SAGE Journal Articles

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SAGE Journal User Guide

Article 1:

Wittkowski, J. (2015). Coping and Attitudes Toward Dying and Death in German Adults. OMEGA-Journal of Death and Dying, 0030222815575283.


The idea of an existential threat caused by the awareness of mortality has been rarely investigated within coping research. The study explores relationships between coping strategies and attitudes toward dying and death in a sample of German adults aged 20 to 93 years. Participants responded to a Stress Coping Inventory and a questionnaire for the multidimensional assessment of attitudes toward dying and death. Pearson correlations for men, women, and the young and old age-groups confirm the expectation that attitudes toward dying and death are mainly associated with disengagement and accommodative coping. Gender- and age-specific findings refer to drug intake and aggression. Results are discussed within both a coping and a thanatological frame of reference and issues for future research are outlined.

Questions to Consider:

  1. Describe your understanding of existential concerns such as death anxiety.
  2. What role may culture play in this study?
  3. The study uses a wide age range to make comparisons. Which findings related to the older age group provide helpful information for working with the dying and their loved ones?

Article 2:

Willems, D. L., Hak, A., Visser, F., & Van der Wal, G. (2004). Thoughts of patients with advanced heart failure on dying. Palliative medicine18(6), 564-572.


Objective: To explore, over a one-year period, the ideas and attitudes of patients with end-stage cardiac failure concerning dying. Design: Prospective longitudinal multiple case study using qualitative interview techniques. Participants: Thirty-one patients from two hospitals who fulfilled one or more of the following criteria: NYHA 11.1 or IV, ejection fraction < 25% at least one hospitalization for heart failure. Main outcomes: Statements of patients with advanced heart failure, expressed in semi-structured interviews, concerning the quality of dying and medical decisions at the end of life. Results: Many respondents only thought about death during exacerbations. Mentioned aspects of appropriate dying include: a degree of usefulness, prognostic knowledge, appropriate duration and mental awareness. Few respondents were in favor of euthanasia or suicide, but all wanted life-prolonging treatment to be withheld or withdrawn when appropriate. Conclusions: Our study found some elements of 'appropriate dying' that differ from other studies and that are relatively specific for advanced heart failure. The tendency of patients not to think about death raises ethical concerns.

Questions to Consider:

  1. Discuss your thoughts on “appropriate dying” with attention to how you would help a client in the end phase of his/her life.
  2. Describe the ethical concerns discussed in this study, especially those related to euthanasia or assisted suicide.
  3. Imagine you are placed in an Integrated Healthcare setting. What do you believe is your role in helping clients like those described in the article?