Page 250 - EJMO-9-3

Eurasian Journal of
Medicine and Oncology Nursing students’ views on advance directives

and regression models as an independent variable. 12 (30.8%) student’s pre-module to 11 (28.2%) post-
However, it was excluded from the correlation analysis due module. Approval of artificial nutrition increased
to insufficient variability. To identify predictors of post- slightly from 14 (35.9%) students to 15 (38.5%), whereas
intervention willingness to donate organs, a binary logistic acceptance of deep sedation increased from 29 (74.4%)
regression model was conducted, including age, gender, students to 30 (76.9%). Preferences for dialysis remained
and consistency as independent variables. unchanged (n = 11, 28.2%) at both time points, mirroring
approval for emergency surgery (n = 13, 33.3%). Finally,
Finally, thematic analysis of open-ended responses
was performed, followed by frequency analysis and support for blood transfusions increased from 12 (30.8%)
students to 14 (35.9%), and antibiotic therapy rose from
graphical visualization of thematic shifts. All analyses were 16 (41.0%) students to 17 (43.6%). These marginal
conducted using R version 4.3.2 (R Core Team, Vienna, shifts underscore that, even after targeted palliative care
Austria). A two-tailed p<0.05 was considered statistically education, core attitudes toward these critical treatments
significant.
were largely stable. Preferences for cardiopulmonary
3. Results resuscitation and dialysis demonstrated a non-significant
increase after the intervention (odds ratio [OR] = 2.50 and
3.1. Sample characteristics 2.00, respectively), whereas palliative sedation remained
A total of 39 3 -year nursing students participated in this unchanged (OR = 1.00). These findings may indicate a
rd
study, with a mean age of 22.4 ± 1.8 years, and 74.6% were trend toward greater therapeutic openness, although this
female. All participants completed both the pre- and post- change was not statistically significant (Table 1).
module questionnaires, yielding a fully paired dataset. The 3.4. Religious support and funeral arrangements
homogeneity of the academic level and the narrow age
range helped control for extraneous variability, although The module appeared to affect students’ views on spiritual
the predominance of female respondents reflects the care and post-mortem planning. Before instruction,
broader gender distribution typical within nursing cohorts. 5 (12.8%) participants opted against any religious assistance
All data are presented in Tables S1-S6. at the end of life. However, after completing the module,
none (n = 0, 0%) chose “no religious assistance,” indicating
3.2. Advance disclosure of health status a unanimous openness to spiritual support. In parallel, the
Before the educational intervention, nearly all students proportion selecting a religious funeral increased from
(n = 36, 92.3%) reported feeling comfortable authorizing 28 (71.8%) participants to 32 (82.1%), suggesting that the
disclosure of their health status and life expectancy to their educational content may have highlighted the role of faith
parents. This proportion decreased slightly to 34 (87.2%) and tradition in holistic palliative care. In addition, the
after the module. In contrast, the willingness to share proportion choosing “other” types of assistance decreased
such information with siblings increased slightly from slightly from 3 (7.7%) to 2 (5.1%), whereas non-response
31 (79.5%) to 32 (82.1%) students, while authorization for rates increased from 4 (10.3%) to 5 (12.8%). These shifts
friends rose from 19 (48.7%) to 20 (51.3%) students. The suggest not only a growing preference for formal religious
most pronounced change occurred regarding participants’ rites but also a modest consolidation of opinions, with
own children: initial willingness was 16 (41.0%) but fewer participants opting for unspecified options.
decreased significantly to 8 (20.5%) post-intervention, 3.5. Post-mortem dispositions
suggesting that students reconsidered the ethical and
emotional appropriateness of involving minors in end- Students’ post-mortem preferences also shifted to a
of-life discussions. Authorization to inform partners limited extent. Support for organ donation for transplant
remained largely unchanged, shifting from 27 (69.2%) to remained nearly universal, declining only slightly from
26 (66.7%) participants. 37 participants (94.9%) before the module to 36 (92.3%)
afterward (χ² [1 =1.778, p=0.182), indicating stable attitudes
3.3. Preferences for life-sustaining treatments in toward this option. Willingness to donate one’s body for
irreversible conditions scientific purposes increased from 14 (35.9%) pre-module

When asked about specific life-sustaining interventions in to 16 (41.0%) post-module, and preference for cremation
the context of an irreversible illness, students’ responses increased from 18 (46.2%) to 21 (53.8%) (χ² [1 = 0.205,
remained remarkably consistent. Cardiopulmonary p=0.651). In contrast, the choice of inhumation remained
resuscitation was accepted by 14 students (35.9%) out unchanged, shifting from 10 (25.6%) before to 9 (23.1%).
of 39, both before and after the module. Mechanical These patterns suggest that the educational content may
ventilation showed a slight reduction in approval, from have influenced less familiar dispositions—particularly

Volume 9 Issue 3 (2025) 242 doi: 10.36922/EJMO025250263