Intern nursing students' perceived barriers to providing end-of-life care for dying cancer patients in a death taboo cultural context: A qualitative study

Asia Pac J Oncol Nurs. 2023 Feb 21;10(4):100210. doi: 10.1016/j.apjon.2023.100210. eCollection 2023 Apr.

Abstract

Objective: Internationally, intern nursing students' experiences with dying patients and death are an area of great concern. However, barriers to providing end-of-life care for dying cancer patients have not been extensively investigated in mainland China, where death remains a taboo issue. Therefore, this study aimed to elucidate intern nursing students' perceived barriers to their performance in providing end-of-life cancer care in the Chinese cultural context.

Methods: This was a descriptive, qualitative study. Twenty-one intern nursing students from three cancer centers in mainland China were interviewed between January 2021 and June 2022. A thematic analysis method was used to analyze the data. The theory of planned behavior was adopted to design the study and identify themes.

Results: A range of barriers related to attitudes, subjective norms, and perceived behavioral control that hindered intern nursing students from acquiring abilities to deal with patient dying and death were identified in the Chinese cultural context.

Conclusions: Chinese intern nursing students encountered many barriers that affected their provision of end-of-life care to dying cancer patients. Strategies to improve their ability to provide appropriate end-of-life care should focus on helping them develop appropriate attitudes toward dying and death and how to overcome subjective norms and behavioral control barriers.

Keywords: Barriers; China; Death taboo; End-of-life care education; Intern nursing students; Oncology settings.