Integrating Personalized Psychological Support With Death Education in Nursing Interventions for Elderly Terminal Cancer Patients: A Retrospective Study on Life and Death Perception.

Abstract

Aims/Background Terminal cancer patients face profound physical, psychological, and existential challenges. Traditional support often lacks comprehensive approaches to address the nuanced emotional needs of patients. This study evaluates the effectiveness of nursing interventions integrating death education with personalized psychological support-a combined approach designed to synergistically address existential distress-in reshaping life and death perceptions among terminal cancer patients. Methods This retrospective cohort study analyzed 251 advanced cancer patients aged ≥60 years. Propensity score matching (1:1 ratio) balanced covariates, including age, gender, body mass index (BMI), education, employment status, clinical stage, cancer type, and comorbidities, yielding 212 matched patients (106 pairs). Based on the type of nursing care, patients were divided into a conventional care group (n = 106) and a combined care group (n = 106). The conventional care group received standard health education, while the combined care group received additional death education and psychological support. Baseline and post-intervention assessments were conducted using the Death Attitude Profile-Revised (DAP-R), Anticipatory Grief Scale, Distress Thermometer (DT), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) for quality-of-life evaluation. Results After the intervention, the combined care group showed significant improvements in grief sensation, anger sensation, religious comfort, and perceived social support (p < 0.05) compared to the conventional care group. DAP-R scores indicated an enhanced approach and natural acceptance, with a decrease in death fear and avoidance (p < 0.05). Distress levels declined significantly, as evidenced by DT scores (p < 0.001). Quality-of-life scores demonstrated improvements in physical, role, emotional, and social functions (p < 0.05). Conclusion Integrating death education in nursing interventions effectively reshapes outlooks on life and death for terminal cancer patients. These interventions correlate with reduced negative emotional responses and improvements in quality-of-life metrics, suggesting their potential utility in palliative care settings.