A Multicenter Cross-Sectional Study on Nurses’ Attitudes Toward End-of-Life Care and Influencing Factors: A Latent Profile Analysis

Background: Nurses’ attitudes and beliefs regarding end-of-life issues significantly impact the quality of care provided to dying patients. While several studies have explored medical students' attitudes toward end-of-life care, there is a lack of in-depth analysis of the internal variations and factors influencing clinical nurses' attitudes toward death. This study aimed to identify different profiles of attitude toward care for dying patients and explore the factors influencing each profile. Methods: This multicenter cross-sectional study recruited 1698 participants using convenience sampling from 60 hospitals across Sichuan Province, China. Data were collected from February 1 to April 30, 2024. The study utilized a self-designed General Information Questionnaire, Frommelt Attitudes Toward Care of the Dying Scale Form B (FATCOD-B), Templer-Death Anxiety Scale (T-DAS), and Meaning in Life Questionnaire (MLQ). Binary regression analysis and Latent Profile Analysis (LPA) are used to identify the latent classes and factors impacting the classes of attitudes toward caring for the dying. Results: Nurses’ attitudes toward caring for dying patients were categorized into two distinct profiles: the positive attitude group (40.9%, N=673) and the negative attitude group (59.1%, N=971). The mean scores for these profiles were 103.67 ± 0.40 and 94.10 ± 0.22, respectively, with a significant difference between them (F=480.282, P ＜0.001). The key factors contributing to these differences included bereavement experience within 1-year, prior death education training, sense of meaning in life, and death anxiety ( P < 0.05). Conclusions: Nurses’ attitudes toward caring for dying patients can be classified into positive and negative attitude profiles, with key influencing factors including bereavement experience, death education training, sense of meaning in life, and death anxiety. Healthcare administrators, educators, and policymakers should develop targeted interventions based on the specific features of each categoryand influencing factors to enhance end-of-life care practices.