Selected Factors Related to Death Acceptance Among Persons with end Stage Kidney Disease

Authors

  • Chanjira phen Faculty of Nursing, Chulalongkorn University
  • Sureeporn Thanasilp Faculty of Nursing, Chulalongkorn University

Keywords:

Death acceptance, Persons with end stage kidney disease, Buddhist beliefs about death

Abstract

Purpose: This study aimed to examine the relationships between age, treatment modality, death anxiety, Buddhist beliefs about death, unfinished burdens, and self-care perception with death acceptance among patients with end-stage kidney disease.

Design: Descriptive correlational research

Methods: The sample consisted of 125 patients diagnosed with end-stage kidney disease who were receiving treatment at the Kidney Center and Hemodialysis Unit of Vachira Phayabal Faculty of Medicine, Navamindradhiraj University, and the Hemodialysis Unit of the Kidney Foundation of Thailand. The research instruments included questionnaires that gathered information on personal data, Buddhist death acceptance, death anxiety, religious beliefs about death, lingering burdens, and self-efficacy. The Cronbachs alpha coefficients for these instruments were .85, .87, .80, .73, and .74, respectively. Data were analyzed using descriptive statistics and Pearsons product-moment correlation coefficient.

Results: Patients with end-stage kidney disease reported a high level of death acceptance (Mean=39.20, SD=5.16). age (r=.74) and Buddhist beliefs about death (r=.77) were positively and highly correlated with death acceptance (p < .05). and perceived ability to take care of oneself (r=.65) were positively and moderate level with death acceptance (p < .05). Conversely, death anxiety (r=-.78) negatively and highly correlated with death acceptance (p < .05).unfinished burden (r=-.66) were negatively and moderate level with death acceptance (p < .05). Treatment modality was not significantly correlated with death acceptance.

Conclusion: Death acceptance in patients with end-stage kidney disease is influenced by various factors. It is crucial to consider these factors, including Buddhist beliefs about death, when creating a nursing intervention to support a good death for this population.

References

The Nephrology Society of Thailand. Clinical practice guidelines for hemodialysis. Bangkok: Text and Journal Publication Co., Ltd; 2022.

Satirapoj B, Tantiyavarong P, Chuasuwan A, Lumpaopong A, Limbutara K, Kiattilunthorn K, et al. Thailand Renal Replacement Therapy Registry 2023: Epidemiology and Trends in Incident Dialysis Patients. J Nephrol Soc Thailand [Internet]. 2025 Apr 4 [cited 2025 Dec 3]; 29(2): [about 14 p.]. Available from: https://he01.tci-thaijo.org/index.php/JNST/article/view/277563/187384

Fresenius Medical Care. 2018 annual medical report going further, faster: Translating science into practice [Internet]. Waltham (MA): Fresenius Medical Care North America; 2018 [cited 2025 Dec 7]. Available from: newsroom.fmcna.com.

Department of Disease Control, Non-Communicable Disease Division. Epidemiology and review of chronic kidney disease prevention measures. Bangkok: Population-Level Policy Development Group; 2022.

Arkhayakorn L. Acceptance of death. Chulalongkorn Med J. 2018; 62(5): 761–72. (In Thai)

Pagels AA, Söderquist BK, Heiwe S. Differences in illness representations in patients with chronic kidney disease. J Ren Care. 2015; 41(3): 146-55.

Muksiritipanun B, Pongsathornwiboon K, Suwith B, Chansuwan A, Wongrosatrai Y. Spiritual well-being and essential needs in end-stage renal disease patients at Vajira Hospital, Navamindradhiraj University. Songklanagarind J Nurs. 2018;38(1):63-76.

Yanin N, Tipaporn W, Jiraporn T. Illness representation and end-of-life coping in patients with end-stage renal disease. Nurs J CMU. 2022 Jul-Sep; 49(3): 95-108. (In Thai)

Molzahn A, Sheilds L, Bruce A, Stajduhar KI, Makaroff KS, Beuthin R, et al. Perceptions regarding death and dying of individuals with chronic kidney disease. Nephrol Nurs J. 2012; 39(3): 197.

Krapho M, Chimluang C. Factors related to death acceptance in patients with advanced cancer [master’s thesis]. Bangkok: Faculty of Nursing, Chulalongkorn University; 2018.

Yimniam A. Factors related to death preparation behaviors among elderly end-stage chronic kidney disease patients in Chachoengsao Province [master’s thesis]. Chonburi: Burapha University; 2023.

Kübler-Ross E. On death and dying: what the dying have to teach doctors, nurses, clergy and their own families. New York: Simon & Schuster; 1997

Phudibut K, Khamsa S,Oradee O. The survival rate of end-stage renal disease patients receiving renal replacement therapy at Yang Talat Hospital, Kalasin Province. Srinagarind Med J. 2022;37 (1): 49-55

Akkayagom L, Suwannapong K, Long NH, Chimluang J, Upasen R, et al. Development and psychometric testing of the Buddhist Death Acceptance Scale. Pac Rim Int J Nurs Res. 2020; 24(4).

RungsKosai S, Pipatvanitcha N, Paokanha R. Factors related to preparation behaviors for facing terminal illness and death among elderly in the elderly club of Pattani Province. Songklanagarind J Nurs. 2013; 33(1): 43-56.

Sukmak W, Sirisuntorn A, Meena P. Reliability of the self-efficacy perception questionnaire. J Psychiatr Assoc Thailand. 2002; 47(1): 36.

DeVellis RF. Scale development: theory and applications. 3rd ed. Thousand Oaks (CA): Sage publications; 2012.

Kübler-Ross E. On death and dying. New York: Macmillan; 1969

Chan CK, Yau MK. Death preparation among the ethnic Chinese well-elderly in Singapore: an exploratory study. Omega J Death Dying. 2009; 60(3): 225-39.

Supawadee W. Factors affecting advance directives for the right to a peaceful death at the end of life in the elderly. [master’s thesis]. Bangkok: Kasetsart University; 2003.

Department of Medical Services, Ministry of Public Health. Manual of palliative and end-of-life care (for medical personnel).Nonthaburi: Department of Medical Services; 2020

Bandura A. Self-efficacy: the exercise of control. New York: Worth Publishers; 1997.

Buranarat W. Perspectives on terminal illness and death of patients with severe diseases under palliative care [master’s thesis]. Bangkok: Chulalongkorn University; 2013.

Vichaisak W, Lueboonthavatchai P, Avihingsanon Y. Comparative study of quality of life between end-stage renal disease patients undergoing hemodialysis or peritoneal dialysisand those who underwent kidney transplantation at King Chulalongkorn Memorial Hospital. Chulalongkorn Med J. 2018; 62(1): 89-105.

Sayin A, Mutluay R, Sindel S. Quality of life in hemodialysis, peritoneal dialysis, and transplantation patients. Transplant Proc. 2007; 39(10): 3047-53.

Phetkham M, Phetkham L, Intholo S. [Comparison of quality of life between end-stage renal disease patients treated with peritoneal dialysis and hemodialysis at Somdejphrajaoyuparaj Sawangdaendin Hospital]. Journal of Nursing and Health Care. 2020; 38(1): 137-46.

Downloads

Published

2025-12-29

Issue

Section

Research articles