Ready for the end? Fear of death and training in palliative care: a look at nursing and physiotherapy students in Bolivia

Abstract Background Confronting death is a highly stressful task for health science students, shaped significantly by cultural and gender-related factors. Objective To evaluate levels of fear of death and coping strategies associated among nursing and physiotherapy students in Bolivia, identifying key predictors of preparedness. Methods A descriptive, cross-sectional, and multicenter study was conducted with 816 students (414 Nursing students) and 402 Physiotherapy students) from different Bolivian higher education institutions. Data were collected using the Bugen Death Coping Scale, the Collett-Lester Fear of Death Scale (CL- Fods), and ad-hoc clinical preparedness self-assessment. Statistical analysis included independent t-tests, Chi-square tests, and multiple linear regression models. Results Students reported significantly lower preparedness for terminally ill patients compared to non-terminal ones (21.8% vs. 43.4% reporting being “quite” or “very” prepared). Similarly, emotional preparedness was lower for terminal care (32.6% vs. 51.5%). According to the Bugen scale, women demonstrated significantly higher coping scores than men (105.77 vs. 98.12; p<0.001). However, the CL-FODS revealed that women also experience significantly higher fear regarding their own dying process (p<0.001) and the death of others (p<0.001). Regression models identified gender as a primary predictor for coping (β = 0.14, p=0.001). For fear of death (CL-FODS), gender (β = 0.12, p=0.003), academic program (β = 0.07, p=0.038), and age (β=−0.09, p=0.045) were significant predictors, with fear decreasing as age increases. Conclusion A significant gap exists in clinical and emotional preparedness for end-of-life care among health science students in Bolivia. While female students show higher coping capacity, they also report greater anxiety. Results suggest that academic curricula should be redesigned to include specific palliative care competencies, addressing the influence of gender and age on the emotional management of death. Clinical trial number Not applicable.