Hospice Care Knowledge and Death Attitude Profiles Among Healthcare Workers: A Latent Profile Analysis

Background Healthcare workers’ attitudes toward death play an important role in the quality of end-of-life care, yet such attitudes are often treated as homogeneous and insufficiently examined in relation to hospice care preparedness. Understanding heterogeneity in death attitudes and their educational correlates is essential for strengthening the palliative care workforce. Methods A cross-sectional survey was conducted among 1,421 healthcare workers from secondary and tertiary hospitals in Zhejiang Province, China. Death attitudes were assessed using the Death Attitude Profile–Revised (DAP-R), and hospice care knowledge was measured using a structured questionnaire. Latent profile analysis was applied to identify distinct death attitude profiles. A multinomial logistic regression model was used to examine associations between hospice care knowledge, demographic characteristics, and profile membership. Results Three distinct death attitude profiles were identified: a moderate profile characterized by balanced acceptance and fear, a more adaptive profile marked by higher acceptance and lower fear, and a less adaptive profile characterized by lower acceptance and higher fear or avoidance. Hospice care knowledge showed a consistent and graded association with profile membership, with higher knowledge levels associated with increased likelihood of belonging to more adaptive profiles. In contrast, demographic and occupational characteristics were not significantly associated with profile membership. Overall, hospice care knowledge levels were relatively low, with most participants scoring in the poor or very poor range. Conclusion Healthcare workers exhibit substantial heterogeneity in attitudes toward death, which is closely associated with hospice care knowledge. These findings highlight the relevance of educational preparedness in shaping engagement with end-of-life care and support the integration of structured hospice and palliative care education into routine professional training to enhance workforce readiness and improve the quality of end-of-life care