The Influence of Spirituality, Meaning in Life and Hospice Perception on Attitudes towards Terminal Care in Nursing Students

간호대학생의 영성, 생의 의미, 호스피스 인식 정도가 임종간호태도에 미치는 영향

  • 심미경 (신성대학교 간호학부) ;
  • 박정모 (경인여자대학교 간호학과)
  • Received : 2017.05.01
  • Accepted : 2017.07.07
  • Published : 2017.07.31


This study was conducted to evaluate the spirituality, perceived meaning in life, hospice perception, and attitudes towards terminal care among nursing students, as well as to identify the relationships between variables and examine factors influencing their attitudes towards terminal care. Data were collected using a self-reported questionnaire completed by 308 nursing students at two universities from April 11, 2017 to April 17, 2017. Data were analyzed using descriptive analysis, a t-test, Pearson's correlation coefficients and stepwise multiple regression with the SPSS/Win 14.0 program. Attitudes toward terminal care among nursing students were significantly correlated with hospice perception(r=0.30, p<0.001) and meaning in life(r=0.30, p<0.001). Meaning in life among nursing students was significantly correlated with hospice perception(r=0.25, p<0.01) and spirituality(r=0.53, p<0.01). The significant predictors of the attitudes towards terminal care in nursing students were hospice perception(${\beta}=0.40$, p<0.001) and meaning in life(${\beta}=0.27$, p<0.001). Hospice perception explained 22.7% and meaning in life explained 5.0% of the variance. These variables explained 27.7% of the variance in attitudes toward terminal care. Overall, these findings suggest that the terminal care education program, including hospice perception and meaning in life, is necessary to enhance the positive attitude toward terminal care among nursing students.


Attitude;Hospice;Nursing students;Spirituality;Terminal care


  1. Atul G, Being mortal, H. J. Kim, Translator Seoul: Bookie Publishing House, pp. 23-287, 2015.
  2. S. N. Kim, S. O. Choi, "Nurses' death anxiety and spirituality", The Journal of Korean Academic Society of Nursing Education, vol. 16, no. 1, pp. 101-110, 2010. DOI:
  3. S. N. Kim, H. J. Kim, S. O. Choi, "Effects of a hospice and palliative care education program including meaning in life on attitude toward end-of-life care and meaning in life among nursing college students", The Journal of Korean Academic Society of Nursing Education, vol. 17, no. 3, pp. 454-463, 2011. DOI:
  4. J. Y. Han, N. Y. Lee, "Nursing students' attitude toward death and perception on hospice care", Asian Oncology Nursing, vol. 9, no. 2, pp. 95-103, 2009.
  5. Y. J. Cho, "The influence of elderly's spirituality and gerotranscendence on the life satisfaction", Ph. D. dissertation, Jeonju, Chonbuk National University, 2015.
  6. E, R. Canda, "Conceptualizing spirituality for social work: insights from diverse perspective", Social Thought, vol. 14, no. 1, pp. 30-46, 1988. DOI:
  7. Y. S. Kwon, C. N. Kim, "A correlation study on spiritual well-being and death anxiety of the elderly", The Journal of Korean Academic Community Health Nursing, vol. 14, no. 1, pp. 132-143, 2003.
  8. M. O. Yoon, "The effect of a death preparing education program on death anxiety, spiritual well-being, and meaning of life in adults", The Journal of Korean Academic Community Health Nursing, vol. 20, no. 4, pp. 513-521, 2009.
  9. K. H. Jo, A. R. Park, J. J. Lee, S. J. Choi, "The influence of humanistic knowledge, hospice perception and spirituality on terminal care performance of clinical nurses", Korean Journal of Medical Ethics, vol. 18, no. 2, pp. 103-116, 2015.
  10. M. J. Jo, "Factors affecting attitudes toward terminal care in nursing students". The Korean Journal of Hospice and Palliative Care, vol. 18, no. 4, pp. 306-312, 2015. DOI:
  11. V. E. Frankl, Man's search for meaning:an introduction to logotherapy. S. H. Lee, translator, pp. 140-228, Seoul: Chung-A Publishing Co, 2005.
  12. S. O. Chang, P. M. Burbank, "Meaning in life among the elderly", Journal of Korean Academy of Nursing, vol. 30, no. 2, pp. 259-271, 2000. DOI:
  13. D. Simmons, "Purpose in life and the three aspects of valuing", Journal of Clinical Psychololgy, vol. 36, pp. 921-922, 1980. DOI:<921::AID-JCLP2270360414>3.0.CO;2-N<921::AID-JCLP2270360414>3.0.CO;2-N
  14. S. O. Choi, S. N. Kim, K. I. Shin, J. J Lee, "Development of Meaning in Life Scale II", Journal of Korean Academy of Nursing, vol. 35, no. 5, pp. 931-942, 2005
  15. S. O. Choi, S. N. Kim, "Inquisition of meaning in life for logotherapy application in hospice nursing". The Journal of Korean Academic Society of Nursing Education, vol. 9, no. 2, pp. 329-339, 2003.
  16. Y. E. Lee, E. A. Choi, K. E. Lee, "Spiritual well-being, Attitude to death and perception of hospice care in college students", The Korean Journal of Hospice and Palliative Care, vol. 18, no. 4, pp. 294-305, 2015. DOI:
  17. G. H. Kim, "The perceptions of hospice palliative care and terminal care attitudes of nurses at long-term care hospitals", Unpublished master' thesis, Pusan, Catholic University, 2016.
  18. Y. S. Seo, K. W. Sung, "Influence of nurses' spirituality on hospice nursing intervention in long-term care facilities", Journal of Korean Gerontological Nursing, vol. 14, no. 1, pp. 12-20, 2012.
  19. E. M. Hong, M. D. Jun, E. S. Park, E. J. Ryu, "Death perceptions, death anxiety and attitudes to death in oncology nurses". Asian Oncology Nursing, vol. 13, no. 4, pp. 265-272, 2013.
  20. S. A. Yang, "Convergence analysis of factors influencing the end-of-life care attitude in undergraduate nursing students", Journal of the Korea Convergence Society, vol. 7, no. 4, pp. 141-154, 2016. DOI:
  21. K. H. Formmelt, "The effect of death education on nurses' attitudes toward caring for terminally ill person and their families", The American Journal of Hospice & Palliative Care, vol. 8, no. 5, pp. 37-43, 1991. DOI:
  22. H. J. Cho, E. S. Kim, "The effect of the death education program on the death anxiety and attitudes toward nursing care of the dying patients of nursing students", The Korean Journal of Hospice and Palliative Care, vol. 18, no. 2, pp. 163-172, 2005.
  23. R. F. Paloutzian, C. W. Ellison, Loneliness, spiritual well-being and the quality of life. In loneliness: a sourcebook of current theory, research and therapy, New York, L. A. Peplau & D. Perlman, 1982.
  24. J. S. Park, "A correlation study among loneliness, spiritual well-being, and quality of life in the elderly", Unpublished master's thesis, Seoul, Koreaa University, 2005.
  25. Y. J. Roh, Hospice & death.. Seoul, Hyunmoonsa, 1994.
  26. J. H. Kim, "A study of attitude about death and hospice of medical professionals", Unpublished master's thesis, Seoul, Hanyang University, 1990.
  27. M. S. Kim, C. S. Lee, H. C. Kim, "The effect of hospice volunteer education program on perceptions about hospice and the meaning of life", Asian Oncology Nursing. vol. 7, no. 2, pp. 131-139. 2007.
  28. Y. E. Lee, H. S. Park, S. K. Son, "The relationship between spiritual well-being and attitude toward death in nursing students", Faith & Scholarship. vol. 12, pp. 195-232, 2007.
  29. S. M. Kim, S. O. Kim, "Factors influencing meaning in life of nursing students", The Journal of Korean Academic Society of Nursing Education. vol. 23, no. 1 pp. 57-65, 2017. DOI:
  30. Y. E. Lee, E. J. Choi, J. S. Park, S. H. Shin, "Perception and knowledge of hospice care and attitude toward death held by medical professionals from the same region in Korea", The Korean Journal of Hospice and Palliative Care, vol. 16, no. 4, pp. 242-252, 2013. DOI:
  31. M. S. Kim, "Comparison on the perception about hospice and the meaning of life of participants and non-participants of the hospice volunteer education program", Unpublished master's thesis, Gwangju, Chonnam National University, 2007.
  32. S. E. Kim, "Knowledge of hospice and attitude toward care of the dying in university students". Unpublished master's thesis, Pusan, Catholic University, 2014.
  33. J. Swinton, "Spiritual care: a multidisciplinary model of care", Health Mission, vol. 17, no. 1, pp. 5-23, 2009.
  34. B. R. Kim, C. U. Oh, H. K. Kang, "Effect of death education program on self-esteem, spiritual well-being, and pain of adults", Journal of the Korea Academia-Industrial cooperation Society, vol. 17, no. 9, pp. 156-162, 2016. DOI: