Death anxiety, sense of meaning in life, and willingness to body donation among nursing students in anatomy course: An explanatory sequential mixed study.

BACKGROUND: Anatomy education is a fundamental part of clinical nursing, but anatomy courses may lead to a range of psychological changes, such as death anxiety and sense of meaning in life. Such experiences and changes may influence student's willingness to donate their body. There is insufficient evidence on whether anatomy courses bring about these changes, and the reasons behind experiences are unclear. Focusing on these changes is essential to improve anatomy education in nursing and to promote the mental health of students in the nursing field.

OBJECTIVES: To explore changes and underlying reasons for death anxiety, sense of meaning in life, and the willingness to donate a body before and after anatomy courses.

DESIGN: An explanatory sequential explanatory mixed-methods study.

PARTICIPANTS: A total of 60 students completed quantitative surveys and 16 students from the sub-samples of the quantitative stage were included in the qualitative interviews. All students were from a comprehensive university in Changsha, Hunan Province, China.

METHODS: Data were collected from September 2022 to April 2023, including two rounds of questionnaire surveys and one interview. The questionnaires included sociodemographic data, the Death Anxiety Scale (CT-DAS), the Meaning of Life Scale (MLQ), and a body donation willingness question. Interviews were conducted based on the research objectives. The statistical methods included descriptive statistics, z-tests, and thematic analysis.

RESULTS: Quantitative results showed a decrease in emotional dimension of death anxiety (z = -2.534, P < 0.05) and an increase in body donation willingness (z = -3.183, P < 0.05). Qualitative analysis revealed cognitive experience and value assessment may relate to the changes. Based on the two themes, the reduction of death anxiety in emotional dimension can be further attributed to four factors: demystification, instrumentalization, desensitization, and respect and gratitude towards donors. The increase in willingness to donate bodies can be further attributed to two aspects: increase in knowledge of body donation and the affirmation of the value of donation.

CONCLUSION: The study found that students experience a decrease in death anxiety in the emotional dimension and an increased inclination to donate their bodies after anatomy courses, which may be related to cognitive experience and value assessment. Future nursing anatomy education could delve deeper into these two perspectives and support students to positively cope with death anxiety and rethink body donation through enriching death education activities such as donor memorial ceremonies. These results provide a basis for designing anatomy courses and improving the psychological well-being and professional competence of nursing students.