Abstract
BACKGROUND: Death anxiety is a common emotional response to death, and it varies in intensity across cultures and regions. However, there is a paucity of research on death anxiety among nursing students during their clinical internship, especially in relation to their emotional experiences and behavioral responses. AIM: To explore the relationship between empathy and death anxiety as well as to identify factors influencing students' empathetic skills during their initial clinical experiences. METHODS: This cross-sectional study included 473 nursing students enrolled from across vocational colleges in Quanzhou (Fujian Province, China) during June-July 2023. These students were trained at three Grade-A general hospitals. The Empathy Scale and Death Anxiety Scale were applied to assess their empathetic skills and death anxiety levels during the early stages of the clinical internship. Data analyses employed descriptive statistics, correlation analyses, independent sample t-tests, one-way analysis of variance, and multiple linear regression analysis. RESULTS: The mean death anxiety score was 46.33 ± 6.29, with 95.6% of participants exhibiting high death anxiety. The mean scores across dimensions were as follows: Cognitive-affective, 18.08 ± 3.15; pain and illness, 13.25 ± 2.41; awareness of the passage of time, 5.58 ± 1.40; stimuli related to death, 9.40 ± 1.56. The mean empathy score was 63.78 ± 11.49. Regression analysis revealed that students' subject major, total death anxiety level, and pain and stress dimensions acted as significant predictors of their empathetic skills during early clinical practice (P < 0.05). CONCLUSION: Vocational nursing students, especially those in midwifery with higher death anxiety, exhibited lower empathetic skills during the early stages of their clinical internship. Nursing educators should take measures to enhance the empathetic skills of students through appropriate training and support for students with high death anxiety levels.