Personality traits associated with less favourable attitudes toward end-of-life care among hospital nurses: a cross-sectional predictive study
This cross-sectional study of 303 hospital nurses reveals that higher levels of conscientiousness, agreeableness, and openness, along with working outside critical care units, are associated with more favorable attitudes toward end-of-life care, suggesting that personality traits could inform tailored educational support while cautioning against their use for staffing decisions.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
Every hospital has a corner where the work shifts from fixing to accompanying. It is the place where nurses care for patients who are dying, managing pain, offering comfort, and supporting families through the final hours. This kind of care, often called end-of-life or palliative care, is a core part of nursing, yet it is emotionally heavy and complex. While we know that training and experience help nurses handle these situations, a deeper question remains: does a nurse's natural personality shape how they approach the end of life? Scientists have long studied five broad personality traits that describe how people generally think and act: how open they are to new ideas, how agreeable and kind they tend to be, how conscientious and responsible they feel, how much they worry, and how outgoing they are. Understanding if these deep-seated traits influence a nurse's attitude toward dying patients could help hospitals support their staff better, ensuring that every patient receives a dignified and compassionate farewell.
A team of researchers at the Puerta del Mar University Hospital in Spain set out to explore this connection. They focused on 303 registered nurses working in various hospital units where death is a regular occurrence, such as emergency rooms, intensive care, and oncology wards. The nurses were asked to fill out two well-known questionnaires. One measured their attitudes toward caring for the dying, asking them to agree or disagree with statements about their feelings and readiness to help. The other measured their personality across the five standard traits. The researchers then looked for patterns, asking whether certain personality types were linked to more positive or negative feelings about end-of-life care, and whether the specific hospital unit where a nurse worked made a difference.
The study found a clear link between personality and attitude. Nurses who scored higher on conscientiousness, agreeableness, and openness tended to have more favorable attitudes toward caring for dying patients. Conscientiousness, which reflects a sense of duty and organization, showed the strongest connection; nurses who felt a strong professional commitment were more likely to view end-of-life care positively. Similarly, those who were naturally more agreeable, showing kindness and a desire to help others, and those who were more open to new experiences and ideas, also reported better attitudes. In contrast, the other two personality traits measured—how much a person worries and how outgoing they are—did not show a significant link to these attitudes.
The location of the work also mattered. Nurses working in the critical care unit, often known as the intensive care unit, reported less favorable attitudes toward end-of-life care compared to those working in the general emergency department. The researchers suggest this might be because critical care nurses face intense pressure to keep patients alive, which can create a conflict when the focus must shift to comfort and letting go. While having training in palliative care was associated with slightly better attitudes, the difference was not statistically strong enough to be certain, suggesting that training alone does not fully explain how nurses feel about this work.
To make these findings useful for real-world support, the researchers built a simple model to estimate the likelihood of a nurse having a less favorable attitude based on their personality scores. They found that nurses with low scores in conscientiousness, agreeableness, and openness were much more likely to struggle with end-of-life care attitudes. For example, a nurse with low scores in all three areas had a high probability of having a less favorable outlook, while a nurse with high scores in those same areas had a very low probability. The model was able to distinguish between these groups with moderate accuracy, offering a way to identify which nurses might benefit most from additional emotional support or specialized training.
The authors are careful to state that these findings are not a way to label nurses or decide who should work in which department. Personality is just one piece of the puzzle, and attitudes are also shaped by experience, team culture, and hospital resources. Instead, the study suggests that understanding these personality patterns can help hospitals tailor their support systems. Nurses who are naturally less open might benefit from training that encourages reflection, while those who are less agreeable might need extra help with communication skills. By recognizing that different personalities approach the end of life in different ways, hospitals can create a more supportive environment for both the staff and the patients they serve.
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