Trauma levels and perspectives on dignified death among nurses and physicians who directly experienced the recent earthquake

Abstract

Background Unexpected, sudden, and tragic losses can prompt us to reflect on the concept of a good death. The earthquake disaster that struck our country in 2023 vividly demonstrated the challenging impact of such events, which can turn lives upside down and compel us to question the notion of a good death. This study aims to determine the perceptions of a good death and the levels of trauma experienced by physicians and nurses who directly witnessed the earthquake disaster, and to understand the relationship between these factors. Methods This cross-sectional study was conducted between October 1 and December 31, 2023, using phone interviews facilitated by a web-based Google form. Data were collected from 560 healthcare professionals (280 nurses and 280 doctors) working in hospitals located in Kahramanmara & scedil;, Hatay, Malatya, and Ad & imath;yaman provinces in Turkiye, which were directly impacted by the earthquake of February 6, 2023, and who consented to participate in the study. Trauma levels were assessed using the Post-Earthquake Trauma Level Determination Scale, and perceptions of a good death were evaluated using the Good Death Scale (GDS). Data were analyzed using SPSS 25 and AMOS 24 software. Normal distribution was checked with the Kolmogorov-Smirnov Test. Independent t-tests were used to compare independent binary groups, Pearson correlation analysis was used to examine the relationship between scale scores, and Cronbach's alpha coefficient was used to evaluate the reliability of the scales (Good Death Scale: 0.931; Trauma Scale: 0.957). Structural equation modeling and multi-group analysis were conducted to examine the relationship between scale scores according to the profession variable. Findings The mean score for the perception of a good death was found to be 52.76 +/- 8.77 for physicians and 55.84 +/- 9.63 for nurses. A statistically significant difference was detected between physicians and nurses in the psychosocial spirituality, personal control, and clinical sub-dimensions of the scale (p<0.05). The mean trauma scores were 56.81 +/- 17.58 for physicians and 64.82 +/- 18.56 for nurses. A significant difference was found in the trauma scale and its sub-dimensions (excitement limitation, emotional, cognitive restructuring, sleep problems) (p<0.05). It was observed that higher trauma levels positively influenced good death perception scores. Conclusion This study reveals that healthcare workers are deeply affected psychologically by major disasters, with high levels of trauma. A significant relationship was found between trauma levels and perceptions of a good death. These findings provide an important basis for future research to understand how trauma shapes the lives and job performance of healthcare workers in the long term.