Nurse education in practice · 2025
The effect of the "Tears of Life" situational puzzle board game on death anxiety among nursing students: A randomized controlled trial.
СтатьяРандомизированное исследованиеНазвание и аннотация: Перевод в очереди
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Qian Wenna, Liu Siyi, Sun Huizi, Zhang Yue, Fang Yiting, Li Xiaohan, Li Jialin
Аннотация
OBJECTIVES: To examine the effects of death education using a situational puzzle board game versus reflective writing on nursing students' death anxiety, self-esteem and sense of meaning in life.
BACKGROUND: Pre-clinical nursing students often exhibit high death anxiety due to limited clinical experience, potentially compromising future palliative care quality. Game-based learning shows promise in nursing education, warranting investigation for death education.
DESIGN: Parallel randomized controlled trial with pretest-posttest control group.
METHODS: The intervention group completed the "Tears of Life" board game, featuring clue cards, quotation cards, growth cards and freedom cards based on Tolstoy's The Death of Ivan Ilyich and Kalanithi's When Breath Becomes Air. The control group completed DEAL (Description- Examination- Articulate Learning-Apply to Future) model-guided reflective writing on the same texts. Outcomes were measured using Templer's Death Anxiety Scale, Meaning in Life Questionnaire and Rosenberg Self-Esteem Scale.
RESULTS: Both interventions significantly reduced death anxiety and enhanced meaning in life (p < 0.05 for within-group differences). Crucially, the situational puzzle board game intervention demonstrated significantly greater efficacy in reducing death anxiety and enhancing meaning in life compared with reflective writing (p < 0.05 for between-group differences). Neither intervention significantly improved self-esteem (p > 0.05 for within-group and between-group differences).
CONCLUSION: Death education using the situational puzzle board game was significantly more effective than reflective writing in reducing death anxiety and enhancing meaning in life among nursing students. This game-based approach offers an innovative and engaging pedagogical tool for death education, though long-term effects on self-esteem require further investigation.
BACKGROUND: Pre-clinical nursing students often exhibit high death anxiety due to limited clinical experience, potentially compromising future palliative care quality. Game-based learning shows promise in nursing education, warranting investigation for death education.
DESIGN: Parallel randomized controlled trial with pretest-posttest control group.
METHODS: The intervention group completed the "Tears of Life" board game, featuring clue cards, quotation cards, growth cards and freedom cards based on Tolstoy's The Death of Ivan Ilyich and Kalanithi's When Breath Becomes Air. The control group completed DEAL (Description- Examination- Articulate Learning-Apply to Future) model-guided reflective writing on the same texts. Outcomes were measured using Templer's Death Anxiety Scale, Meaning in Life Questionnaire and Rosenberg Self-Esteem Scale.
RESULTS: Both interventions significantly reduced death anxiety and enhanced meaning in life (p < 0.05 for within-group differences). Crucially, the situational puzzle board game intervention demonstrated significantly greater efficacy in reducing death anxiety and enhancing meaning in life compared with reflective writing (p < 0.05 for between-group differences). Neither intervention significantly improved self-esteem (p > 0.05 for within-group and between-group differences).
CONCLUSION: Death education using the situational puzzle board game was significantly more effective than reflective writing in reducing death anxiety and enhancing meaning in life among nursing students. This game-based approach offers an innovative and engaging pedagogical tool for death education, though long-term effects on self-esteem require further investigation.