Study On Death Education Course For Medical Students And Its Effects

Objectives To discussion the meaning and components of death education for medical students; to work out Death Education course for medical students by using literature searching, expert consulting and questionnaire survey; to carrying out Death Education course among medical students; to explore the effects of death education on the meaning of life, attitudes toward death and self-efficacy of medical students; to provide a reference for the development of professional death education for medical students and general death education for the public in future.Methods This study was a Quasi-experimental study. In the first stage, Death Education course for medical students was worked out by synthetically using literature searching, expert consulting and questionnaire survey. In the second stage,70 nursing students in grade three of Xiangya Medical college were divided into two groups, the experimental group and the control group randomly, each group includes 35 subjects. Meanwhile,70 clinical students in grade three of Xiangya Medical college were selected randomly, and also been divided into two groups, the experimental group and the control group. There are 65 students in the control group, and 60 students in the experimental group after subtracting students who did not finish the questionnaire completely. Subjects in the experimental group were given ten weeks' Death Education course which is about 20 class hours. While those in the control group were given no intervention. All subjects in both experimental and control group were tested by the Purpose in Life Test, Death Attitude Profile-Revised, Death Attitudes questionnaire made by Yitai Cui, and the General Self-Efficacy Scale to evaluate their purposes of life, attitudes toward death,views on death, and self-efficacy before and after Death Education course. Meanwhile, the experimental group were also required to finish evaluation forms for each unit and the whole class in order to assess the effects of Death Education course for medical students. Two months after the Death Education course finished, subjects were resurvied by the Purpose in Life Test, Death Attitude Profile-Revised, Death Attitudes questionnaire made by Yitai Cui, and the General Self-Efficacy Scale to evaluate the lasting effects of death education.Results 1.More than 80% medical and nursing experts and medical students showed positive attitudes toward death education, they showed agree with the function of death education on mental health for medical students, and they also believed that it was necessary for medical students to receive death education.2.The results of one-way ANOVE showed that:Among all of the general condition, the current feeling of physiology(P=0.000) and psychology(P=0.000) health of medical students were significantly related to PIF; Among all of the background condition, experience of contact with patients with terminal illness(P=0.045), and the feeling of the most impressed death (P=0.022) were significantly related to PIF; sex difference of medical students were significantly related to Approach Acceptance-DAP (P=0.001), major difference of medical students were significantly related to Approach Acceptance-DAP (P=0.025) and Escape Acceptance-DAP (P=0.004), the current feeling of psychology health of medical students were significantly related to Escape Acceptance-DAP (P=0.024); Sex difference(P=0.001), current feeling of physiology(P=0.000) and psychology health (P=0.021), and education level of the fathers (P=0.027) of medical students were significantly related to the GSES.3.By two-independent samples t-test, the score of Quality of Life-PIL and Goal of Life-PIL were significantly different(the score of control group was lower) before intervention(P<0.05); the score of Quality of Life-PIL and Goal of Life-PIL were not significantly different(the score of intervention group was lower) after intervention(P>0.05).4.By paired t-test, the score of PIL of control group before and after intervention were not significantly different(P>0.05); the PIL score of intervention group before and after intervention were significantly different(P<0.05), the score after intervention were higher, and the difference had statistical meaning.5.By paired t-test, the score of PIL of intervention group before intervention and two months after intervention were increased, and the difference had statistical meaning; the PIL score of intervention group after intervention and two months after intervention were not significantly different(P>0.05).6.By two-independent samples t-test, the score of Fear of Death-DAP and Escape Acceptance-DAP were significantly different(the score of control group was lower) before intervention(P<0.05); the score of Fear of Death-DAP and Escape Acceptance-DAP were not significantly different(the score of intervention group was lower) after intervention(P>0.05).7.By paired t-test, the score of DAP of control group before and after intervention were not significantly different(P>0.05); the score of Fear of Death-DAP, Death Avoidance-DAP, and Escape Acceptance-DAP of intervention group before and after intervention were significantly different(P<0.05), the score after intervention were lower, and the difference had statistical meaning.8.By paired t-test, the score of DAP of intervention group before intervention and two months after intervention were not significantly different(P>0.05); the DAP score of intervention group after intervention and two months after intervention were also not significantly different(P>0.05).9.By paired t-test, the score of GSES of control group before and after intervention were not significantly different(p=0.767); the score of GSES of intervention group before and after intervention were significantly different(P=0.041), the score after intervention were higher, and the difference had statistical meaning.lO.By paired t-test, the score of GSES of intervention group before intervention and two months after intervention were significantly different(P<0.05); the GSES score of intervention group after intervention and two months after intervention were not significantly different(P>0.05).11.The repeated measures analysis of variance showed that the main effects of intervention on Quality of Life-PIL, Goal of Life-PIL, and Freedom of Life-PIL were significant (P<0.01), in other word, scores of Quality of Life-PIL, Goal of Life-PIL, and Freedom of Life-PIL were significantly different with the change of the intervention level without considering time; The main effects of time on none indicators was significant (P>0.05); There were significant interactions between time and intervention on Goal of Life-PIL, Fear of Death-DAP, Death Avoidance-DAP and Escape Acceptance-DAP.12.This study also assessed the effects of death education by feedback from medical students in intervention group. More than 82% medical students were satisfied with this class; the self-evaluation of medical students were high,76% of them were higher than 7; 58 of 60 medical students(96.7%) in intervention group would like to attend this kind of class again.Conclusion 1. Both medical and nursing experts and medical students showed positive attitude toward death education, and believed that Death Education Course was necessary for medical students.2. Death education could promote the meaning of life of medical student, and showed prolonged effects.3. Death education could improve the attitudes toward death of medical student. Though the immediate effects were remarkable, the prolonged effects were not observable.4. Death education could improve the self-efficacy of medical with better prolonged effects.5. More than 80% medical students in the intervention group were satisfied with the course, and more than 90% of them would like to attend this kind of class again. All of these indicated that the Death Education Course in this study was successful, and worthed being popularized.