Educational death café programme as an intervention for coping with death, thanatophobia and readiness for advance...

This study aimed to develop and evaluate an educational death café programme on coping with death, thanatophobia, and readiness for advance care planning (ACP) among final year nursing students.

Nursing students often feel unprepared to face death, struggle to cope with death and discussions surrounding ACP. Death cafés have emerged as a potential educational strategy to normalise death conversations in a safe, informal setting. Hence, this study aimed to examine the effects of a new educational death café on nursing students' outcomes within an Asian setting.

A sequential explanatory mixed methods design comprising of a two-arm quasi-experimental study and a descriptive qualitative study was conducted to evaluate the educational death café programme.

In Phase I, a two-arm quasi-experimental study recruited nursing students from a one university in Singapore to participate in a facilitator-led educational death café. The Coping with Death, Thanatophobia and Readiness for Advance Care Planning scales were used. In Phase II, a descriptive qualitative study was conducted to explore participants' experiences of the educational death café. Descriptive and inferential statistics were used to analyse demographic characteristics. Intention-to-treat paired t-tests and independent t-tests examined within group and between group differences respectively. Thematic analysis was used for the qualitative data. A mixed method analysis method was used to integrate the quantitative and qualitative data.

A total of 194 students completed pre-test measures and were allocated to intervention group (n = 112) or waitlist control group (n = 82). The educational death café significantly improved coping with death and readiness for practice of talking and writing of ACP scores while the waitlist control group improved in coping with death and readiness for recognising the importance of talking and writing about ACP scores. Between group analyses revealed significant differences in coping with death scores. Both groups were comparable in thanatophobia. The three themes that elucidated from the participants' narratives are (1) conducive environment facilitates death conversations, (2) death café facilitates coping and fear of death, and (3) death conversations stimulate one's readiness for advance care planning.

This study provides preliminary evidence that an educational death café is an acceptable and appropriate programme for nursing students. Educational death café programmes have the potential to improve nursing students' ability to cope with death and stimulate students' interest to engage in ACP. Future research is needed to optimise death cafes' educational impact and its potential as a community-based intervention to promote ACP awareness and uptake.