title: Medical Students' Death Anxiety: Severity and Association With Psychological Health and Attitudes Toward Palliative Care.
abstract: BACKGROUND
  Death anxiety (DA) is related to awareness of the reality of dying and death and can be negatively related to a person's psychological health. Physicians' DA also may influence their care for patients approaching death. Doctors face death in a professional context for the first time at medical school, but knowledge about DA among medical students is limited.
  
  
  OBJECTIVE
  This study examined medical students' DA in relation to: 1) its severity, gender differences, and trajectory during medical education and 2) its associations with students' attitudes toward palliative care and their psychological health.
  
  
  METHODS
  Four cohorts of core science and four cohorts of clinical students at the University of Cambridge Medical School took part in a questionnaire survey with longitudinal follow-up. Students who provided data on the revised Collett-Lester Fear of Death Scale were included in the analysis (n = 790).
  
  
  RESULTS
  Medical students' DA was moderate, with no gender differences and remained very stable over time. High DA was associated with higher depression and anxiety levels and greater concerns about the personal impact of providing palliative care.
  
  
  CONCLUSIONS
  The associations between high DA and lower psychological health and negative attitudes toward palliative care are concerning. It is important to address DA during medical education to enhance student's psychological health and the quality of their future palliative care provision.
authors.affiliation: Primary Care Unit, University of Cambridge, Cambridge, United Kingdom; School of Clinical Medicine, Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom. Electronic address: pt350@medschl.cam.ac.uk.
authors.forename: Pia
authors.initials: P
authors.lastname: Thiemann
authors.affiliation: Primary Care Unit, University of Cambridge, Cambridge, United Kingdom; School of Clinical Medicine, Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Thelma
authors.initials: T
authors.lastname: Quince
authors.affiliation: Primary Care Unit, University of Cambridge, Cambridge, United Kingdom; School of Clinical Medicine, Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom.
authors.forename: John
authors.initials: J
authors.lastname: Benson
authors.affiliation: Primary Care Unit, University of Cambridge, Cambridge, United Kingdom; School of Clinical Medicine, Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Diana
authors.initials: D
authors.lastname: Wood
authors.affiliation: Primary Care Unit, University of Cambridge, Cambridge, United Kingdom; School of Clinical Medicine, Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Stephen
authors.initials: S
authors.lastname: Barclay
mesh_terms: D001007:Anxiety; D001291:Attitude of Health Personnel; D001293:Attitude to Death; D003643:Death; D003863:Depression; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D010166:Palliative Care / Q000523:psychology*; D011581:Psychological Tests; D012727:Sex Characteristics; D013337:Students, Medical / Q000523:psychology*; D013997:Time Factors
keywords: Death anxiety; attitudes; medical students; palliative care; psychological health