Goal of this interventional study
The purpose of this research is to investigate the effects of a scenario-based puzzle educational game on death anxiety and meaning in life among nursing students. It aims to answer the following key questions:
Can the scenario-based puzzle educational game enhance nursing students' sense of meaning in life?
Can the scenario-based puzzle educational game reduce death anxiety in nursing students?
What are nursing students' experiences and perceptions of this educational game?
Study design Researchers will compare the intervention group (participating in the game) with a control group (receiving death education manuals) to evaluate the effectiveness of the game-based intervention.
Participants will:
Be recruited through campus posters
Be randomly assigned to either the intervention or control group and complete baseline questionnaires
In the control group: Receive death education manuals twice weekly for 3 weeks
In the intervention group: Participate in group sessions (5 students per group) to play the scenario-based puzzle game twice weekly for 3 weeks
Complete follow-up questionnaires and participate in qualitative interviews regarding their experiences with manual-based education or the game intervention after the 3-week intervention period
Third-year full-time undergraduate nursing students
Completed clinical observation training but not yet entered clinical internship phase
Aged ≥18 years
Provide informed consent and voluntarily participate in the study
Participated in similar death education interventions within the past 3 months
Diagnosed with severe mental or psychological disorders
Currently on a leave of absence (academic or personal)
Parallel
Puzzle game
Other interventionScenario-based puzzle game sessions (group format)
Manual Education
Other interventionStandardized death education manual distribution
Death Anxiety
A 15-item self-report scale developed by psychologist Templer (1967/1970) measuring death-related distress. Dimensions: Affective (Items 1,3,10,13,14), Stress/Pain (Items 4,5,6,9,11), Time Awareness (Items 8,12), Cognitive (Items 2,7,15) Scoring: Dichotomous (Yes/No) with 9 forward-scored and 6 reverse-scored items (Items 2,3,5,6,7,16\*). Total score range: 0-15 (higher = greater anxiety). Reliability: Test-retest reliability (3-week) = 0.83; KR-20 = 0.76 (original English version).
Meaning in Life
A 10-item scale (Steger et al.) assessing two dimensions: Presence of Meaning (5 items): Perceived life purpose Search for Meaning (5 items): Active pursuit of meaning Scoring: 7-point Likert (1="Strongly Disagree" to 7="Strongly Agree"). Higher scores indicate stronger meaning. Reliability: Cronbach's α = 0.878 (total), 0.850 (Presence), 0.907 (Search)
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