Ruishuang Zheng 

MSN, RN, Nurse,Department of Nursing,Tianjin Medical University Cancer Institute &Hospital  

Cancer Nursing, IF 1.850

Death self-efficacy, attitudes toward death and burnout among oncology nurses: A multicenter cross-sectional study

Ruishuang Zheng, Qiaohong Guo, Fengqi Dong, Li Gao


Background: Oncology nurses are supposed to demonstrate a certain level of death self-efficacy when caring for dying patients and patient death. Failure to do so may lead to burnout.

Objectives: To clarify the perceived level of death self-efficacy of oncology nurses and to explore its relationships with attitudes toward death and burnout.

Methods: A multi-center, cross-sectional study was performed in seven cancer hospitals between June and July, 2019 across mainland China. Data were collected through an online survey with the Death Self-efficacy Scale, Death Attitude Profile-Revised Scale, and Maslach Burnout Inventory. 

Results: Oncology nurses reported low death self-efficacy and high levels of burnout. Those who had more years of clinical experience, had the highest professional rank, talked death quite often, and have received palliative care trainings, doing no shift work, scored higher on death self-efficacy. Death self-efficacy was positively correlated with positive attitudes towards death and negatively correlated with levels of burnout. The multiple regression analysis showed that death self-efficacy and attitudes toward death were independent, significant predictors of oncology nurses’ burnout.

Conclusions: Oncology nurses are not well prepared to care for dying cancer patients and cope with death related issues. They are advised to improve death self-efficacy through continuing education and professional growth, which in turn would decrease burnout.

Implications for practice: Improvement in death self-efficacy among oncology nurses is necessary, especially for those who are young, unmarried, doing shift work, and never received training on palliative care.


Attitudes toward death, Burnout, Cancer, Death competency, Death self-efficacy, Oncology nurses