%0 Journal Article
%T Resilience and Attitudes toward Death among Nursing Professionals: A Cross-Sectional Study
%A Mina Takahashi
%A Daichi Fujimoto
%J Journal of Integrative Nursing and Palliative Care
%@ 3006-5550
%D 2026
%V 7
%N 1
%R 10.51847/hWekGBBsWH
%P 136-151
%X Nursing professionals regularly care for patients facing the end of life, yet a significant portion report feeling insufficiently equipped to handle the emotional burdens of this work. Individual orientations toward death affect both the standard of end-of-life care provided and the psychological health of the clinicians themselves. Although resilience has been posited as a key protective resource, its precise function in determining attitudes toward death among nursing staff has not been thoroughly investigated. This investigation analyzed how resilience relates to attitudes toward death and evaluated the personal and work-related variables linked to these orientations before the COVID-19 pandemic. An observational cross-sectional design was utilized, enrolling 742 nursing professionals employed within Intensive Care, Palliative Care, and Oncology units across seven public hospital facilities in Spain. Between June 2018 and April 2019, data were collected using the Death Attitude Profile-Revised, the Connor-Davidson Resilience Scale, and a custom-designed questionnaire that captured sociodemographic and professional characteristics. Statistical evaluations involved multivariate analyses of variance, correlation testing, mediation and moderation modeling, and principal component analysis. The primary orientation toward death reported by participants was Neutral-Acceptance (M = 5.68, SD = 0.90), with lower scores observed for Fear-of-Death (M = 3.70, SD = 1.39) and Death-Avoidance (M = 3.53, SD = 1.59). Clinicians’ viewpoints on death were significantly associated with professional designation, chronological age, specialized education in death and bereavement, clinical department, and individual resilience levels (all p < .05). Resilience demonstrated a positive correlation with Neutral-Acceptance and inverse correlations with Fear-of-Death and Death-Avoidance. Furthermore, mediation testing indicated that resilience functioned as a total mediator between multiple professional variables and primary death attitudes, with suppression phenomena detected within specific models. Individual resilience and targeted education on death and dying appear to be vital components in shaping how nursing staff perceive mortality. Embedding resilience-building initiatives and structured death education within academic degrees and ongoing professional development could enhance the psychological well-being of nursing staff and raise the standard of end-of-life healthcare delivery.
%U https://journalinpc.com/article/resilience-and-attitudes-toward-death-among-nursing-professionals-a-cross-sectional-study-mpie1zqcovsy1e2