. This study aimed to investigate the association between DA and CDC among Chinese oncology nurses, with a focus on the mediating roles of death attitude and resilience.
To investigate the association between DA and CDC among Chinese oncology nurses.
A national cross-sectional survey was conducted among Chinese oncology nurses using an electronic questionnaire distributed in Wenjuanxing, China. In total, 615 valid responses were obtained. The participants completed the Templer death anxiety scale, death attitude profile-revised, Connor-Davidson resilience scale, and coping with death scale. A chain mediation analysis was performed using the PROCESS macro in SPSS to examine the relationships between these variables.
The findings indicated that DA had a significant direct effect on CDC [effect = 0.201, 95% confidence interval (CI): 0.112-0.322]. In addition to this direct effect, three significant indirect pathways were observed: (1) Death attitude (effect = 0.118, 95%CI: 0.056-0.163); (2) Resilience (effect = 0.108, 95%CI: 0.032-0.176); and (3) A sequential mediation pathway involving both death attitude and resilience (effect = 0.071, 95%CI: 0.042-0.123). The total indirect effects of the three mediation paths accounted for 29.7% of the relationship between DA and CDC.
Using a chain mediation model, this study explored the mechanisms linking DA, death attitude, resilience, and CDC among Chinese oncology nurses. These findings highlighted the crucial role of death attitude and resilience in mediating the relationship between DA and CDC. Interventions aimed at fostering adaptive attitudes toward death and enhancing resilience may improve nurses' ability to cope with death-related stressors, ultimately benefiting their psychological well-being and professional competence.
死亡焦虑（DA）是肿瘤护理人员中普遍存在的心理挑战，会影响他们的情绪健康以及应对与死亡相关情况的专业能力。与死亡相关的态度和心理韧性是可能调节死亡焦虑与应对死亡能力（CDC）之间关系的关键因素。然而，很少有研究探讨这些因素在中国肿瘤护理人员中的链式中介作用。本研究旨在调查中国肿瘤护理人员中死亡焦虑与应对死亡能力之间的关联，重点关注死亡态度和心理韧性的中介作用。
调查中国肿瘤护理人员中死亡焦虑与应对死亡能力之间的关联。
在中国通过问卷星分发电子问卷，对中国肿瘤护理人员进行了一项全国性横断面调查。共获得615份有效回复。参与者完成了坦普勒死亡焦虑量表、修订后的死亡态度量表、康纳-戴维森心理韧性量表和应对死亡量表。使用SPSS中的PROCESS宏进行链式中介分析，以检验这些变量之间的关系。
研究结果表明，死亡焦虑对应对死亡能力有显著直接效应[效应=0.201，95%置信区间（CI）：0.112 - 0.322]。除了这种直接效应外，还观察到三条显著的间接路径：（1）死亡态度（效应=0.118，95%CI：0.056 - 0.163）；（2）心理韧性（效应=0.108，95%CI：0.032 - 0.176）；（3）涉及死亡态度和心理韧性的顺序中介路径（效应=0.071，95%CI：0.042 - 0.123）。这三条中介路径的总间接效应占死亡焦虑与应对死亡能力之间关系的29.7%。
本研究使用链式中介模型，探讨了中国肿瘤护理人员中死亡焦虑、死亡态度、心理韧性和应对死亡能力之间的联系机制。这些发现突出了死亡态度和心理韧性在调节死亡焦虑与应对死亡能力之间关系中的关键作用。旨在培养对死亡的适应性态度和增强心理韧性的干预措施可能会提高护士应对与死亡相关压力源的能力，最终有益于他们的心理健康和专业能力。
