The relationship between death attitude and professional identity in nursing students from mainland China

Background: Professional identity reduces the risk of job burnout in nurses, and attitudes towards death might be a factor affecting nurses' professional identity. Little research has been conducted to directly investigate the relationship between professional identity and death attitudes in nursing students. In addition, there are cultural differences in the formation of death attitudes. It is necessary to explore attitudes towards death in Chinese nursing students and investigate the relationship between death attitudes and professional identity. Objectives: To investigate the relationship between professional identity and death attitudes in nursing students in mainland China. Design: A cross-sectional study. Participants: A total of 2119 nursing students from mainland China were included in this survey. Methods: The survey was conducted online. The questionnaire included the Chinese version of the Professional Identification Scale and the Chinese version of the Death Attitude Profile - Revised to measure the nursing students' professional identity and attitudes towards death. The survey also collected the participants' age, gender, institution type, place of residence and self-assessed health state. Results: The professional identity of the nursing students (average scores: 33.68 +/- 5.12) from mainland China was above an intermediate level, and their attitudes towards death were positive overall (escape acceptance: 3.37 +/- 0.96, approach acceptance: 3.36 +/- 0.79, fear of death: 2.88 +/- 0.77, death avoidance: 2.74 +/- 0.84, neutral acceptance: 2.29 +/- 0.77). Among the nursing students, professional identity was correlated with attitudes towards death. Specifically, professional identity was positively correlated with approach acceptance (p < 0.001), escape acceptance (p < 0.001) and neutral acceptance (p < 0.001) but negatively correlated with fear of death (p < 0.001) and death avoidance (p < 0.001). The nursing students with relatively low professional identity showed stronger death anxiety than those with relatively high professional identity (p < 0.001). Conclusion: The outcome of this study suggests that education on life and death and internship experience in palliative care contribute to the development of a high level of professional identity in nursing work.