A Multicenter Cross-Sectional Study on Nurses’ Attitudes Toward End-of-Life Care and Influencing Factors: A Latent Profile Analysis

A Multicenter Cross-Sectional Study on Nurses’ Attitudes Toward End-of-Life Care and Influencing Factors: A Latent Profile Analysis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article A Multicenter Cross-Sectional Study on Nurses’ Attitudes Toward End-of-Life Care and Influencing Factors: A Latent Profile Analysis Hongling Zheng, Rui Li, Hongli Ma, Qinqin Cheng, Yuxia Zhang, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5654763/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 05 Jun, 2025 Read the published version in BMC Nursing → Version 1 posted 8 You are reading this latest preprint version Abstract Background: Nurses’ attitudes and beliefs regarding end-of-life issues significantly impact the quality of care provided to dying patients. While several studies have explored medical students' attitudes toward end-of-life care, there is a lack of in-depth analysis of the internal variations and factors influencing clinical nurses' attitudes toward death. This study aimed to identify different profiles of attitude toward care for dying patients and explore the factors influencing each profile. Methods: This multicenter cross-sectional study recruited 1698 participants using convenience sampling from 60 hospitals across Sichuan Province, China. Data were collected from February 1 to April 30, 2024. The study utilized a self-designed General Information Questionnaire, Frommelt Attitudes Toward Care of the Dying Scale Form B (FATCOD-B), Templer-Death Anxiety Scale (T-DAS), and Meaning in Life Questionnaire (MLQ). Binary regression analysis and Latent Profile Analysis (LPA) are used to identify the latent classes and factors impacting the classes of attitudes toward caring for the dying. Results: Nurses’ attitudes toward caring for dying patients were categorized into two distinct profiles: the positive attitude group (40.9%, N=673) and the negative attitude group (59.1%, N=971). The mean scores for these profiles were 103.67 ± 0.40 and 94.10 ± 0.22, respectively, with a significant difference between them (F=480.282, P ＜0.001). The key factors contributing to these differences included bereavement experience within 1-year, prior death education training, sense of meaning in life, and death anxiety ( P < 0.05). Conclusions: Nurses’ attitudes toward caring for dying patients can be classified into positive and negative attitude profiles, with key influencing factors including bereavement experience, death education training, sense of meaning in life, and death anxiety. Healthcare administrators, educators, and policymakers should develop targeted interventions based on the specific features of each categoryand influencing factors to enhance end-of-life care practices. Cross-sectional studies Attitude to death Nurses Value of life Latent Profile Analysis Figures Figure 1 1. Background Providing care for patients is a fundamental responsibility and a significant challenge for healthcare professionals ( 1 ). Professional nurses serve as communicators, coordinators, and educators, and their attitudes and beliefs about end-of-life issues influence the quality of care for dying patients ( 2 , 3 ). In routine nursing work, nurses collaborate with physicians to provide end-of-life care, which includes estimating life expectancy, preserving patient dignity, and maintaining relationships ( 4 ). Discussions about death are an inherent part of this process. However, in China, discussions about death remain a cultural taboo. On most occasions, the word "death" is avoided as it symbolizes misfortune, fear, and bad luck( 5 ). Even the Arabic numeral "4" is often avoided in various contexts due to its phonetic similarity to the Chinese word for "death". This cultural aversion has contributed to the delayed development of palliative care, which is still in its early stages in the country ( 6 ). Nurses who are inadequately prepared for end-of-life care may experience emotional distress, which can adversely affect dying patients ( 7 ). Furthermore, insufficient professional skills in caring for dying patients can compromise the quality of care ( 8 ). Therefore, it is crucial for nurses to cultivate positive attitudes and beliefs, develop essential end-of-life care skills, and enhance their communication abilities ( 9 ). Levels of death anxiety and meaning in life are closely related to the quality of care provided to dying patients ( 10 , 11 ). Nurses may experience psychological stress, fear of death, and trauma when confronted with patient mortality, which can adversely affect their personal lives and caregiving responsibilities ( 12 , 13 ). Death anxiety refers to an individual's inner turmoil, including discomfort, preoccupation, and dread when contemplating the inevitability of death or the universal reality of mortality. This anxiety generates self-protective withdrawal motivations and behaviors ( 9 ), which may negatively impact end-of-life care. In contrast, death reflection constitutes a mental exercise where individuals contemplate mortality, serving as a form of death awareness that fosters positive intentions toward behavior ( 14 ). Reflecting on death promotes an understanding of the true meaning of life and facilitates comprehensive end-of-life care ( 15 ). Moreover, a sense of meaning in life is intimately related to care quality. Previous studies have indicated that nurses with a high sense of meaning in life can imperceptibly improve the quality of their work ( 16 ). Nurses involved in end-of-life care witness the final stages of patients, prompting self-reflection on the meaning of their own lives, which motivates them to pursue life values and enhances the quality of care they provide. Furthermore, there is a potential correlation between death anxiety and a sense of meaning in life. Terror management theory suggests that on the one hand, everyone dies, and on the other hand, human beings possess the instinct to ensure individual survival, and the conflict between the two leads to death anxiety( 17 , 18 ). Moreover, worldview defense is one of the most effective means of alleviating death anxiety. A worldview is a shared psychological structure that gives life a sense of meaning, order, and eternity( 19 ). Currently, there is a lack of specialized research examining the interrelationships between death attitude, death anxiety, and meaning in life. In recent years, several studies have examined medical students’ attitudes toward end-of-life care ( 20 – 22 ). However, medical students are generally not involved in patient care, and their attitudes toward end-of-life care may differ from those of clinical nurses. To understand nurses’ knowledge and attitudes toward palliative care and death, Yanping Hao conducted a study among 97 nurses from oncology departments across five hospitals, utilizing a mobile terminal combined with a virtual forum and face-to-face interactions ( 23 ). This study compared death attitude scores at baseline and 3 weeks after the intervention to validate its effectiveness but did not explore the inherent differences in death attitudes or the factors that influence them. Due to inconsistencies in the evaluation tools, the comparability of the studies was limited, and the judgment criteria relied solely on total scores, which failed to adequately capture inter-individual differences. To date, no studies have explored the potential categories of Chinese nurses' attitudes toward death or the factors contributing to the differences between these categories. To address this gap, it is crucial to adopt an individual-centered research approach that analyzes the diverse manifestations of attitudes toward care for the dying among nurses. Latent Profile Analysis (LPA) is a person-centered statistical approach used to identify distinct typologies or clusters based on patterns of responses to observed variables ( 24 , 25 ). By grouping couples with similar death attitude profiles into the same subgroup and those with differing profiles into separate categories, LPA maximizes heterogeneity between groups while minimizing heterogeneity within each group( 26 ). This method enables researchers to uncover meaningful subgroups within a population, providing insights into the diverse ways individuals or dyads respond to specific variables. Therefore, the objective of this study was to categorize attitudes toward care of the dying into different groups using LPA and explore the influencing factors that contribute to the differences between these profiles. The findings of this study provide valuable insights into the development of targeted interventions to change attitudes toward death among nurses, thereby enhancing their professional skills. 2. Methods 2.1 Design Considering both time and financial constraints, as well as gaps identified in previous studies, we conducted a multicenter cross-sectional study. 2.2 Participant Data were collected using convenience sampling from 60 hospitals across Sichuan Province between February 1 to April 30, 2024. The sample comprised nurses from various departments and regions with a diverse range of experiences and perspectives. The inclusion criteria were as follows: ( 1 ) registered nurses and ( 2 ) nurses engaged in patient care (not limited to specific types of patients). The exclusion criteria were as follows: ( 1 ) nurses who maintained an employment relationship but were not involved in patient contact during the study period, such as those on sick leave, maternity leave, or further study leave, ( 2 ) those with a history of diagnosed mental illness or currently undergoing related treatment, and ( 3 ) those who did not consent to participate in the study. 2.3. Measurement 2.3.1 General information questionnaire The questionnaire was developed based on a comprehensive literature review and discussions within the research team. It included 20 entries, including age, sex, department, whether the nurse had received death education, and whether they had experienced bereavement within the past year. 2.3.2 Frommelt Attitudes Toward Care of the Dying Scale Form B (FATCOD-B) To assess attitudes toward end-of-life care, we utilized the Frommelt Attitudes Toward Care of the Dying Scale (FATCOD-B) ( 27 , 28 ). The Chinese version of this scale consists of 29 items and six subscales. It uses a 5-point Likert scale, with 14 positive items scored from "strongly agree" to "strongly disagree" (5 to 1 points). The 15 negative items are scored in reverse, from "strongly disagree" to "strongly agree" (1 to 5 points). The total score ranges from 29 to 145, with higher scores indicating a more positive attitude towards end-of-life care and a greater likelihood of engaging in proactive caregiving behaviors for dying patients. The scale demonstrated a Cronbach’s alpha coefficient and a content validity of 0.79 and 0.92, respectively ( 29 ). 2.3.3 Templer-Death Anxiety Scale (T-DAS) To assess the level of death anxiety among participants, we employed the Templer-Death Anxiety Scale (T-DAS) ( 30 ). This scale comprises 15 items, rated on a 5-point Likert scale. Nine items are positively scored, with responses ranging from 1= "strongly agree" to 5= "strongly disagree" and six items are negatively scored, with responses ranging from 5= "strongly disagree" to 1= "strongly agree”. The total score ranges from 15 to 75, with scores above 35 indicating a high level of death anxiety( 31 ). The Chinese version of the scale has a Cronbach’s alpha coefficient of 0.71, internal consistency, and a test-retest reliability coefficient of 0.831 ( 23 ). 2.3.4 The Meaning in Life Questionnaire (MLQ) To explore nurses' sense of meaning in life, we used the Meaning in Life Questionnaire (MLQ) ( 32 ). The Chinese version consists of 10 items, divided into two subscales: ( 1 ) the presence of meaning (five items), and ( 2 ) the search for meaning (five items). Each item is rated on a 7-point Likert scale, with a total score of 10–70. The scale has demonstrated excellent reliability and validity ( 33 ). 2.4 Data collection The online survey was completed using "Wenjuanxing" ( www.wjx.cn ) and converted into a QR code. To avoid missing data, we set the questionnaire so that all entries had to be completed before the questionnaire could be submitted. The corresponding author distributed the QR code of the questionnaire to hospital heads, who forwarded it to the head nurse WeChat group, and the head nurses subsequently shared it with department nurse WeChat groups. To ensure the diversity and representativeness of the sample, the geographical distribution of respondents was monitored via the backend of Questionnaire Star halfway through the process. If a certain municipality had a lower response rate, additional surveys were distributed to that area. Participants were provided with explanations of the study's purpose and survey requirements. The survey was only completed by participants after they had read and signed an informed consent form. They were explicitly informed that they could withdraw from the study at any time and questionnaires completed under 3 minutes were excluded. 2.5 Data analysis Data analysis was conducted using SPSS 26.0 and Mplus 8.3. A total of 1644 valid questionnaires were included in the analysis. Measurement data with a non-normal distribution were presented as median and interquartile ranges, and intergroup comparisons were performed using the Kruskal–Wallis H test. Count data were reported as frequencies and percentages, with intergroup comparisons conducted using the chi-square test. Models were established, starting from model category "1" and progressively increasing the number of models. The fitting results of the models were evaluated comprehensively using the best-fitting model selected based on the fitting indicators. Common fitting indicators include the Akaike Information Criterion (AIC), Bayesian Information Criterion (BIC), Adjusted Bayesian Information Criterion (aBIC), Entropy, Lo-Mendell-Rubin Likelihood Ratio (LMR), Bootstrap Likelihood Ratio Test (BLRT). Entropy values ranged from 0 to 1, with values above 0.8 indicating that the model classification accuracy exceeded 90%. Model comparisons were performed using the Lo-Mendell-Rubin Likelihood Ratio (LMR), and Bootstrap Likelihood Ratio Test (BLRT) with k-category models. P < 0.05 indicated that the fit of model k was better than that of model k-1. Statistical significance was set at P < 0.05. 2.6 Clinical trial number Not applicable. 3. Results 3.1 Description of the participants A total of 1698 questionnaires were collected, of which 1644 were valid, yielding a validity rate of 96.8%. Nearly half of the participants (52.5%) were aged 31–40 years, and the majority (75.2%) held a bachelor’s degree. Most nurses (56.0%) were from tertiary grade A hospitals (Table 1). 3.2 Potential profile analysis of death attitude in nurses Five potential category models were fitted, and the model fit indices are presented in Table 2. When adjusting for models, only the LMR test of the second model reached statistical significance ( P ＜0.05), while other models lacked clarity. Consequently, the second model was selected as the best-fitting model (BIC= 122453.744, entropy=0.916). In the five-class solution of the LPA, the conditional item response probabilities (Figure 1) illustrate how the classes are distinguished. The x-axis represents the 29 items of the FATCOD-B, while the y-axis represents their mean scores. The figure shows the scores of Class 1 (negative attitude group, n=971) were significantly lower than those of Class 2 (positive attitude group, n=673) ( P <0.05). 3.3 Differences in latent classes by characteristics The FATCOD-B scores for the positive attitude group and negative attitude groups were 103.67 ± 0.40 and 94.10 ± 0.22, respectively, indicating there was a significant difference in total scores between the two groups (F=480.282, P <0.001). Univariate analysis (Table 1) showed that the differences between departments, average monthly income, bereaved experience within 1 year, death education training, the importance of receiving death education training, the urgency of receiving death education training, and total T-DAS, and the MLQ scores were statistically significant ( P < 0.05). Binary logistic regression was performed to evaluate the differences between the two classes, using the negative attitude group as the reference. Variables that were statistically significant in univariate analysis were included in logistic regression equations. The results (Table 3) showed different types of attitudes toward care for the dying in terms of whether they had experienced bereavement within 1 year OR=0.623, 95%CI[0.468, 0.829]), whether they had received death education (OR=0.756, 95% CI [0.594, 0.962]), the total score of the MLQ (OR=1.053, 95% CI [1.040, 1.066]), and the total score of T-DAS (OR=0.974, 95% CI [0.961,0.986]) which were compared, with statistically significant differences ( P <0.05). 4. Discussion LPA identified two profiles of attitude: positive (40.9%) and negative (59.1%). The results demonstrated that most nurses maintained a negative attitude toward caring for dying patients. In traditional Chinese culture, discussing death is often viewed as a cultural taboo, leading many individuals to adopt avoidance coping strategies to minimize their awareness of mortality ( 34 ). The total FATCOD-B scores in the negative and positive attitude groups were 94.10 ± 0.22 and 103.67 ± 0.40, respectively, which were lower than those reported in a previous study. Xian Chen et al ( 3 ) conducted a cross-sectional survey regarding palliative care among registered oncology nurses in Jiangsu Province, China. Using latent class analysis, participants were categorized into a low-death anxiety group (n = 1095) and a high-stress and pain group (n = 4161). The total FATCOD-B in these groups were 103.05 ± 11.12 and 101.39 ± 10.7, respectively. The differences in scores between these two studies may be attributed to the following factors: Firstly, Jiangsu Province has a higher level of economic development than Sichuan Province. A higher monthly per capita income is associated with a more positive public attitude towards death, as financial stability allows individuals to adopt a more open-minded perspective on life and mortality ( 35 ). Second, economically developed regions typically have greater medical resources, enabling them to provide more advanced training facilities and programs. Financial input directly affects medical education, with wealthier regions allocating more funds for nurse training ( 36 , 37 ). Third, oncology nurses receive more training related to end-of-life and death than nurses working in other departments. These findings highlight the urgent need for increased investment in death education training and the development of targeted interventions to improve nurses’ attitudes toward care for dying patients. Nurses who had experienced bereavement within 1 year typically had higher scores for attitude toward care for the dying, consistent with a previous study ( 38 ). Yang Yuli conducted a survey of 652 oncology nurses from May 2021 to October 2021 to understand the current situation of oncology nurses' attitudes toward death and to analyze influencing factors. The study found that nurses who had experienced the death of a loved one and participated in funerals were more likely to accept death more positively ( 38 ). The impact of personal bereavement experiences on nurses' attitudes towards end-of-life care is multifaceted. Nurses who have lost a loved one will be more sensitive and compassionate towards patients and caregivers, helping them establish stronger emotional connections with patients and their families ( 38 ). Furthermore, personal experiences with bereavement may heighten nurses' awareness of the importance of end-of-life care, encouraging them to provide warmer, more respectful, and supportive care. Nurses who had received death education tended to have more positive attitudes toward end-of-life care ( 39 ). In China, traditional beliefs suggest that discussing death leads to bad luck and misfortune ( 3 ). Previous studies have highlighted the urgent need for death education among Chinese nurses ( 40 , 41 ). First, death education can provide nurses with the necessary professional knowledge and skills to better understand and address end-of-life care challenges. Second, it could help nurses develop emotional and psychological preparedness for end-of-life care ( 42 ). Death education provides individuals with an opportunity and platform to discuss the topics of life and death ( 43 ), helping nurses understand their emotions and coping strategies. It can provide ethical guidance to help nurses make complex end-of-life decisions, address moral dilemmas, and guide individuals to rationally confront death ( 44 ). Currently, there is a lack of intervention research related to death education. Yinglan Li provided a scoping overview of death education-related research, suggesting that its content should be systematic and comprehensive, encompassing psychology, ethics, philosophy, and pedagogy. Additionally, she proposed conducting online and offline interactive teaching, peace of mind teahouse or peace of mind card workshop, role-playing, simulation exercises, and discussion of real-life cases, which could help stimulate the enthusiasm for learning and improve the effectiveness of the training ( 45 ). Training programs focused on communication skills, emotional support systems for nurses, or comprehensive death education curricula are critical components that should be included in future interventions. This study revealed a negative correlation between death anxiety and attitudes toward caring for the dying, consistent with previous research findings ( 3 , 46 ). From October 2021 to April 2022, Xu Guiru conducted a cross-sectional study involving 363 nursing students from seven Class A tertiary hospitals in Fujian Province ( 46 ). A key difference between Xu's study and the present study lies in participant selection; while Xu's study focused on nursing students, this study examined clinical nurses. Death anxiety can influence several aspects of nurses' attitudes towards end-of-life care. First, anxiety can affect nurses’ emotions and psychological states, causing feelings of unease, nervousness, or stress when caring for terminally ill patients. Furthermore, it may affect their interactions with patients and caregivers, resulting in less warm and compassionate attitudes ( 47 ). Second, death anxiety may lead to avoidance or aversion to important topics such as death, end-of-life care, and end-of-life decisions, thereby influencing attitudes toward end-of-life care ( 48 ). Some nurses might intentionally avoid or exclude terminally ill patients, or impede the development of knowledge and skills related to death and dying, ultimately compromising their capacity to deliver high-quality care to dying patients ( 10 , 49 ). Finally, death anxiety may impair nurses' application of professional knowledge and skills in end-of-life care. It can disrupt cognitive processes and decision-making abilities, leading to uncertainty or hesitation in providing care. This may result in a lack of confidence or professionalism in their approaches to end-of-life care, particularly among newly qualified nurses ( 50 ). This study also found that higher levels of meaning in life were associated with more favorable attitudes toward care for the dying, consistent with previous findings ( 3 , 29 , 51 ). Shiyang Zhou conducted a study using convenience sampling to select 121 clinical nurses from Henan Provincial Chest Hospital between April to June 2021 to investigate the current situation and influencing factors of clinical nurses' attitudes toward end-of-life care ( 51 ). However, Zhou's study was limited by its small sample size and restriction to a single hospital. According to Terror Management Theory, all individuals must eventually face death, and the fear of death can profoundly influence the human pursuit of meaning in life. This pursuit is considered one of the distal defense mechanisms in fear management. When confronted with death-related events, individuals often seek meaning through their cultural worldviews. These worldviews can help nurses reframe death as a natural part of the life process, thereby reducing death-related fear and anxiety. This shift in perspective enables nurses to participate in end-of-life care with a more positive and constructive attitude ( 52 ). Then nurses may cherish each patient's life, strive harder to provide the support and care needed by terminally ill patients and their caregivers, and uphold the belief that every individual should be treated with dignity and peace in their final stages of life ( 50 ). Strengths and limitations There are certain limitations of this study that should not be overlooked. First, for convenience and accessibility, we used a convenience sample and included participants solely from Sichuan Province. Geographical limitations, homogeneity in demographic characteristics, voluntary participation bias, and cultural and contextual uniformity can limit sample diversity and the sample may not accurately represent the broader population. Second, it is important to note that the survey was entirely self-reported data, introducing the possibility of reported biases. In this study, the primary source of response bias may be social desirability bias. Caring for terminally ill patients involves significant physical and psychological stress and is a highly demanding task that not every nurse is willing to undertake. However, this reluctance may conflict with the professional ethic of "healing the wounded and rescuing the dying." Therefore, some participants may have concealed their true feelings and selected responses that align more closely with societal values when completing the questionnaire. Thirdly, the absence of direct interaction with participants may lead to response biases, as some respondents might not have completed the questionnaires with the necessary care and attention. Furthermore, while cross-sectional study has advantages such as speed and cost-effectiveness, they also have inherent limitations, including an inability to establish causality, time-point restrictions, recall bias, and selection bias. Despite these constraints, this research boasts significant merits. The application of LPA has yielded insightful perspectives on the subgroup of attitudes toward death and the determinants influencing each category. These findings help identify potential strategies to enhance attitudes toward death within specific demographics, presenting actionable implications for subsequent investigations. Future studies should consider expanding the survey scope and integrating longitudinal and qualitative research to develop a more comprehensive understanding of nurses' attitudes toward death. Conclusions Overall, this study offers valuable insights into variations in death attitudes and influencing factors among nurses in Sichuan Province. The results indicate that nurses’ attitudes toward dying care can be classified into positive and negative attitude groups, with most nurses exhibiting a negative attitude toward caring for the dying. This phenomenon is related to bereavement experience, death education, death anxiety, and the sense of meaning in life. In the future, healthcare administrators, educators, and policymakers should target these factors to develop interventions that enhance end-of-life care practices. For example, traditional educational methods such as workshops, seminars, real-life case studies, and role-playing can be combined with emerging technologies such as virtual reality and artificial intelligence to help nurses master the theoretical knowledge and practical skills of end-of-life care. Abbreviations BIC – Bayesian information criterion AIC–Akaike Information Criterion aBIC –Adjusted Bayesian Information Criterion Lo-Mendell-Rubin LMR–Likelihood Ratio BLRT–Bootstrap Likelihood Ratio Test (FATCOD-B) – Frommelt Attitudes Toward Care of the Dying Scale Form B MLQ – Meaning in Life Questionnaire T-DAS – Templer-Death Anxiety Scale LPA – Latent Profile Analysis OR–Odd Ratio CI–Confidence Interval Declarations Acknowledgements The authors thank the nurses who participated in the study. Author contributions All authors contributed to the study's conception and design. Hongling Zheng, Rui Li, and Lei Luo collected data. Hongling Zheng and Rui Li analyzed the data. Hongling Zheng wrote the first draft of the manuscript. Qinqin Cheng, Youwen Gong, Yuxia Zhang, and Hongling Ma: revised the manuscript. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. Fund This research was supported by funds from the Cadre Healthcare Research Program of Sichuan Province, China. (Subject No. 2023-806). Data availability Anonymized data could be shared with an academic research team upon request to the corresponding author by a qualified research investigator. Ethics approval and consent to participate This study has been approved by the Ethics Committee of Sichuan Cancer Hospital, the ethics approval number is SCCHEC-02-2023-035.Each participant was required to complete an electronic informed consent form before proceeding with the questionnaire. The questionnaire could only be filled out after the participant had signed the consent form. Additionally, all information regarding the study participants, including personal details and responses, was kept strictly confidential. Consent for publication Not applicable. Competing interests The authors declare no competing interests. References Chua J, Shorey S. Effectiveness of end-of-life educational interventions at improving nurses and nursing students' attitude toward death and care of dying patients: A systematic review and meta-analysis. NURS EDUC TODAY. [Journal Article; Meta-Analysis; Review; Systematic Review]. 2021 2021-6-1;101:104892. Hagan TL, Xu J, Lopez RP, Bressler T. 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Revise and Application Attitudes Toward of Care Chinese of the Version Dying of Scale Form B: South Medical University; 2016. Templer DI. The construction and validation of a Death Anxiety Scale. J GEN PSYCHOL. [Journal Article]. 1970 1970-4-1;82(2d Half):165-77. Yang H, Li Y, Yao Q, Wen X. Application of the Chinese version of Templer-Death Anxiety Scale:enlightenment for death education. Journal of Nursing Science. 2013;21(28):64-7. Steger MF, Kashdan TB, Sullivan BA, Lorentz D. Understanding the search for meaning in life: personality, cognitive style, and the dynamic between seeking and experiencing meaning. J PERS. [Journal Article]. 2008 2008-4-1;76(2):199-228. Wang X. Psychometric Evaluation of the Meaning in Life Questionnaire in Chinese Middle School Students. Chinese Journal of Clinical Psychology. 2013;21(5):763-8. Lei L, Zhao H, Ran L, Wang L, Luo Y. Influencing factors of attitudes towards death and demands for death education among community-dwelling Chinese older adults: a cross-sectional study. BMC PUBLIC HEALTH. [Journal Article; Research Support, Non-U.S. Gov't]. 2022 2022-6-23;22(1):1242. Chen K, LV X, Zhang Y, Deng K. Influence of socioeconomic characteristics, social support on death of the elderly population in the urban community. Modern Preventive Medicine. 2022;49(13):2377-80. Tian Y, Xu Z, Wang X. The impact of economic growth on health resource allocation in China: based on a PVAR dynamic analysis. J SOCIAL EC DEV. 2024 2024-10-26. Niu X, Yang Y, Wang Y. Does the Economic Growth Improve Public Health? A Cross-Regional Heterogeneous Study in China. FRONT PUBLIC HEALTH. 2021 2021-6-18;9. Yang Y, Liang X. Analysis on the status quo and influencing factors of death attitude of oncology nurses in Yinchuan city. CHINESE EVIDENSE-BASED NURSING. 2023;9(2):278-82. Liu Y, Zhang X, Wang S, Shi F, Guo M. Effect of death education and training based on "Thousand Chats live" on hospice care attitude and death attitude of emergency department nurses. Chinese Nursing Research. 2023;37(5):922-5. Luo L, Li F, Zhang J, Li Y, Cheng Q, Wen Y. The correlation between the attitude to death and death education of the palliative care specialist nurses. Chinese Nursing Management. 2021;21(2):194-201. Yang H, Zhao D, Zhong H, Yu L. Current situation and correlation analysis of attitude towards death and demands for death education among emergency nurses in Hunan Province. Chongqing Medicine.;52(8):1219-24. Doka KJ. Hannelore Wass: Death Education--An Enduring Legacy. DEATH STUD. [Biography; Historical Article; Journal Article]. 2015 2015-1-20;39(9):545-8. Lei L, Lu Y, Zhao H, Tan J, Luo Y. Construction of life-and-death education contents for the elderly: a Delphi study. BMC PUBLIC HEALTH. [Journal Article; Research Support, Non-U.S. Gov't]. 2022 2022-4-21;22(1):802. Zhang H, Hu M, Zeng L, Ma M, Li L. Impact of death education courses on emergency nurses' perception of effective behavioral responses in dealing with sudden death in China: A quasi-experimental study. NURS EDUC TODAY. [Journal Article]. 2020 2020-2-1;85:104264. Li Y, Zhao Y, Long Y, Tian L. Death education for clinical nurses in China:a scoping review. Chinese Nursing Management.;24(2):186-91. Xu G, Yu W. Mediating effect of meaning in life on death anxiety and attitude toward palliative care among undergraduate nursing students. BMC PALLIAT CARE. [Journal Article]. 2024 2024-6-5;23(1):139. Ay MA, Oz F. Nurses attitudes towards death, dying patients and euthanasia: A descriptive study. NURS ETHICS. [Journal Article]. 2019 2019-8-1;26(5):1442-57. Cevik B, Kav S. Attitudes and experiences of nurses toward death and caring for dying patients in Turkey. CANCER NURS. [Journal Article; Multicenter Study]. 2013 2013-11-1;36(6):E58-65. Gong Y, Chen Y, Liu Y. Factors Influencing Coping with Death Competence Among Chinese Oncology Nurses: A National Cross-Sectional Study. J MULTIDISCIP HEALTH. [Journal Article]. 2024 2024-1-20;17:4781-9. Cheong CY, Ha N, Tan L, Low JA. Attitudes towards the dying and death anxiety in acute care nurses - can a workshop make any difference? A mixed-methods evaluation. PALLIAT SUPPORT CARE. [Journal Article; Research Support, Non-U.S. Gov't]. 2020 2020-4-1;18(2):164-9. Zhou S, Li N, Xu G. Status quo of hospice care attitude of nurses and its influencing factors. Chinese Journal of Modern Nursing. 2022;28(36):5129-32. Olson JM, Zanna MP. Advances in experimental social psychology. First edition. ed.; 2015. Tables Table 1 Characteristics of potential categories of attitudes toward care for dying Variable N(%) Negative attitude group(n=971) Positive attitude group(n=673) x 2 /t P Sex 0.354 0.552 Female 1608(97.8) 948(97.6) 660(98.1) Male 36(2.2) 23(2.4) 13(1.9) Age 0.641 0.887 ＜30 years 523(31.8) 302(31.1) 221(32.8) 31–40 years 863(52.5) 517(53.2) 346(51.4) 41–50 years 210(12.8) 124(12.8) 86(12.8) ＞50 years 48(2.9) 28(1.7) 20(3.0) Ethnic group 0.492 0.483 Han ethnic group 1589(96.7) 936(96.4) 653(97.0) Others 55(3.3) 35(3.6) 20(3.0) Marital status 0.897 0.639 Unmarried 371(22.6) 227(23.4) 144(21.4) Married 1211(73.7) 708(72.9) 503(74.7) Divorced or widowed 62(3.8) 36(3.7) 26(3.9) Educational level 1.714 0.424 Junior college 389(23.7) 239(24.6) 150(22.3) Bachelor's degree 1237(75.2) 723(74.5) 514(76.4) Master’s degree and above 18(1.0) 9(0.9) 9(1.3) Title 2.944 0.229 Junior title 832(50.6) 503(51.8) 329(48.9) Intermediate title 690(42.0) 404(41.6) 286(42.5) Senior title 122(7.4) 64(6.6) 58(8.6) Departments 23.844 ＜0.001** Internal medicine 727(44.2) 423(43.6) 304(46.1) Surgery department 323(19.6) 210(21.6) 113(10.7) Acute and critical care unit 104(6.3) 40(4.1) 64(8.6) Others 490(29.8) 298(30.7) 192(34.6) Grade of hospital 4.000 0.261 Tertiary grade A hospital 920(56.0) 538(55.4) 382(56.9) Tertiary grade B hospital 414(25.2) 235(24.2) 179(26.7) Secondary grade A hospital 199(12.1) 127(13.1) 72(10.7) Secondary grade B and below 111(6.8) 71(6.4) 40(5.9) Responsible unit 5.836 0.120 Nation 149(9.1) 89(9.2) 60(8.9) Province 190(11.6) 108(11.1) 82(12.2) City 786(47.8) 446(45.9) 340(50.5) Others 519(31.6) 328(33.8) 191(28.4) Nature of the hospital 0.046 0.830 General hospital 1207(73.4) 711(73.2) 496(73.7) Specialized hospital 437(26.6) 260(26.8) 177(26.3) The location of your hospital 6.883 0.142 Western Sichuan 114(6.9) 77(7.9) 37(5.5) Chengdu 227(13.8) 128(13.2) 99(14.7) Eastern Sichuan 97(5.9) 51(5.3) 46(6.8) South Sichuan 925(56.3) 556(57.3) 369(54.8) Northern Sichuan 281(17.1) 159(16.4) 122(18.1) Position 7.634 0.054 Responsible nurse 1276(77.6) 773(79.6) 503(74.7) Nursing team leader 171(10.4) 99(10.2) 72(10.7) Head nurse 185(11.3) 93(9.6) 92(13.7) Deputy director/director of nursing 12(0.7) 6(0.6) 6(0.9) Average monthly income 10.480 0.015* <3000 RMB 121(7.4) 78(8.0) 43(6.4) 3000–6000 RMB 946(57.5) 577(59.4) 369(54.8) 6001–10000 RMB 530(32.2) 296(30.5) 234(34.8) ＞10000 RMB 47(2.9) 20(2.1) 27(4.0) Whether a specialized nurse? 1.171 0.279 No 1131(68.8) 678(69.8) 453(67.3) Yes 513(31.2) 293(30.2) 220(32.7) Religious belief 0.350 0.554 No 1562(95.0) 920(94.7) 642(95.4) Yes 82(5.0) 51(5.3) 31(4.6) Have been bereaved within one year? 17.851 ＜0.001** No 1380(83.9) 846(87.1) 534(79.3) Yes 264(16.1) 125(12.9) 139(20.7) Average number of terminally ill patients cared for per month 7.147 0.028* 0 935(56.9) 574(59.1) 361(53.6) 1–5 630(38.3) 359(37.0) 271(40.3) >5 79(4.8) 38(3.9) 41(6.1) Whether have received death education training 22.388 ＜0.001** No 1158(70.4) 727(74.8) 431(64.0) Yes 486(29.6) 244(25.1) 242(36.0) Importance of receiving death education training 22.354 ＜0.001** Extremely unimportant 3(0.2) 1(0.1) 2(0.3) Not important 8(0.5) 5(0.5) 3(0.4) Fairly important 233(14.2) 161(16.6) 72(10.7) Very important 493(30.0) 255(26.3) 238(35.4) Extremely important 907(55.2) 549(56.5) 358(53.2) Urgency of receiving death education training 27.085 ＜0.001** Extremely unurgent 9(0.5) 5(0.5) 4(0.6) Not urgent 76(4.6) 59(6.1) 17(2.5) Fairly urgent 611(37.2) 385(39.6) 226(33.6) Very urgent 426(25.9) 253(26.1) 173(25.7) Extremely urgent 522(31.8) 269(27.7) 253(37.6) The Meaning in Life 48.48±9.50 53.37±8.76 -10.586 ＜0.001** The Templer Death Anxiety Scale 48.01±7.68 45.86±9.26 4.952 ＜0.001** Note: Statistically significant at * P ＜ 0.05;** P ＜0.01 Table 2 Latent Profile Fitting Model Index for death attitude among nurses Model AIC BIC aBIC Entropy LMR BLRT Classified probability 2 121978.114 122453.744 122174.182 0.916 0.0099 0.0000 0.59063/0.40937 3 118607.889 119245.666 118870.799 0.998 0.5970 0.0000 0.05535/0.49270/0.45195 4 116452.728 117252.651 116782.479 0.963 0.0895 0.0000 0.05535/0.49209/0.18005/0.27251 5 112171.142 113133.212 112567.734 0.970 0.3828 0.0000 0.00912/0.04866/0.18127/0.48966/0.27129 Note: AIC, Akaike information criterion; BIC,the Bayesian Information Criterion;aBIC, sample-size adjusted BIC; LMR, Lo-Mendell-Rubin; BLRT, Bootstrapped likelihood ratio test Table 3 Result of binary logistic regression Variables P OR 95% CI Have been bereaved within one year? Yes 1 No 0.001** 0.623 (0.468, 0.829) Whether have received death education training Yes 1 No 0.023* 0.756 (0.594, 0.962) The total score of The Meaning in Life Questionnaire ＜0.001** 1.053 (1.040, 1.066) The total score of Templer-Death Anxiety Scale ＜0.001** 0.974 (0.961, 0.986) Note: OR=Odd Ratio; CI=Confidence Interval Statistically significant at * P ＜ 0.05;** P ＜0.01 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 05 Jun, 2025 Read the published version in BMC Nursing → Version 1 posted Editorial decision: Revision requested 01 Apr, 2025 Reviews received at journal 31 Mar, 2025 Reviewers agreed at journal 25 Mar, 2025 Reviews received at journal 20 Mar, 2025 Reviewers agreed at journal 20 Mar, 2025 Reviewers invited by journal 20 Mar, 2025 Submission checks completed at journal 20 Mar, 2025 First submitted to journal 18 Mar, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5654763","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":431833670,"identity":"162b7357-8ba8-49cf-be7d-c08dd4375de3","order_by":0,"name":"Hongling Zheng","email":"","orcid":"","institution":"Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital \u0026 Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China","correspondingAuthor":false,"prefix":"","firstName":"Hongling","middleName":"","lastName":"Zheng","suffix":""},{"id":431833671,"identity":"e085c284-69b2-4fc8-a828-312cb4dafa41","order_by":1,"name":"Rui Li","email":"","orcid":"","institution":"Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital \u0026 Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China","correspondingAuthor":false,"prefix":"","firstName":"Rui","middleName":"","lastName":"Li","suffix":""},{"id":431833673,"identity":"0f03e39a-a85a-49c4-85a1-1bc4a863089a","order_by":2,"name":"Hongli Ma","email":"","orcid":"","institution":"Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital \u0026 Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China","correspondingAuthor":false,"prefix":"","firstName":"Hongli","middleName":"","lastName":"Ma","suffix":""},{"id":431833675,"identity":"fe3ddd22-03e6-474a-83e0-031d5671919f","order_by":3,"name":"Qinqin Cheng","email":"","orcid":"","institution":"Hunan Cancer Hospital","correspondingAuthor":false,"prefix":"","firstName":"Qinqin","middleName":"","lastName":"Cheng","suffix":""},{"id":431833677,"identity":"86a91ce6-27fe-4eee-aa37-1950b114da7c","order_by":4,"name":"Yuxia Zhang","email":"","orcid":"","institution":"Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital \u0026 Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China","correspondingAuthor":false,"prefix":"","firstName":"Yuxia","middleName":"","lastName":"Zhang","suffix":""},{"id":431833678,"identity":"f7c6c96c-3513-4edf-b386-46e3dde83b76","order_by":5,"name":"Youwen Gong","email":"","orcid":"","institution":"The First People's Hospital of Changde City","correspondingAuthor":false,"prefix":"","firstName":"Youwen","middleName":"","lastName":"Gong","suffix":""},{"id":431833680,"identity":"80a2ad21-a64c-48dd-a6b7-8bdb873eefbd","order_by":6,"name":"Lei Luo","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA3klEQVRIiWNgGAWjYBACPgYGxgMMBjYgNpBBDGADYqCWNDCHFC0Mh0nRIpF84MCHgvP2/P3HHxzmbWOQM+9fwPi5AK+WtISDMwxuJ864kZAA0mIsc+MBs/QMvFpyDA7zGNxOMJBgOADSkjhD4gAbMw8hLX8Mztkb8B9sIEELg8EBxg0MyQwQLfwNBLTwPEs42GOQDPRLGsPBOeckjCUkGJul8WnhZ08++ODHHztQiD188KbMRk6C//DBz/i0oAAmXjYJBgaJxAZiNQBTzI8/IIsPEK9jFIyCUTAKRgQAAKWBSh+Nr2SjAAAAAElFTkSuQmCC","orcid":"","institution":"Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital \u0026 Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China","correspondingAuthor":true,"prefix":"","firstName":"Lei","middleName":"","lastName":"Luo","suffix":""}],"badges":[],"createdAt":"2024-12-16 14:38:36","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5654763/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5654763/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12912-025-03240-4","type":"published","date":"2025-06-05T15:57:02+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":79256407,"identity":"6ad9c5a8-7f01-40a6-be18-be5611ca0e95","added_by":"auto","created_at":"2025-03-26 08:59:28","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":70135,"visible":true,"origin":"","legend":"\u003cp\u003eLegend not included with this version.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-5654763/v1/01637069577b09335b65429a.png"},{"id":84242719,"identity":"47afae07-472c-4c24-bd7d-2d7d34c9b5dd","added_by":"auto","created_at":"2025-06-09 16:11:50","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1059093,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5654763/v1/8b99a227-b770-422d-a273-f2dcd33d38be.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"A Multicenter Cross-Sectional Study on Nurses’ Attitudes Toward End-of-Life Care and Influencing Factors: A Latent Profile Analysis","fulltext":[{"header":"1. Background","content":"\u003cp\u003eProviding care for patients is a fundamental responsibility and a significant challenge for healthcare professionals (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Professional nurses serve as communicators, coordinators, and educators, and their attitudes and beliefs about end-of-life issues influence the quality of care for dying patients (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). In routine nursing work, nurses collaborate with physicians to provide end-of-life care, which includes estimating life expectancy, preserving patient dignity, and maintaining relationships (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Discussions about death are an inherent part of this process. However, in China, discussions about death remain a cultural taboo. On most occasions, the word \"death\" is avoided as it symbolizes misfortune, fear, and bad luck(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). Even the Arabic numeral \"4\" is often avoided in various contexts due to its phonetic similarity to the Chinese word for \"death\". This cultural aversion has contributed to the delayed development of palliative care, which is still in its early stages in the country (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Nurses who are inadequately prepared for end-of-life care may experience emotional distress, which can adversely affect dying patients (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Furthermore, insufficient professional skills in caring for dying patients can compromise the quality of care (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Therefore, it is crucial for nurses to cultivate positive attitudes and beliefs, develop essential end-of-life care skills, and enhance their communication abilities (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eLevels of death anxiety and meaning in life are closely related to the quality of care provided to dying patients (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Nurses may experience psychological stress, fear of death, and trauma when confronted with patient mortality, which can adversely affect their personal lives and caregiving responsibilities (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). Death anxiety refers to an individual's inner turmoil, including discomfort, preoccupation, and dread when contemplating the inevitability of death or the universal reality of mortality. This anxiety generates self-protective withdrawal motivations and behaviors (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e), which may negatively impact end-of-life care. In contrast, death reflection constitutes a mental exercise where individuals contemplate mortality, serving as a form of death awareness that fosters positive intentions toward behavior (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). Reflecting on death promotes an understanding of the true meaning of life and facilitates comprehensive end-of-life care (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). Moreover, a sense of meaning in life is intimately related to care quality. Previous studies have indicated that nurses with a high sense of meaning in life can imperceptibly improve the quality of their work (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Nurses involved in end-of-life care witness the final stages of patients, prompting self-reflection on the meaning of their own lives, which motivates them to pursue life values and enhances the quality of care they provide. Furthermore, there is a potential correlation between death anxiety and a sense of meaning in life. Terror management theory suggests that on the one hand, everyone dies, and on the other hand, human beings possess the instinct to ensure individual survival, and the conflict between the two leads to death anxiety(\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). Moreover, worldview defense is one of the most effective means of alleviating death anxiety. A worldview is a shared psychological structure that gives life a sense of meaning, order, and eternity(\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). Currently, there is a lack of specialized research examining the interrelationships between death attitude, death anxiety, and meaning in life.\u003c/p\u003e \u003cp\u003eIn recent years, several studies have examined medical students\u0026rsquo; attitudes toward end-of-life care (\u003cspan additionalcitationids=\"CR21\" citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). However, medical students are generally not involved in patient care, and their attitudes toward end-of-life care may differ from those of clinical nurses. To understand nurses\u0026rsquo; knowledge and attitudes toward palliative care and death, Yanping Hao conducted a study among 97 nurses from oncology departments across five hospitals, utilizing a mobile terminal combined with a virtual forum and face-to-face interactions (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). This study compared death attitude scores at baseline and 3 weeks after the intervention to validate its effectiveness but did not explore the inherent differences in death attitudes or the factors that influence them. Due to inconsistencies in the evaluation tools, the comparability of the studies was limited, and the judgment criteria relied solely on total scores, which failed to adequately capture inter-individual differences. To date, no studies have explored the potential categories of Chinese nurses' attitudes toward death or the factors contributing to the differences between these categories. To address this gap, it is crucial to adopt an individual-centered research approach that analyzes the diverse manifestations of attitudes toward care for the dying among nurses. Latent Profile\u003c/p\u003e \u003cp\u003eAnalysis (LPA) is a person-centered statistical approach used to identify distinct typologies or clusters based on patterns of responses to observed variables (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). By grouping couples with similar death attitude profiles into the same subgroup and those with differing profiles into separate categories, LPA maximizes heterogeneity between groups while minimizing heterogeneity within each group(\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). This method enables researchers to uncover meaningful subgroups within a population, providing insights into the diverse ways individuals or dyads respond to specific variables.\u003c/p\u003e \u003cp\u003eTherefore, the objective of this study was to categorize attitudes toward care of the dying into different groups using LPA and explore the influencing factors that contribute to the differences between these profiles. The findings of this study provide valuable insights into the development of targeted interventions to change attitudes toward death among nurses, thereby enhancing their professional skills.\u003c/p\u003e"},{"header":"2. Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Design\u003c/h2\u003e \u003cp\u003eConsidering both time and financial constraints, as well as gaps identified in previous studies, we conducted a multicenter cross-sectional study.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Participant\u003c/h2\u003e \u003cp\u003eData were collected using convenience sampling from 60 hospitals across Sichuan Province between February 1 to April 30, 2024. The sample comprised nurses from various departments and regions with a diverse range of experiences and perspectives. The inclusion criteria were as follows: (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e) registered nurses and (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e) nurses engaged in patient care (not limited to specific types of patients). The exclusion criteria were as follows: (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e) nurses who maintained an employment relationship but were not involved in patient contact during the study period, such as those on sick leave, maternity leave, or further study leave, (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e) those with a history of diagnosed mental illness or currently undergoing related treatment, and (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e) those who did not consent to participate in the study.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.3. Measurement\u003c/h2\u003e \u003cdiv id=\"Sec6\" class=\"Section3\"\u003e \u003ch2\u003e2.3.1 General information questionnaire\u003c/h2\u003e \u003cp\u003eThe questionnaire was developed based on a comprehensive literature review and discussions within the research team. It included 20 entries, including age, sex, department, whether the nurse had received death education, and whether they had experienced bereavement within the past year.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section3\"\u003e \u003ch2\u003e2.3.2 Frommelt Attitudes Toward Care of the Dying Scale Form B (FATCOD-B)\u003c/h2\u003e \u003cp\u003eTo assess attitudes toward end-of-life care, we utilized the Frommelt Attitudes Toward Care of the Dying Scale (FATCOD-B) (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). The Chinese version of this scale consists of 29 items and six subscales. It uses a 5-point Likert scale, with 14 positive items scored from \"strongly agree\" to \"strongly disagree\" (5 to 1 points). The 15 negative items are scored in reverse, from \"strongly disagree\" to \"strongly agree\" (1 to 5 points). The total score ranges from 29 to 145, with higher scores indicating a more positive attitude towards end-of-life care and a greater likelihood of engaging in proactive caregiving behaviors for dying patients. The scale demonstrated a Cronbach\u0026rsquo;s alpha coefficient and a content validity of 0.79 and 0.92, respectively (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section3\"\u003e \u003ch2\u003e2.3.3 Templer-Death Anxiety Scale (T-DAS)\u003c/h2\u003e \u003cp\u003eTo assess the level of death anxiety among participants, we employed the Templer-Death Anxiety Scale (T-DAS) (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e). This scale comprises 15 items, rated on a 5-point Likert scale. Nine items are positively scored, with responses ranging from 1= \"strongly agree\" to 5= \"strongly disagree\" and six items are negatively scored, with responses ranging from 5= \"strongly disagree\" to 1= \"strongly agree\u0026rdquo;. The total score ranges from 15 to 75, with scores above 35 indicating a high level of death anxiety(\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e). The Chinese version of the scale has a Cronbach\u0026rsquo;s alpha coefficient of 0.71, internal consistency, and a test-retest reliability coefficient of 0.831 (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section3\"\u003e \u003ch2\u003e2.3.4 The Meaning in Life Questionnaire (MLQ)\u003c/h2\u003e \u003cp\u003eTo explore nurses' sense of meaning in life, we used the Meaning in Life Questionnaire (MLQ) (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e). The Chinese version consists of 10 items, divided into two subscales: (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e) the presence of meaning (five items), and (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e) the search for meaning (five items). Each item is rated on a 7-point Likert scale, with a total score of 10\u0026ndash;70. The scale has demonstrated excellent reliability and validity (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003e2.4 Data collection\u003c/h2\u003e \u003cp\u003eThe online survey was completed using \"Wenjuanxing\" (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e\u003ca href=\"http://www.wjx.cn\" target=\"_blank\"\u003ewww.wjx.cn\u003c/a\u003e\u003c/span\u003e\u003cspan address=\"http://www.wjx.cn\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e) and converted into a QR code. To avoid missing data, we set the questionnaire so that all entries had to be completed before the questionnaire could be submitted. The corresponding author distributed the QR code of the questionnaire to hospital heads, who forwarded it to the head nurse WeChat group, and the head nurses subsequently shared it with department nurse WeChat groups. To ensure the diversity and representativeness of the sample, the geographical distribution of respondents was monitored via the backend of Questionnaire Star halfway through the process. If a certain municipality had a lower response rate, additional surveys were distributed to that area. Participants were provided with explanations of the study's purpose and survey requirements. The survey was only completed by participants after they had read and signed an informed consent form. They were explicitly informed that they could withdraw from the study at any time and questionnaires completed under 3 minutes were excluded.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e2.5 Data analysis\u003c/h2\u003e \u003cp\u003eData analysis was conducted using SPSS 26.0 and Mplus 8.3. A total of 1644 valid questionnaires were included in the analysis. Measurement data with a non-normal distribution were presented as median and interquartile ranges, and intergroup comparisons were performed using the Kruskal\u0026ndash;Wallis H test. Count data were reported as frequencies and percentages, with intergroup comparisons conducted using the chi-square test. Models were established, starting from model category \"1\" and progressively increasing the number of models. The fitting results of the models were evaluated comprehensively using the best-fitting model selected based on the fitting indicators. Common fitting indicators include the Akaike Information Criterion (AIC), Bayesian Information Criterion (BIC), Adjusted Bayesian Information Criterion (aBIC), Entropy, Lo-Mendell-Rubin Likelihood Ratio (LMR), Bootstrap Likelihood Ratio Test (BLRT). Entropy values ranged from 0 to 1, with values above 0.8 indicating that the model classification accuracy exceeded 90%. Model comparisons were performed using the Lo-Mendell-Rubin Likelihood Ratio (LMR), and Bootstrap Likelihood Ratio Test (BLRT) with k-category models. \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05 indicated that the fit of model k was better than that of model k-1. Statistical significance was set at \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003e2.6 Clinical trial number\u003c/h2\u003e \u003cp\u003eNot applicable.\u003c/p\u003e \u003c/div\u003e"},{"header":"3. Results","content":"\u003cp\u003e\u003cstrong\u003e3.1 Description of the participants\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA total of 1698 questionnaires were collected, of which 1644 were valid, yielding a validity rate of 96.8%. Nearly half of the participants (52.5%) were aged 31\u0026ndash;40 years, and the majority (75.2%) held a bachelor\u0026rsquo;s degree. Most nurses (56.0%) were from tertiary grade A hospitals (Table 1).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.2 Potential profile analysis of\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;death attitude\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003ein nurses\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFive potential category models were fitted, and the model fit indices are presented in Table 2. When adjusting for models,\u0026nbsp;only the LMR test of\u0026nbsp;the second model\u0026nbsp;reached statistical significance (\u003cem\u003eP\u003c/em\u003e＜0.05), while other models lacked clarity.\u0026nbsp;Consequently, the second\u0026nbsp;model was selected as the best-fitting model\u0026nbsp;(BIC= 122453.744, entropy=0.916).\u0026nbsp;In the five-class solution of the LPA, the conditional item response probabilities (Figure 1) illustrate how the classes are distinguished. The x-axis represents the 29 items of the FATCOD-B, while the y-axis represents their mean scores. The figure shows the scores of Class 1 (negative attitude group, n=971) were significantly lower than those of Class 2 (positive attitude group, n=673) (\u003cem\u003eP\u003c/em\u003e\u0026lt;0.05).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.3 Differences in latent classes by characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe FATCOD-B scores for the\u0026nbsp;positive attitude group and negative attitude groups were 103.67 \u0026plusmn; 0.40 and 94.10 \u0026plusmn; 0.22, respectively, indicating there was a significant difference in total scores between the two groups\u0026nbsp;(F=480.282, \u003cem\u003eP\u003c/em\u003e\u0026lt;0.001). Univariate analysis (Table 1) showed that the differences between departments, average monthly income, bereaved experience within 1 year, death education training, the importance of receiving death education training, the urgency of receiving death education training, and total T-DAS, and the MLQ\u0026nbsp;scores were statistically significant (\u003cem\u003eP\u003c/em\u003e \u0026lt; 0.05).\u003c/p\u003e\n\u003cp\u003eBinary logistic regression was performed to evaluate the differences between the two classes, using the negative attitude group as the reference. Variables that were statistically significant in univariate analysis were included in logistic regression equations. The results (Table 3) showed different types of attitudes toward care for the dying in terms of whether they had experienced bereavement within 1 year OR=0.623, 95%CI[0.468, 0.829]), whether they had received death education (OR=0.756, 95% CI [0.594, 0.962]), the total score of the MLQ\u0026nbsp;(OR=1.053, 95% CI [1.040, 1.066]), and the total score of T-DAS (OR=0.974, 95% CI [0.961,0.986]) which were compared, with statistically significant differences (\u003cem\u003eP\u003c/em\u003e\u0026lt;0.05).\u003c/p\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eLPA identified two profiles of attitude: positive (40.9%) and negative (59.1%). The results demonstrated that most nurses maintained a negative attitude toward caring for dying patients. In traditional Chinese culture, discussing death is often viewed as a cultural taboo, leading many individuals to adopt avoidance coping strategies to minimize their awareness of mortality (\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e). The total FATCOD-B scores in the negative and positive attitude groups were 94.10 ± 0.22 and 103.67 ± 0.40, respectively, which were lower than those reported in a previous study. Xian Chen et al (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e) conducted a cross-sectional survey regarding palliative care among registered oncology nurses in Jiangsu Province, China. Using latent class analysis, participants were categorized into a low-death anxiety group (n = 1095) and a high-stress and pain group (n = 4161). The total FATCOD-B in these groups were 103.05 ± 11.12 and 101.39 ± 10.7, respectively. The differences in scores between these two studies may be attributed to the following factors: Firstly, Jiangsu Province has a higher level of economic development than Sichuan Province. A higher monthly per capita income is associated with a more positive public attitude towards death, as financial stability allows individuals to adopt a more open-minded perspective on life and mortality (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e). Second, economically developed regions typically have greater medical resources, enabling them to provide more advanced training facilities and programs. Financial input directly affects medical education, with wealthier regions allocating more funds for nurse training (\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e). Third, oncology nurses receive more training related to end-of-life and death than nurses working in other departments.\u003c/p\u003e \u003cp\u003eThese findings highlight the urgent need for increased investment in death education training and the development of targeted interventions to improve nurses’ attitudes toward care for dying patients.\u003c/p\u003e \u003cp\u003eNurses who had experienced bereavement within 1 year typically had higher scores for attitude toward care for the dying, consistent with a previous study (\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e). Yang Yuli conducted a survey of 652 oncology nurses from May 2021 to October 2021 to understand the current situation of oncology nurses' attitudes toward death and to analyze influencing factors. The study found that nurses who had experienced the death of a loved one and participated in funerals were more likely to accept death more positively (\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e). The impact of personal bereavement experiences on nurses' attitudes towards end-of-life care is multifaceted. Nurses who have lost a loved one will be more sensitive and compassionate towards patients and caregivers, helping them establish stronger emotional connections with patients and their families (\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e). Furthermore, personal experiences with bereavement may heighten nurses' awareness of the importance of end-of-life care, encouraging them to provide warmer, more respectful, and supportive care.\u003c/p\u003e \u003cp\u003eNurses who had received death education tended to have more positive attitudes toward end-of-life care (\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e). In China, traditional beliefs suggest that discussing death leads to bad luck and misfortune (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Previous studies have highlighted the urgent need for death education among Chinese nurses (\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e). First, death education can provide nurses with the necessary professional knowledge and skills to better understand and address end-of-life care challenges. Second, it could help nurses develop emotional and psychological preparedness for end-of-life care (\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e). Death education provides individuals with an opportunity and platform to discuss the topics of life and death (\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e), helping nurses understand their emotions and coping strategies. It can provide ethical guidance to help nurses make complex end-of-life decisions, address moral dilemmas, and guide individuals to rationally confront death (\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e). Currently, there is a lack of intervention research related to death education. Yinglan Li provided a scoping overview of death education-related research, suggesting that its content should be systematic and comprehensive, encompassing psychology, ethics, philosophy, and pedagogy. Additionally, she proposed conducting online and offline interactive teaching, peace of mind teahouse or peace of mind card workshop, role-playing, simulation exercises, and discussion of real-life cases, which could help stimulate the enthusiasm for learning and improve the effectiveness of the training (\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e). Training programs focused on communication skills, emotional support systems for nurses, or comprehensive death education curricula are critical components that should be included in future interventions.\u003c/p\u003e \u003cp\u003eThis study revealed a negative correlation between death anxiety and attitudes toward caring for the dying, consistent with previous research findings (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e). From October 2021 to April 2022, Xu Guiru conducted a cross-sectional study involving 363 nursing students from seven Class A tertiary hospitals in Fujian Province (\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e). A key difference between Xu's study and the present study lies in participant selection; while Xu's study focused on nursing students, this study examined clinical nurses.\u003c/p\u003e \u003cp\u003eDeath anxiety can influence several aspects of nurses' attitudes towards end-of-life care. First, anxiety can affect nurses’ emotions and psychological states, causing feelings of unease, nervousness, or stress when caring for terminally ill patients. Furthermore, it may affect their interactions with patients and caregivers, resulting in less warm and compassionate attitudes (\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e). Second, death anxiety may lead to avoidance or aversion to important topics such as death, end-of-life care, and end-of-life decisions, thereby influencing attitudes toward end-of-life care (\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e). Some nurses might intentionally avoid or exclude terminally ill patients, or impede the development of knowledge and skills related to death and dying, ultimately compromising their capacity to deliver high-quality care to dying patients (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e). Finally, death anxiety may impair nurses' application of professional knowledge and skills in end-of-life care. It can disrupt cognitive processes and decision-making abilities, leading to uncertainty or hesitation in providing care. This may result in a lack of confidence or professionalism in their approaches to end-of-life care, particularly among newly qualified nurses (\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThis study also found that higher levels of meaning in life were associated with more favorable attitudes toward care for the dying, consistent with previous findings (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e). Shiyang Zhou conducted a study using convenience sampling to select 121 clinical nurses from Henan Provincial Chest Hospital between April to June 2021 to investigate the current situation and influencing factors of clinical nurses' attitudes toward end-of-life care (\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e). However, Zhou's study was limited by its small sample size and restriction to a single hospital.\u003c/p\u003e \u003cp\u003eAccording to Terror Management Theory, all individuals must eventually face death, and the fear of death can profoundly influence the human pursuit of meaning in life. This pursuit is considered one of the distal defense mechanisms in fear management. When confronted with death-related events, individuals often seek meaning through their cultural worldviews. These worldviews can help nurses reframe death as a natural part of the life process, thereby reducing death-related fear and anxiety. This shift in perspective enables nurses to participate in end-of-life care with a more positive and constructive attitude (\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e). Then nurses may cherish each patient's life, strive harder to provide the support and care needed by terminally ill patients and their caregivers, and uphold the belief that every individual should be treated with dignity and peace in their final stages of life (\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cb\u003eStrengths and limitations\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThere are certain limitations of this study that should not be overlooked. First, for convenience and accessibility, we used a convenience sample and included participants solely from Sichuan Province. Geographical limitations, homogeneity in demographic characteristics, voluntary participation bias, and cultural and contextual uniformity can limit sample diversity and the sample may not accurately represent the broader population. Second, it is important to note that the survey was entirely self-reported data, introducing the possibility of reported biases. In this study, the primary source of response bias may be social desirability bias. Caring for terminally ill patients involves significant physical and psychological stress and is a highly demanding task that not every nurse is willing to undertake. However, this reluctance may conflict with the professional ethic of \"healing the wounded and rescuing the dying.\" Therefore, some participants may have concealed their true feelings and selected responses that align more closely with societal values when completing the questionnaire. Thirdly, the absence of direct interaction with participants may lead to response biases, as some respondents might not have completed the questionnaires with the necessary care and attention. Furthermore, while cross-sectional study has advantages such as speed and cost-effectiveness, they also have inherent limitations, including an inability to establish causality, time-point restrictions, recall bias, and selection bias.\u003c/p\u003e \u003cp\u003eDespite these constraints, this research boasts significant merits. The application of LPA has yielded insightful perspectives on the subgroup of attitudes toward death and the determinants influencing each category. These findings help identify potential strategies to enhance attitudes toward death within specific demographics, presenting actionable implications for subsequent investigations. Future studies should consider expanding the survey scope and integrating longitudinal and qualitative research to develop a more comprehensive understanding of nurses' attitudes toward death.\u003c/p\u003e "},{"header":"Conclusions","content":"\u003cp\u003eOverall, this study offers valuable insights into variations in death attitudes and influencing factors among nurses in Sichuan Province. The results indicate that nurses’ attitudes toward dying care can be classified into positive and negative attitude groups, with most nurses exhibiting a negative attitude toward caring for the dying. This phenomenon is related to bereavement experience, death education, death anxiety, and the sense of meaning in life. In the future, healthcare administrators, educators, and policymakers should target these factors to develop interventions that enhance end-of-life care practices. For example, traditional educational methods such as workshops, seminars, real-life case studies, and role-playing can be combined with emerging technologies such as virtual reality and artificial intelligence to help nurses master the theoretical knowledge and practical skills of end-of-life care.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cul\u003e\n \u003cli\u003eBIC \u0026ndash; Bayesian information criterion\u003c/li\u003e\n \u003cli\u003eAIC\u0026ndash;Akaike Information Criterion\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eaBIC \u0026ndash;Adjusted Bayesian Information Criterion Lo-Mendell-Rubin\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eLMR\u0026ndash;Likelihood Ratio\u003c/li\u003e\n \u003cli\u003eBLRT\u0026ndash;Bootstrap Likelihood Ratio Test\u003c/li\u003e\n \u003cli\u003e(FATCOD-B) \u0026ndash; Frommelt Attitudes Toward Care of the Dying Scale Form B\u003c/li\u003e\n \u003cli\u003eMLQ \u0026ndash; Meaning in Life Questionnaire\u003c/li\u003e\n \u003cli\u003eT-DAS \u0026ndash; Templer-Death Anxiety Scale\u003c/li\u003e\n \u003cli\u003eLPA \u0026ndash; Latent Profile Analysis\u003c/li\u003e\n \u003cli\u003eOR\u0026ndash;Odd Ratio\u003c/li\u003e\n \u003cli\u003eCI\u0026ndash;Confidence Interval\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors thank the nurses who participated in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors contributed to the study\u0026apos;s conception and design. Hongling Zheng, Rui Li, and Lei Luo collected data. Hongling Zheng and Rui Li analyzed the data. Hongling Zheng wrote the first draft of the manuscript. Qinqin Cheng, Youwen Gong, Yuxia Zhang, and Hongling Ma: revised the manuscript. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFund\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research was supported by funds from the Cadre Healthcare Research Program of Sichuan Province, China. (Subject No. 2023-806).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAnonymized data could be shared with an academic research team upon request to the corresponding author by a qualified research investigator.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study has been approved by the Ethics Committee of Sichuan Cancer Hospital, the ethics approval number is SCCHEC-02-2023-035.Each participant was required to complete an electronic informed consent form before proceeding with the questionnaire. The questionnaire could only be filled out after the participant had signed the consent form. Additionally, all information regarding the study participants, including personal details and responses, was kept strictly confidential.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eChua J, Shorey S. Effectiveness of end-of-life educational interventions at improving nurses and nursing students\u0026apos; attitude toward death and care of dying patients: A systematic review and meta-analysis. NURS EDUC TODAY. [Journal Article; Meta-Analysis; Review; Systematic Review]. 2021 2021-6-1;101:104892.\u003c/li\u003e\n\u003cli\u003eHagan TL, Xu J, Lopez RP, Bressler T. Nursing\u0026apos;s role in leading palliative care: A call to action. 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[Journal Article]. 2019 2019-8-1;24(7):843-52.\u003c/li\u003e\n\u003cli\u003eYounis WY, Hamdan-Mansour AM. Status and predictors of medical students\u0026apos; knowledge and attitude towards palliative care in Jordan: a cross-sectional study. BMC PALLIAT CARE. [Journal Article]. 2024 2024-1-3;23(1):9.\u003c/li\u003e\n\u003cli\u003eHao Y, Zhang L, Huang M, Cui X, Zhou Y, Xu E. Nurses\u0026apos; knowledge and attitudes towards palliative care and death: a learning intervention. BMC PALLIAT CARE. 2021;50(20):1-9.\u003c/li\u003e\n\u003cli\u003eHan K, Kim Y, Lee HY, Lim S. Pre-employment health lifestyle profiles and actual turnover among newly graduated nurses: A descriptive and prospective longitudinal study. INT J NURS STUD. [Journal Article]. 2019 2019-10-1;98:1-8.\u003c/li\u003e\n\u003cli\u003eKober KM, Cooper BA, Paul SM, Dunn LB, Levine JD, Wright F, et al. Subgroups of chemotherapy patients with distinct morning and evening fatigue trajectories. SUPPORT CARE CANCER. 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The construction and validation of a Death Anxiety Scale. J GEN PSYCHOL. [Journal Article]. 1970 1970-4-1;82(2d Half):165-77.\u003c/li\u003e\n\u003cli\u003eYang H, Li Y, Yao Q, Wen X. Application of the Chinese version of Templer-Death Anxiety Scale:enlightenment for death education. Journal of Nursing Science. 2013;21(28):64-7.\u003c/li\u003e\n\u003cli\u003eSteger MF, Kashdan TB, Sullivan BA, Lorentz D. Understanding the search for meaning in life: personality, cognitive style, and the dynamic between seeking and experiencing meaning. J PERS. [Journal Article]. 2008 2008-4-1;76(2):199-228.\u003c/li\u003e\n\u003cli\u003eWang X. Psychometric Evaluation of the Meaning in Life Questionnaire in Chinese Middle School Students. Chinese Journal of Clinical Psychology. 2013;21(5):763-8.\u003c/li\u003e\n\u003cli\u003eLei L, Zhao H, Ran L, Wang L, Luo Y. Influencing factors of attitudes towards death and demands for death education among community-dwelling Chinese older adults: a cross-sectional study. BMC PUBLIC HEALTH. [Journal Article; Research Support, Non-U.S. Gov\u0026apos;t]. 2022 2022-6-23;22(1):1242.\u003c/li\u003e\n\u003cli\u003eChen K, LV X, Zhang Y, Deng K. Influence of socioeconomic characteristics, social support on death of the elderly population in the urban community. Modern Preventive Medicine. 2022;49(13):2377-80.\u003c/li\u003e\n\u003cli\u003eTian Y, Xu Z, Wang X. The impact of economic growth on health resource allocation in China: based on a PVAR dynamic analysis. J SOCIAL EC DEV. 2024 2024-10-26.\u003c/li\u003e\n\u003cli\u003eNiu X, Yang Y, Wang Y. Does the Economic Growth Improve Public Health? A Cross-Regional Heterogeneous Study in China. FRONT PUBLIC HEALTH. 2021 2021-6-18;9.\u003c/li\u003e\n\u003cli\u003eYang Y, Liang X. Analysis on the status quo and influencing factors of death attitude of oncology nurses in Yinchuan city. CHINESE EVIDENSE-BASED NURSING. 2023;9(2):278-82.\u003c/li\u003e\n\u003cli\u003eLiu Y, Zhang X, Wang S, Shi F, Guo M. Effect of death education and training based on \u0026quot;Thousand Chats live\u0026quot; on hospice care attitude and death attitude of emergency department nurses. Chinese Nursing Research. 2023;37(5):922-5.\u003c/li\u003e\n\u003cli\u003eLuo L, Li F, Zhang J, Li Y, Cheng Q, Wen Y. The correlation between the attitude to death and death education of the palliative care specialist nurses. Chinese Nursing Management. 2021;21(2):194-201.\u003c/li\u003e\n\u003cli\u003eYang H, Zhao D, Zhong H, Yu L. Current situation and correlation analysis of attitude towards death and demands for death education among emergency nurses in Hunan Province. Chongqing Medicine.;52(8):1219-24.\u003c/li\u003e\n\u003cli\u003eDoka KJ. Hannelore Wass: Death Education--An Enduring Legacy. DEATH STUD. [Biography; Historical Article; Journal Article]. 2015 2015-1-20;39(9):545-8.\u003c/li\u003e\n\u003cli\u003eLei L, Lu Y, Zhao H, Tan J, Luo Y. Construction of life-and-death education contents for the elderly: a Delphi study. BMC PUBLIC HEALTH. [Journal Article; Research Support, Non-U.S. Gov\u0026apos;t]. 2022 2022-4-21;22(1):802.\u003c/li\u003e\n\u003cli\u003eZhang H, Hu M, Zeng L, Ma M, Li L. Impact of death education courses on emergency nurses\u0026apos; perception of effective behavioral responses in dealing with sudden death in China: A quasi-experimental study. NURS EDUC TODAY. [Journal Article]. 2020 2020-2-1;85:104264.\u003c/li\u003e\n\u003cli\u003eLi Y, Zhao Y, Long Y, Tian L. Death education for clinical nurses in China:a scoping review. Chinese Nursing Management.;24(2):186-91.\u003c/li\u003e\n\u003cli\u003eXu G, Yu W. Mediating effect of meaning in life on death anxiety and attitude toward palliative care among undergraduate nursing students. BMC PALLIAT CARE. [Journal Article]. 2024 2024-6-5;23(1):139.\u003c/li\u003e\n\u003cli\u003eAy MA, Oz F. Nurses attitudes towards death, dying patients and euthanasia: A descriptive study. NURS ETHICS. [Journal Article]. 2019 2019-8-1;26(5):1442-57.\u003c/li\u003e\n\u003cli\u003eCevik B, Kav S. Attitudes and experiences of nurses toward death and caring for dying patients in Turkey. CANCER NURS. [Journal Article; Multicenter Study]. 2013 2013-11-1;36(6):E58-65.\u003c/li\u003e\n\u003cli\u003eGong Y, Chen Y, Liu Y. Factors Influencing Coping with Death Competence Among Chinese Oncology Nurses: A National Cross-Sectional Study. J MULTIDISCIP HEALTH. [Journal Article]. 2024 2024-1-20;17:4781-9.\u003c/li\u003e\n\u003cli\u003eCheong CY, Ha N, Tan L, Low JA. Attitudes towards the dying and death anxiety in acute care nurses - can a workshop make any difference? A mixed-methods evaluation. PALLIAT SUPPORT CARE. [Journal Article; Research Support, Non-U.S. Gov\u0026apos;t]. 2020 2020-4-1;18(2):164-9.\u003c/li\u003e\n\u003cli\u003eZhou S, Li N, Xu G. Status quo of hospice care attitude of nurses and its influencing factors. Chinese Journal of Modern Nursing. 2022;28(36):5129-32.\u003c/li\u003e\n\u003cli\u003eOlson JM, Zanna MP. Advances in experimental social psychology. First edition. ed.; 2015.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTable 1 Characteristics of potential categories of attitudes toward care for dying\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eN(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003eNegative attitude group(n=971)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003ePositive attitude group(n=673)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003ex\u003csup\u003e2\u003c/sup\u003e/t\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e0.354\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.552\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Female\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1608(97.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e948(97.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e660(98.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e36(2.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e23(2.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e13(1.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e0.641\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.887\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e＜30 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e523(31.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e302(31.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e221(32.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e31\u0026ndash;40 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e863(52.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e517(53.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e346(51.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e41\u0026ndash;50 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e210(12.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e124(12.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e86(12.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e＞50 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e48(2.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e28(1.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e20(3.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eEthnic group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e0.492\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.483\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eHan ethnic group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1589(96.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e936(96.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e653(97.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e55(3.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e35(3.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e20(3.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eMarital status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e0.897\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.639\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eUnmarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e371(22.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e227(23.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e144(21.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1211(73.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e708(72.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e503(74.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eDivorced or widowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e62(3.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e36(3.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e26(3.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eEducational level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e1.714\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.424\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eJunior college\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e389(23.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e239(24.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e150(22.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eBachelor\u0026apos;s degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1237(75.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e723(74.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e514(76.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eMaster\u0026rsquo;s degree and above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e18(1.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e9(0.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e9(1.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eTitle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e2.944\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.229\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eJunior title\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e832(50.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e503(51.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e329(48.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eIntermediate title\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e690(42.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e404(41.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e286(42.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eSenior title\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e122(7.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e64(6.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e58(8.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eDepartments\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e23.844\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e＜0.001**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eInternal medicine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e727(44.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e423(43.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e304(46.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eSurgery department\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e323(19.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e210(21.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e113(10.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eAcute and critical care unit\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e104(6.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e40(4.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e64(8.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e490(29.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e298(30.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e192(34.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eGrade of hospital\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e4.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.261\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eTertiary grade A hospital\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e920(56.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e538(55.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e382(56.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eTertiary grade B hospital\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e414(25.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e235(24.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e179(26.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eSecondary grade A hospital\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e199(12.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e127(13.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e72(10.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eSecondary grade B and below\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e111(6.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e71(6.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e40(5.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eResponsible unit\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e5.836\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.120\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eNation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e149(9.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e89(9.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e60(8.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eProvince\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e190(11.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e108(11.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e82(12.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eCity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e786(47.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e446(45.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e340(50.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e519(31.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e328(33.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e191(28.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eNature of the hospital\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e0.046\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.830\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eGeneral hospital\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1207(73.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e711(73.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e496(73.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eSpecialized hospital\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e437(26.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e260(26.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e177(26.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eThe location of your hospital\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e6.883\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.142\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eWestern Sichuan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e114(6.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e77(7.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e37(5.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eChengdu\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e227(13.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e128(13.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e99(14.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eEastern Sichuan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e97(5.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e51(5.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e46(6.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eSouth Sichuan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e925(56.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e556(57.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e369(54.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eNorthern Sichuan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e281(17.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e159(16.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e122(18.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003ePosition\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e7.634\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.054\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eResponsible nurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1276(77.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e773(79.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e503(74.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eNursing team leader\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e171(10.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e99(10.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e72(10.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eHead nurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e185(11.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e93(9.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e92(13.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eDeputy director/director of nursing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e12(0.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e6(0.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e6(0.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eAverage monthly income\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e10.480\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.015*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e\u0026lt;3000 RMB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e121(7.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e78(8.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e43(6.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e3000\u0026ndash;6000 RMB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e946(57.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e577(59.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e369(54.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e6001\u0026ndash;10000 RMB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e530(32.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e296(30.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e234(34.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e＞10000 RMB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e47(2.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e20(2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e27(4.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eWhether a specialized nurse?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e1.171\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.279\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1131(68.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e678(69.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e453(67.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e513(31.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e293(30.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e220(32.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eReligious belief\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e0.350\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.554\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1562(95.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e920(94.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e642(95.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e82(5.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e51(5.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e31(4.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eHave been bereaved within one year?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e17.851\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e＜0.001**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1380(83.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e846(87.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e534(79.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e264(16.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e125(12.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e139(20.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eAverage number of terminally ill patients cared for per month\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e7.147\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.028*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e0\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e935(56.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e574(59.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e361(53.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e1\u0026ndash;5 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e630(38.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e359(37.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e271(40.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e\u0026gt;5 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e79(4.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e38(3.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e41(6.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eWhether have received death education training\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e22.388\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e＜0.001**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1158(70.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e727(74.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e431(64.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e486(29.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e244(25.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e242(36.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eImportance of receiving death education training\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e22.354\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e＜0.001**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eExtremely unimportant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e3(0.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e1(0.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e2(0.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eNot important\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e8(0.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e5(0.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e3(0.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eFairly important\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e233(14.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e161(16.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e72(10.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eVery important\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e493(30.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e255(26.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e238(35.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eExtremely important\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e907(55.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e549(56.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e358(53.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eUrgency of receiving death education training\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e27.085\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e＜0.001**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eExtremely unurgent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e9(0.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e5(0.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e4(0.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eNot urgent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e76(4.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e59(6.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e17(2.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eFairly urgent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e611(37.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e385(39.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e226(33.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eVery urgent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e426(25.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e253(26.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e173(25.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eExtremely urgent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e522(31.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e269(27.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e253(37.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eThe Meaning in Life\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e48.48\u0026plusmn;9.50\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e53.37\u0026plusmn;8.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e-10.586\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e＜0.001**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eThe Templer Death Anxiety Scale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e48.01\u0026plusmn;7.68\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e45.86\u0026plusmn;9.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e4.952\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e＜0.001**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n\u003c/table\u003e\n\u003cp\u003eNote: Statistically significant at *\u003cem\u003eP\u003c/em\u003e＜ 0.05;** \u003cem\u003eP\u003c/em\u003e ＜0.01\u003c/p\u003e\n\u003cp\u003eTable 2 Latent Profile Fitting Model Index for death attitude among nurses\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"95%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 8.003%;\"\u003e\n \u003cp\u003eModel\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.2332%;\"\u003e\n \u003cp\u003eAIC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8613%;\"\u003e\n \u003cp\u003eBIC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8613%;\"\u003e\n \u003cp\u003eaBIC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.346%;\"\u003e\n \u003cp\u003eEntropy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.6311%;\"\u003e\n \u003cp\u003eLMR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.4475%;\"\u003e\n \u003cp\u003eBLRT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34.8704%;\"\u003e\n \u003cp\u003eClassified probability\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 8.003%;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.2332%;\"\u003e\n \u003cp\u003e121978.114\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8613%;\"\u003e\n \u003cp\u003e122453.744\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8613%;\"\u003e\n \u003cp\u003e122174.182\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.346%;\"\u003e\n \u003cp\u003e0.916\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.306%;\"\u003e\n \u003cp\u003e0.0099\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.4314%;\"\u003e\n \u003cp\u003e0.0000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34.8704%;\"\u003e\n \u003cp\u003e0.59063/0.40937\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 8.003%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.2332%;\"\u003e\n \u003cp\u003e118607.889\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8613%;\"\u003e\n \u003cp\u003e119245.666\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8613%;\"\u003e\n \u003cp\u003e118870.799\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.346%;\"\u003e\n \u003cp\u003e0.998\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.306%;\"\u003e\n \u003cp\u003e0.5970\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.4314%;\"\u003e\n \u003cp\u003e0.0000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34.8704%;\"\u003e\n \u003cp\u003e0.05535/0.49270/0.45195\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 8.003%;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.2332%;\"\u003e\n \u003cp\u003e116452.728\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8613%;\"\u003e\n \u003cp\u003e117252.651\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8613%;\"\u003e\n \u003cp\u003e116782.479\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.346%;\"\u003e\n \u003cp\u003e0.963\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.306%;\"\u003e\n \u003cp\u003e0.0895\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.4314%;\"\u003e\n \u003cp\u003e0.0000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34.8704%;\"\u003e\n \u003cp\u003e0.05535/0.49209/0.18005/0.27251\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 8.003%;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.2332%;\"\u003e\n \u003cp\u003e112171.142\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8613%;\"\u003e\n \u003cp\u003e113133.212\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8613%;\"\u003e\n \u003cp\u003e112567.734\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.346%;\"\u003e\n \u003cp\u003e0.970\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.306%;\"\u003e\n \u003cp\u003e0.3828\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.4314%;\"\u003e\n \u003cp\u003e0.0000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34.8704%;\"\u003e\n \u003cp\u003e0.00912/0.04866/0.18127/0.48966/0.27129\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote: AIC, Akaike information criterion; BIC,the Bayesian Information Criterion;aBIC, sample-size adjusted BIC; LMR, Lo-Mendell-Rubin; BLRT, Bootstrapped likelihood ratio test\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 3 Result of binary logistic regression\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 222px;\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eOR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e95% CI\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 222px;\"\u003e\n \u003cp\u003eHave been bereaved within one year?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 222px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e0.001**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e0.623\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e(0.468, 0.829)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 222px;\"\u003e\n \u003cp\u003eWhether have received death education training\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 222px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e0.023*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e0.756\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e(0.594, 0.962)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 222px;\"\u003e\n \u003cp\u003eThe total score of The Meaning in Life Questionnaire\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e＜0.001**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e1.053\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e(1.040, 1.066)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 222px;\"\u003e\n \u003cp\u003eThe total score of Templer-Death Anxiety Scale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e＜0.001**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e0.974\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e(0.961, 0.986)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;Note: OR=Odd Ratio; CI=Confidence Interval\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; Statistically significant at *\u003cem\u003eP\u003c/em\u003e＜ 0.05;** \u003cem\u003eP\u003c/em\u003e ＜0.01\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Cross-sectional studies, Attitude to death, Nurses, Value of life, Latent Profile Analysis","lastPublishedDoi":"10.21203/rs.3.rs-5654763/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5654763/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Nurses’ attitudes and beliefs regarding end-of-life issues significantly impact the quality of care provided to dying patients. While several studies have explored medical students' attitudes toward end-of-life care, there is a lack of in-depth analysis of the internal variations and factors influencing clinical nurses' attitudes toward death. This study aimed to identify different profiles of attitude toward care for dying patients and explore the factors influencing each profile.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eThis multicenter cross-sectional study recruited 1698 participants using convenience sampling from 60 hospitals across Sichuan Province, China. Data were collected from February 1 to April 30, 2024. The study utilized a self-designed General Information Questionnaire, Frommelt Attitudes Toward Care of the Dying Scale Form B (FATCOD-B), Templer-Death Anxiety Scale (T-DAS), and Meaning in Life Questionnaire (MLQ). Binary regression analysis and Latent Profile\u003c/p\u003e\n\u003cp\u003eAnalysis (LPA) are used to identify the latent classes and factors impacting the classes of attitudes toward caring for the dying.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e Nurses’ attitudes toward caring for dying patients were categorized into two distinct profiles: the positive attitude group (40.9%, N=673) and the negative attitude group (59.1%, N=971). The mean scores for these profiles were 103.67 ± 0.40 and 94.10 ± 0.22, respectively, with a significant difference between them (F=480.282, \u003cem\u003eP \u003c/em\u003e＜0.001). The key factors contributing to these differences included bereavement experience within 1-year, prior death education training, sense of meaning in life, and death anxiety (\u003cem\u003eP\u003c/em\u003e \u0026lt; 0.05).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions:\u003c/strong\u003e Nurses’ attitudes toward caring for dying patients can be classified into positive and negative attitude profiles, with key influencing factors including bereavement experience, death education training, sense of meaning in life, and death anxiety. Healthcare administrators, educators, and policymakers should develop targeted interventions based on the specific features of each categoryand influencing factors to enhance end-of-life care practices.\u003c/p\u003e","manuscriptTitle":"A Multicenter Cross-Sectional Study on Nurses’ Attitudes Toward End-of-Life Care and Influencing Factors: A Latent Profile Analysis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-03-26 08:59:23","doi":"10.21203/rs.3.rs-5654763/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-04-01T06:02:21+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-03-31T15:53:41+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"180400160245992558180993287447929522592","date":"2025-03-25T17:01:20+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-03-21T02:13:04+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"94687076545896158966181385112820597087","date":"2025-03-21T00:46:56+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-03-20T23:31:14+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-03-20T12:14:26+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Nursing","date":"2025-03-18T13:09:42+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"44694bbc-5a68-4588-9474-09c197816e22","owner":[],"postedDate":"March 26th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-06-09T16:07:37+00:00","versionOfRecord":{"articleIdentity":"rs-5654763","link":"https://doi.org/10.1186/s12912-025-03240-4","journal":{"identity":"bmc-nursing","isVorOnly":false,"title":"BMC Nursing"},"publishedOn":"2025-06-05 15:57:02","publishedOnDateReadable":"June 5th, 2025"},"versionCreatedAt":"2025-03-26 08:59:23","video":"","vorDoi":"10.1186/s12912-025-03240-4","vorDoiUrl":"https://doi.org/10.1186/s12912-025-03240-4","workflowStages":[]},"version":"v1","identity":"rs-5654763","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5654763","identity":"rs-5654763","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}