Depression, traumatic cognition, and death anxiety in pre-hospital and emergency staff depending on prior COVID-19 infection - aTurkish example.

ABSTRACTBackground and AimsAs first responders to accidents and disasters, prehospital emergency personnel encounter psychological crises and mental stressors like death anxiety and job burnout. The present study aimed to investigate death anxiety, resilience, and job burnout in prehospital emergency personnel.MethodsThis investigation employed a descriptive, cross‐sectional, observational, and multi‐centric study design. The research population encompassed prehospital emergency personnel affiliated with three universities of medical sciences in Fars Province, Southern Iran. A convenience sampling technique yielded a participant pool of 417 prehospital emergency personnel. Data was gathered using the Templer Death Anxiety Scale, Prehospital Emergency Personnel Resilience Scale and Maslach Burnout Inventory. Data were analyzed in SPSS‐26 through descriptive statistics, one‐way ANOVA, Pearson coefficient, and multiple linear regression. The significance level was set at p < 0.05.ResultsThe mean score for job burnout was 61.36 (SD ± 36.76), while the mean score for death anxiety was 99.5 (SD ± 94.10). These scores can be interpreted as indicative of high levels of both job burnout and death anxiety. Conversely, the mean resilience score of 96.37 (SD ± 77.06) suggests moderate resilience within the sample population. The findings revealed an inverse correlation between resilience and job burnout (r = −0.49, p < 0.001) and an inverse correlation between resilience and death anxiety (r = −0.51 p < 0.001). Also, the findings revealed a statistically significant positive correlation was found between job burnout and death anxiety (r = 0.37, p < 0.001). The results showed that age, work experience, resilience, and job burnout explained 44.4% of the variance in death anxiety (R2 = 0.44, p < 0.001). In addition, work experience (β = 0.097, p = 0.043), resilience (β = 0. 208 p < 0.001), and job burnout (β = 0.337, p < 0.001) had the highest predictive impact on death anxiety.ConclusionWhile the present study revealed high levels of death anxiety and job burnout among prehospital personnel, it also found their resilience to be moderate. Senior managers in prehospital emergency services should prioritize strategies to improve cognitive abilities, particularly resilience. By doing so, they can not only enhance employee well‐being but also potentially reduce job burnout and death anxiety.

BackgroundVarious factors have been found to be associated with high levels of death anxiety experienced by oncology nurses. The aim of this study was to use a person-oriented approach to examine the death anxiety patterns of Chinese oncology nurses and to analyze the differences in anxiety characteristics and their associated influencing factors.MethodsA cross-sectional survey regarding palliative care among registered oncology nurses was conducted in Jiangsu Province, China.Latent class analyses was applied to identify their patterns of death anxiety. The score of PCQN-C (The Chinese version of the Palliative Care Quiz for Nursing) and FATCOD-B-C (The Chinese version of the Frommelt Attitude Toward Care of the Dying scale), the demographic and working characteristics were further analyzed through covariance analysis (ANCOVA) and multivariate (or logistic) regression across the subgroups.ResultsA two-potential-category model was selected based on the fit index. The results showed that 79% of oncology nurses belonged to the high pressure and pain group and 21% belonged to the low death anxiety group. The high pressure and pain group had significantly higher scores in the dimensions of emotion, stress and pain, time awareness, and cognition compared to the low death anxiety group. Factors influencing the high pressure and pain group included shorter working years, non-national or provincial oncology nursing specialists, non-national palliative care specialists, never discussing the topic of death with patients or family members, no palliative care related training, and PCQN and FATCOD scores.ConclusionsOur study suggests that oncology nurses’ death anxiety can be divided into two categories: low death anxiety and high stress pain, and certain factors, such as being female, having a short work experience, and lacking palliative care-related training, increase the likelihood of death anxiety.

The relationship between internal and external resources, coping strategies, PTS and death-anxiety of elderly caregivers’ Philippine immigrants and local workers after the Gaza war

BackgroundDeath anxiety in physicians is considered to be a possible factor affecting the quality of palliative care. As the reserve force of future medical careers, the level of death anxiety among clinical medical freshmen and its impact mechanism deserves attention. Previous studies have indicated that personality traits and self-efficacy may be factors influencing death anxiety. However, there is limited research on the current state of death anxiety among clinical medical freshmen, and the impact of health personality, death coping self-efficacy on death anxiety. The objectives of this study were to investigate the death anxiety levels of clinical medical freshmen, explore whether death anxiety is affected by health personality and death coping self-efficacy, and examine whether death coping self-efficacy mediates the association between health personality and death anxiety among clinical freshmen.MethodsA cross-sectional survey among 378 clinical medical freshmen was conducted at a university in Wuhan, Hubei Province, China between June and July 2023. Demographic questionnaire, the Chinese versions of the Health Personality Assessment (HPA), Death Coping Self-efficacy Scale (DCSS) and Death Anxiety Scale (DCS) were used. SPSS 25.0 statistical software was used for descriptive analysis, independent sample t-tests, one-way ANOVA, and Pearson correlation analysis. The mediating effect analysis was performed with PROCESS version 4.1 Model.ResultsA total of 360 valid questionnaires were collected. Clinical medical freshmen exhibited high levels of death anxiety was (45.55 ± 7.57). Health neuroticism has a significant positive impact on death anxiety (β = 0.407, t = 2.323, P < 0.05). In contrast, death anxiety was significantly impacted negatively by death coping self-efficacy (β=-0.105, t=-3.441, P < 0.05). The association between health neuroticism and death anxiety was partially mediated by death coping self-efficacy; the mediating impact accounted for 18.44% of the total effect, with a 0.092 coefficient.ConclusionsThis study revealed that clinical medical freshmen had high levels of death anxiety. Health neuroticism and death coping self-efficacy directly affected clinical medical freshmen’ death anxiety. Death coping self-efficacy mediated the relationship between health neuroticism and death anxiety among clinical medical freshmen. Interventions by medical educators that focus on both individuals’ health personality and death coping self-efficacy may be most effective in reducing death anxiety among clinical medical freshmen.

PurposeThis study aimed to investigate death anxiety in advanced cancer patients and identify associated factors in the context of Chinese culture.MethodsParticipants (N = 270) with advanced cancer in a tertiary cancer hospital completed anonymous questionnaire surveys. Measures included the Chinese version of a Likert-type Templer-Death Anxiety Scale, Rosenberg’s Self-esteem Scale, Medical Coping Modes Questionnaire, the Social Support Rating Scale, and Connor-Davidson Resilience Scale. Data were analyzed in SPSS using descriptive statistics, Student’s t test, Pearson correlation test, and linear regression.ResultsRespondents returned 252 (93.33%) of the 270 questionnaires. The total CL-TDAS score was 39.56 ± 10.20. The top three items were “I fear dying a painful death” (3.59 ± 1.41), “I often think about how shortly life really is” (3.11 ± 1.33), and “1 am not particularly afraid of getting cancer” (3.09 ± 1.35). Associated factors of death anxiety (R2 = .333, F = 15.756, p < .001) were the medical coping mode (resignation, confronce), self-esteem, the participants’ adult children, the patient-primary caregivers’ relationship, resilience, and the level of activity of daily living.ConclusionsOur results demonstrate high levels of death anxiety in advanced cancer patients. Generally, patients with adult children, high self-esteem and resilience had low death anxiety. Conversely, patients with low levels of activity of daily living and high coping mode (resignation, confrontation) reported high death anxiety. We determined that associated factors contributed to reduce death anxiety. Social interventions are recommended to improve the end-of-life transition for patients and caregivers.

Introduction: With the spread of COVID-19 around the world, this disease became a serious threat to global health and exposed people to coronavirus anxiety and death. Hospitalized patients have faced more anxiety about coronavirus and death, which can affect both the experiences and satisfaction of patients. Aim: The present study investigated the relationship between death anxiety, COVID-19 anxiety, experiences, and satisfaction of patients during the COVID-19 outbreak. Methods: This correlational study was performed on 239 patients admitted to Ali-Ibn Abi-Talib Hospital of Rafsanjani, southern Iran, during the COVID-19 outbreak. The socio-demographic characteristics, Templer death anxiety scale (DAS), Corona disease anxiety scale (CDAS), short-form of the Hong Kong inpatient experience questionnaire (SF-HKIEQ), and patient satisfaction instrument (PSI) were used to collect data. The data were then analyzed using SPSS 25. Results: 10.9% of participants had high COVID-19 anxiety, and 69.0% had high death anxiety. 77.8% of the participants had problems in the inpatient experience. 69.9% of participants were dissatisfied, and 30.1% had moderate satisfaction. A significant negative correlation between death anxiety and COVID-19 anxiety (r = -0.13; p = 0.04) was observed. Death anxiety hurt experiences, and COVID-19 anxiety had a positive impact on patients' experiences. Also, we found a significant positive correlation between experiences and patients' satisfaction. COVID-19 anxiety, age, death anxiety, and infection with COVID-19 predicted 37% of the variance of patients' experiences. COVID-19 anxiety, inpatient experience, and marital status predicted 14% of the variance in patient satisfaction (p &lt; 0.05). Conclusion: Patients have experienced high levels of death anxiety and moderate levels of COVID-19 anxiety during the outbreak of the COVID-19 pandemic, which has affected their experiences and satisfaction. Professional assistance is needed to improve patient experience and satisfaction during pandemics such as COVID-19 disease. The results of this study may help to prepare suitable future interventions and programs to increase patient satisfaction in hospitals.

This study utilized a defense mechanism model of death anxiety to investigate the hypothesis of differential individual and group problem solving ability as well as differing types of orientation as a function of High, Moderate and Low Death Anxiety. Results of Experiment I demonstrated significant effects of levels of Death Anxiety on both individual and group problem solving ability. Results of Experiment II partially replicated the results of Experiment I, but failed to demonstrate predicted significant differences between self, task, and interaction orientations within or between low and moderate death anxiety groups. However, significant differences were reported between moderate and high anxiety groups as well as between low and high death anxiety groups. Discussion focused on the partial replication of Experiment I's findings, and upon the usefulness of specific predictions which arise from utilizing the defense mechanism model for death anxiety and its implications for future research.

Background and Objective: COVID-19 caused many problems in society, including increased fear and anxiety. The present study examined the relationship between patients' death anxiety, COVID-19 anxiety, and trust and quality of communication with patients during the COVID-19 outbreak. Materials and Methods: This correlational study was conducted on 247 patients during the COVID- 19 outbreak. The data collection tools included the demographic characteristics questionnaire, the Templer death anxiety scale (DAS), the coronavirus disease anxiety scale (CDAS), the trust in nurses scale, and the nurse quality of communication with patient questionnaire (NQCPQ). Results: Of the participants, 10.9% and 69.6% had high COVID-19 anxiety and death anxiety, respectively. There was no significant correlation between death anxiety, trust (r = -0.02; p = 0.73), and communication (r = -0.09; p = 0.13). A negative significant correlation was found between COVID- 19 anxiety and communication (r = -0.26; p &lt; 0.001), while a positive significant correlation was found between trust and communication (r = 0.35; p &lt; 0.001). Conclusion: The results of the present study showed that patients hospitalized during the COVID-19 outbreak experienced high levels of death anxiety and moderate levels of COVID-19 anxiety. These findings highlight the importance of providing professional help to patients to reduce their anxiety and improve the quality of communication with nurses during pandemics such as COVID-19.

Depression and quality of life in older adults with pneumoconiosis: The mediating role of death anxiety

IntroductionDeath anxiety is a critical mental-health concern among young adults; however, its heterogeneity and underlying psychological mechanisms remain understudied. This study aimed to identify latent profiles of death anxiety in Chinese youth and examine the predictive roles of self-esteem, perceived social support, and security.MethodsWe conducted a cross-sectional survey of 623 young adults (mean age = 23.62 years, SD = 3.61) aged 18–35 years in mainland China. Latent profile analysis (LPA) was conducted to classify death anxiety subgroups based on responses to the Templer Death Anxiety Scale (C-T-DAS). Self-esteem, perceived social support, and sense of security were assessed using validated scales. Multinomial logistic regression and ANOVA were used to explore predictors and group differences.ResultsThree latent death anxiety profiles emerged, High Death Anxiety (56.2%), Moderate Cognition and Low Death Anxiety (8.8%), and Low Cognition and Moderate Death Anxiety (35%). Higher self-esteem (β = -0.46, p <.001), social support (β = -1.12, P = .004), and security (β = -2.87, P <.001) significantly predicted lower death anxiety. The high death anxiety group exhibited the lowest psychological resource scores. Older age (30–35 years) and recent acute illness recovery were associated with higher death anxiety risk (OR = 0.28, 95% CI [0.09, 0.93]). Security showed the strongest inverse association with DA (F = 50.72, P <.001), particularly in the interpersonal and controllability dimensions.ConclusionDeath anxiety among young adults is heterogeneous, influenced by distinct psychological profiles and demographic factors. Interventions should prioritize enhancing self-esteem, social support networks, and security to mitigate death anxiety, especially in high-risk subgroups. Future research should employ longitudinal designs and cross-cultural samples to validate causal pathways and refine targeted strategies.

One of the few certainties in life is that once you are born, you are bound to die. This certainty does not make death a welcome thought, however. Thus, the most common response to the thought of one's death, or the death of other loved ones, is fear. Some researchers on this topic have suggested that the fear of death is a major motivator of much behavior, and can influence such behavior in both positive and negative ways. On the positive side, this viewpoint suggests that people who are afraid of dying tend to do whatever it takes to ensure that they stay alive. Staying alive contributes to the continuity and socialization of the species because people so driven are more likely to want to have children and to raise them according to their society's acceptable standards. However, the same death anxiety can become a destructive force and could even result in both physical and mental problems. High levels of death anxiety in older adults are associated with lower ego integrity and more physical and psychological problems relative to individuals with low death anxiety. Death anxiety is a multifaceted construct that is difficult to define but has been conceptualized to include: fear of death of oneself; fear of death of others; fear of dying of self; and fear of the dying of others.

Patients who have previously undergone coronary artery bypass surgery (CABG) were prone to death anxiety during the COVID-19 pandemic. It appears that spiritual well-being and appropriate coping strategies may mitigate the harmful effects of death anxiety. Therefore, this study aimed to determine the level of death anxiety in patients with CABG during the COVID-19 pandemic and investigate the relationship between spiritual well-being, coping strategies and death anxiety.This cross-sectional study was conducted on 100 patients with CABG history in Tehran from June 2021 to February 2022. The face-to-face questionnaire, containing questions on demographics, Templer's death anxiety scale, the spiritual well-being questionnaire, and the ways of coping questionnaire was administered to collect data. Statistical analysis was performed using descriptive-analytical statistics, correlation tests, and logistic regression models.Participants' mean age was 55.59 ± 12.78 years. The mean death anxiety score was 10.00 ± 2.16, with 87% of participants reporting high levels and 13% reporting low levels of death anxiety. Based on the results, there was a significant negative correlation between death anxiety and coping strategies, as well as subscales of distancing, seeking social support, accepting responsibility, and planful problem-solving. Logistic regression showed that with the increase in the score of spiritual well-being, the odds of having high levels of death anxiety decreased (p < 0.05). Furthermore, increasing the total score of coping strategies, and the score of self-controlling, seeking social support, accepting responsibility, and planful problem-solving, significantly reduced the odds of high levels of death anxiety (p < 0.05).The study showed that patients with a CABG history experienced high death anxiety during the COVID-19 pandemic. According to the findings, spiritual well-being and coping strategies, especially self-controlling, seeking social support, accepting responsibility, and planful problem-solving,may reduce the odds of severe death anxiety. These should be considered as effective targets for psychological intervention in these patients.

The purpose of this study was to investigate the relationship between death anxiety and attitudes toward the elderly among nursing staff in nursing homes. Questionnaires were distributed to all 310 full-time nursing staff members in six nursing homes; 159 usable questionnaires (51 percent) were returned. The self-administered packet consisted of Templer's Death Anxiety Scale to determine high and low death anxiety groups. Palmore's Facts on Aging Quiz to identify positive or negative attitudes toward the elderly, and a self-developed demographic data questionnaire. A t-test was used to compare the mean attitude toward the elderly scores of the high and low death anxiety groups. Nursing staff with high levels of death anxiety had significantly more negative attitudes toward the elderly than nursing staff with low levels of death anxiety (t = 2.52; p. less than .01). A correlation coefficient was also used to analyze the relationship between death anxiety and attitudes toward the elderly for the entire study sample. The relationship was significant (r = -.21; p less than .007). Findings indicated no significant differences in death anxiety or attitudes toward the elderly when compared with various demographic variables.

Background: Death anxiety is important but understudied in palliative care. New self-report measurements have been developed, but their interpretation and clinical utility may not be evident. Aim: To inform our understanding of death anxiety in patients with advanced cancer by exploring the relationship between this self-reported symptom and its clinical presentation. Design: Participants were part of a psychotherapy trial in advanced cancer. First therapy session transcripts were analyzed using interpretive description in patients reporting low, moderate, and high death anxiety on the Death and Dying Distress Scale (DADDS). Setting/participants: A total of 16 participants (10 women and 6 men) with advanced or metastatic cancer were sampled from the Princess Margaret Cancer Centre, Toronto, Canada. Six participants reported low death anxiety scores (Death and Dying Distress Scale: 0–19), five moderate (Death and Dying Distress Scale: 20–50), and five high (Death and Dying Distress Scale: 51–75). Results: The low death anxiety group exhibited psychological readiness for death, or contrastingly, non-reflectiveness about death. The moderate group recognized the imminence of mortality, which impacted treatment decisions and future plans. Prior experience with death was discussed as raising the salience of mortality. The high group felt dominated by powerful emotions and could not make sense of their situation. Their distress was exacerbated by substantial relational concerns. Conclusion: Self-reported death anxiety is affected by the awareness and ability to reflect on mortality. Death and Dying Distress Scale scores may facilitate exploration of this symptom as part of a clinical assessment and may serve to guide treatment approaches. Greater attention to death anxiety is consistent with and recommended by contemporary approaches to palliative care.

Introduction The fear of death (death anxiety) is a risk factor for psychopathology, including anxiety and depressive disorders. There is little research on the role of death anxiety in sleep disorders like insomnia. We examined the relationship between death anxiety and insomnia and investigated whether distressing dreams/nightmares play a mediating role in this relationship. Methods The study consisted of 515 adult participants (360 females; M age=44.15 years) who completed an online survey via REDCAP. The survey assessed insomnia symptoms (ISI), death anxiety (DABBS), and nightmare severity (DDNSI). Correlations and hierarchical regression analyses were conducted to explore the relationship between insomnia symptoms and death anxiety, with an additional mediation analysis (Hayes PROCESS macro) examining the role of nightmare severity. Results Death anxiety was positively correlated with insomnia (r=.27; p&amp;lt;.001). In the hierarchical regression analysis, death anxiety remained a significant predictor of insomnia, even after controlling for general anxiety (p=.037). Notably, nightmare severity mediated the relationship between death anxiety and insomnia, with higher levels of death anxiety associated with more severe nightmares and, subsequently, more severe insomnia symptoms (all p’s&amp;lt;.001). As the direct effect of death anxiety on insomnia remained significant (p&amp;lt;.001) in the mediation model, our results suggest that nightmares are a partial mediator of the relationship. Discussion Death anxiety is associated with insomnia symptoms, with nightmares partially mediating the relationship. Fears of death may, therefore, play a greater role in insomnia symptomatology than previously thought. Targeting death anxiety in insomnia treatment may be an important avenue for future research.