Death Literacy and Related Factors Among Nursing Students in Turkey: The Role of Spiritual Well-Being

Death literacy is a novel concept that refers to knowledge, skills, and experiences related to end-of-life and death care. The purpose of this study was to identify nursing students' death literacy levels and examine the effects of sociodemographic characteristics, end-of-life care experiences, and spiritual well-being on death literacy. Data for this descriptive and correlational study were collected using a descriptive information form, the death literacy index, and the spiritual well-being scale. The study was carried out between 15 March and 30 May 2024 with the participation of nursing students (n = 930) enrolled in the Nursing Departments of two universities in Western Turkey. The participants' death literacy was moderate, while their spiritual well-being was high. According to the results of the hierarchical linear regression analysis, the statistically significant factors affecting death literacy among nursing students were gender (β = 0.149), class year (β = 0.107), supporting someone with a life-threatening illness (β = 0.077), supporting a grieving person (β = 0.079), and the harmony with nature subdimension of spiritual well-being (β = 0.181). Transcendence was initially a significant predictor of death literacy; however, its direct effect diminished and became non-significant when the harmony with nature subdimension was added to the model. This suggests that transcendence may influence death literacy indirectly through its association with harmony with nature. In addition, the anomie subdimension was not found to be a significant predictor of death literacy. Having high levels of death literacy and spiritual well-being may help nursing students provide patients and patients' relatives with higher-quality care. Therefore, the integration of these concepts into nursing education will increase the quality of patient care by helping nurses become more qualified and sensitive in their provision of end-of-life care.