Death Anxiety Scores Research Articles

The effects of death anxiety on diet‐fluid restriction non‐adherence in hemodialysis patients

AbstractIntroductionThe study was performed to examine the effects of death anxiety on diet‐fluid restriction non‐adherence in hemodialysis patients.MethodsThis descriptive, cross‐sectional, and correlational study was performed with 118 hemodialysis patients who received treatment in the dialysis unit of a university hospital and a state hospital in Elazığ, eastern Turkey. The study data were obtained with the “Descriptive Data Form”, “Death Anxiety Scale”, and “Dietary and Fluid Restriction Non‐Adherence Scale”.FindingsThe average Death Anxiety Scale total score of the patients was 10.00 ± 4.75. The “Duration of non‐adherence with diet” mean score was 1.66 ± 1.70, “Degree of non‐adherence with diet” mean score was 1.24 ± 1.19, “Duration of non‐adherence with fluid restriction” mean score was 1.61 ± 1.71, and “Degree of non‐adherence with fluid restriction” mean score was 1.16 ± 1.13. The independent variable Death Anxiety Scale significantly and negatively affected the dependent variable “Duration of non‐adherence with diet”, “Degree of non‐adherence with diet”, “Duration of non‐adherence with fluid restriction”, and “Degree of non‐adherence with fluid restriction”.DiscussionHemodialysis patients face serious death anxiety, their degree of non‐adherence with diet‐fluid restriction was low as death anxiety scores increased, and the degree of non‐adherence with diet‐fluid restriction decreased.

Spiritual therapy’s impact on death anxiety in Iran: A systematic review and meta-analysis

Recently, spirituality-based interventions for modulating death anxiety in both unhealthy and healthy individuals have increased. However, the effectiveness of this treatment approach in reducing death anxiety remains controversial. Thus, this systematic review and meta-analysis aimed to clarify the impact of spiritual therapy interventions on death anxiety in Iran. We searched for all randomised and controlled trials related to the research topic in national and international databases, including Web of Science, PubMed, Scopus, Wiley, Taylor & Francis, ScienceDirect, SID, Civilica, IranDoc and Noormags. Fifteen studies with 772 participants that were found relevant and fulfilled the defined exclusion and inclusion criteria were included in the analyses. Stata 17 software was used to analyse the data. The results showed a significant difference between the average death anxiety scores in the experimental and control groups after receiving spiritual therapy (standardised mean difference = –5.97, 95% confidence interval: –9.51, –2.44). In addition, the results of the Q and I2 tests indicated significant heterogeneity among the studies (p < 0.001; Q = 411.45; I2 = 99.50%). Thus, although the findings show that interventions based on spiritual therapy can reduce death anxiety, the high heterogeneity and publication bias of some trials limit the validity and generalisability of their effects. The findings of this meta-analysis will help in elucidating the effectiveness of spiritual therapy and open new horizons for this therapeutic approach for psychologists, counsellors and educational planners, thereby creating a relative consensus between advocates and critics of therapeutic spirituality.

Exploring Sense of Coherence and Death Anxiety among patients with Chronic Illness in Greece

Abstract Introduction Chronic illness often brings about existential concerns, including fear of death, which can significantly impact individuals’ well-being. The concept of sense of coherence provides a framework for understanding how individuals perceive and cope with stressors, including those associated with chronic illness. Purpose This study investigated the correlation between Sense of Coherence, death anxiety, and chronic illness among Greek patients, aiming to understand how these factors interplay. Methods An electronic survey was distributed to chronic illness patients in Greece. Sense of Coherence was measured using the Sense of Coherence scale, while death anxiety was assessed using the Collett-Leste Fear of Death scale. Various chronic conditions were considered, and demographic data were collected. Results The final sample consisted of 118 participants (female 79.7%; death anxiety score=mean109.2, Sd = 19.2; sense of coherence score=mean55.12, Sd = 13.61). Women and the age group of 58-65 years presented higher death anxiety score followed by the group of 34-41 years. No differences were found between genders in terms of sense of coherence. The highest coherence was manifested in the age group of 50-57 years and the lowest in the age group of 42-49 years. A significant negative correlation was observed between sense of coherence and fear of death (rs(118)= -.299, p < .01). Further correlation tests were performed between axes of coherence, which indicated a stronger negative correlation in two of the three axes of the sense of coherence (Manageability and Meaningfulness) and among all the axes of fear of death, beyond the first, which concerns the loss of one’s own life. Conclusions The study suggests that individuals with a stronger sense of coherence experience lower death anxiety. Understanding these dynamics is crucial for tailored patient interventions and support strategies. Key messages • Gender and age-specific variations exist in how people approach and experience disease and mortality. • Understanding patients’ coping mechanisms and perceptions of illness is important in disease management.

Death Anxiety and Its Related Factors in Emergency Medical Technicians in Qom, Iran, in the Post-COVID-19 Era

Background and Objectives: Emergency Medical Technicians (EMTs) are the first healthcare providers in the time of crisis. They are exposed to many physical and psychological risks, including death anxiety. The present study aims to investigate the death anxiety level and its related factors in EMTs in Qom, Iran, in the post-COVID-19 era. Methods: This cross-sectional study was conducted on 185 EMTs from the hospitals affiliated to Qom University of Medical Sciences in 2023. Sampling was done by simple random method. The data collection tool was Templer’s Death Anxiety Scale. Data analysis was done in SPSS software, version 23 using descriptive statistics, independent t-tests, ANOVA, and regression analyses. Results: The mean total score of death anxiety was 6.4±3.05. Based on the results of the multivariate regression analysis, the variables of age, marital status, and work experience could explain 43% of the variance in death anxiety of EMTs (β=0.433, P=0.001). Conclusion: Death anxiety of EMTs in Qom in the post-COVID-19 era is at a moderate level. The factors of age, marital status, and work experience are the predictors of death anxiety in EMTs. It is recommended that older, married, and more experienced EMTs should receive more psychological evaluations and consultations.

Relationship between death anxiety and resilience among critical care nurses in Oman.

Critical care nurses encounter numerous work-related stressors that might lead to depression and anxiety. Areas with higher patient mortality can lead to burnout, higher turnover and death anxiety. The possession of resilience and good attitudes towards mental health is of utmost importance for nurses, given their role as influential figures within society. The aim of this study was to examine the relationship between death anxiety and resilience among critical care nurses in Oman. This study employed a cross-sectional design with convenience sampling, sending 300 invitations via a URL link on a popular social media platform for critical care nurses in Oman. Out of 218 responses, the initial response rate was 72.7%. After data cleansing to remove incomplete and illegible submissions, the final sample consisted of 183 nurses who completed the Templer Death Anxiety Scale and the Connor-Davidson Resilience Scale (CD-RISC). The survey was conducted in December 2023. The study found that the mean death anxiety and resilience scores were 38.23 (SD = 6.96) and 37.62 (SD = 5.32), respectively. Most of the participants exhibited a low level of death anxiety and a moderate level of resilience. The results of this study found a significant proportional correlation between death anxiety and resilience among critical care nurses in Oman (p = .000); nurses with a higher degree of resilience were shown to be significantly correlated with a lower level of death anxiety. The results showed that resilience explained 14.9% of the variation in death anxiety. The research in Oman reveals that critical care nurses in the country experience moderate death fear. This anxiety stems from the demanding nature of their profession, which involves providing care for critically ill patients in high-pressure environments. Factors such as cultural and religious beliefs and educational attainment are also influencing this anxiety. Resilience is positively associated with the ability to confront challenges with courage, and a positive correlation exists between resilience and death anxiety. This suggests that nurses with higher resilience may also experience higher death anxiety because of their profession's inherent responsibilities and decision-making. The study on critical care nurses in Oman highlights that workplace stress and high death anxiety negatively impact their well-being and patient care quality. Factors like job demands, cultural beliefs and education influence these experiences, with resilience playing a key role in coping. Enhancing resilience and coping strategies can improve care quality and reduce turnover in nursing.

Effect of Birth Story on Personality Traits and Death Anxiety.

The aim of this study is to determine the effect of the birth story of individuals on personality traits and death anxiety. This descriptive and analytical research was completed with 1,635 people who participated voluntarily. The study data were collected with the Personal Information Form, Cervantes Personality Scale (CPS), and Abdel-Khalek Death Anxiety Scale (ASDA). The research sample is average means 31.63 ± 11.04 years, most of the female (72.7%) and married (54.6%). In our study, it was observed that women's death anxiety was higher than men's. Our study found that individuals born by caesarean section had greater neurotic personality traits, emotional stability/neuroticism score averages, and death anxiety scores compared to individuals born vaginally. In the model made with multiple regression analysis, birth type did not significantly predict death anxiety, while sex and emotional stability/neuroticism personality trait significantly predicted death anxiety.

Death Anxiety and Religious Coping in Heart Failure Patients.

This study was conducted to determine death anxiety and religious coping in heart failure patients. It was determined that 64% of the patients were male, the mean death anxiety score was 7.78 ± 3.91, 38% had ≤6 points and 62% had ≥7 points. Positive religious coping score was 20.54 ± 6.58 and negative religious coping score was 6.86 ± 3.18. Patients with a diagnosis of heart failure ≥3years had higher death anxiety levels. There was a weak positive correlation between death anxiety and positive and negative religious coping scores. Death anxiety and the number of days hospitalized were determined to predict positive religious coping in regression analysis. The model explained 7.6% of the total variance in positive religious coping. Heart failure patients were detected to have high death anxiety. Patients were observed to have high positive religious coping scores. As death anxiety increases, patients exhibit positive religious coping behavior.

Effect of Positive Thinking Skills on Optimism and Death Anxiety of COVID-19 Nurses: A quasi-experimental study

BACKGROUND: The COVID-19 pandemic has placed nurses on the front lines, facing challenging conditions and increased stress levels. The aim of this study was to examine the effect of positive thinking skills training on nurses' optimism and death anxiety while caring for COVID-19 patients. METHODS: In a quasi-experimental, two-group, pre- and post-test study, a total of 52 eligible nurses working at Amir al-Momenin Hospital in Zabol, Iran, between October and December 2022, were divided into intervention and control groups. The intervention group received positive thinking skills training via email or WhatsApp, with eight, 60-minutes sessions over two months. Data were collected using a demographic questionnaire, the Templer Death Anxiety Scale (DAS), and the Scheier and Carver Life Orientation Test, both before and one month after the intervention. RESULTS: There were no significant differences in optimism and death anxiety scores between the two groups before the intervention. However, the intervention group showed a statistically significant increase in optimism (from 13.11±3.78 to 19.03±2.58) and decrease in death anxiety (from 55.15±7.06 to 41.76±4.48) after the intervention (P <0.001). CONCLUSION: Considering the stressful nature of COVID-19 disease, positive thinking skills training can be recommended as an effective method to reduce death anxiety and improve nurses' optimism, thus enhancing their willingness to continue caring for patients.

The Relationship between the Perception of Aging and Death Anxiety in the Older Adults of Eastern Iran during COVID-19

The perception of aging is widely acknowledged as a key determinant of personal satisfaction with the aging process, and it marks an individual’s adaptability to life changes. As older adults encounter psychophysical changes and disabilities, thoughts surrounding mortality often become more pronounced, leading to a surge in death anxiety, which is recognized as prevalent psychological distress among this population. This study aimed to investigate the relationship between aging perception and death anxiety among older adults in Eastern Iran during coronavirus disease 2019 (COVID-19). This descriptive-analytical study included 300 older adults (118 men and 182 women) using a stratified random sampling method. Data were collected using a demographic survey, Barker’s Ageing Perceptions Questionnaire (APQ), and Templer’s Death Anxiety Scale (DAS). Data were analyzed in SPSS software (V.22) using Pearson’s correlation coefficient, independent t-tests, analysis of variance (ANOVA), and linear regression. The mean aging perception score was 102.50 ± 15.55. After normalizing the scores, while the highest mean was related to the chronic and acute dimensions (65.32 ± 16.31), the lowest was related to the positive results dimension (65.29 ± 18.71). Also, the death anxiety score was 6.35 ± 1.99. The results from the linear regression analysis indicated an increase in negative emotions, correlating with an uptick in the death anxiety score (P=0.001). Furthermore, retired individuals had a higher death anxiety score than those still working (P=0.02). According to the results of this study, older adults with more negative emotions toward aging had higher death anxiety levels. Hence, interventions to foster positive emotions and attitudes towards aging are crucial to healthy aging. Moreover, considering the high level of death anxiety among retired people, further studies are required to investigate the mental health of this population.

Death Anxiety in Patients with a History of Coronary Artery Bypass Graft Surgery During the COVID-19 Pandemic: The Role of Spiritual Well-Being and Coping Strategies.

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.

Facing Death Anxiety: Effects of Professional Exposure To Death and Dying

Previous research has examined the relationship between exposure to death and dying and death anxiety. However, the extent to which research in this area provides a coherent body of work is unclear. To investigate varied exposures of death and dying and to reproduce findings, a measure that encompasses the range of ways in which people can be exposed is necessary. Accordingly, this study developed a new measure, the Exposure to Death and Dying Scale (ED&amp;DS), and investigated specifically how professional exposure to death and dying was related to death anxiety in high-exposure and non-exposure professions. Professional exposure is defined as exposure to death and dying in a professional setting, as opposed to in one’s personal relationships or with one’s self. The Death Anxiety Scale Extended (DAS-E) was used to provide a score for unease surrounding death. Participants (N = 468) were separated into different groups based on their profession: non-exposure professions and high-exposure professions, which consisted of 6 sub-categories: mental health professionals, the general medical field, nursing, mortuary professionals, end-of-life care, and forensic professionals. Professional exposure rates to both death and dying were calculated, as well as death anxiety scores and time spent in each profession. Non-exposure professions were shown to have lower levels of exposure than all categories of high-exposure professions. One-way ANOVA revealed that exposure (vs. non) professionals had a lower level of death anxiety. High-exposure occupations varied in levels of death anxiety. The mental health group had the highest mean death anxiety (111.52), followed by the forensic professionals (107.36), general medical field (106.66), nurses (104.79), mortuary professionals (104.60), and end-of-life carers (93.89). Although there was a trend toward a decline in death anxiety with increasing time spent in high-exposure occupations, there was also an increase in death anxiety among individuals with the longest tenure in their field, indicating that this is not a clear linear relationship. Overall, this study showed that the higher professional exposure to death and dying, the lower that individual’s reported death anxiety was, regardless of the type of exposure experienced.

The correlation between death anxiety, loneliness and hope levels in patients treated in the cardiac intensive care unit.

A sense of hope plays an important role in relieving stress and psychological distress of cardiology patients, as well as improving their physical well-being. The aim of this study is to investigate the correlation between death anxiety, loneliness and hope levels in patients receiving treatment in a cardiac intensive care unit (ICU). This is a prospective, descriptive and correlational study. The study was completed with 150 cardiac ICU patients in Istanbul, Turkey. The data were collected using a Patient Information Form, the Templer Death Anxiety Scale (TDAS), the Herth Hope Index (HHI) and the UCLA Loneliness Scale (UCLA-LS). The patients had a mean age of 63.56 ± 12.74 years. Most of the patients (82%) were treated in the ICU for heart failure. There was a statistically significant positive correlation between total scores of TDAS and UCLA-LS (r = .337; p < .001) and a statistically significant negative correlation between total scores of UCLA-LS and HHI (r = -.292; p < .001). Also, there was a statistically significant negative correlation between the scores of UCLA-LS and Positive Readiness and Expectancy Subscale (r = -.164; p = .044). The multiple linear regression indicated that the model was statistically significant (F = 7.177, p < .001). The variables of age and UCLA-LS among those included in the model were statistically significant predictors of the death anxiety scores of the patients (23.1%) (p < .05). The cardiology patients who received treatment in the ICU had a high level of death anxiety and moderate levels of loneliness and hope. The age and loneliness level were statistically significant predictors of death anxiety. It is recommended that individualized nursing care be planned and provided to conscious cardiology patients who are treated in the ICU, considering their age and loneliness levels and that nursing care be planned for individuals who are at risk of fear, anxiety, loneliness and hopelessness by periodically assessing their death anxiety, loneliness and hope levels.

Effect of Telenursing Training on Death Anxiety in Nurses with a History of COVID-19

Introduction: In light of the global spread of COVID-19 and its profound impact on public health and casualties, nurses have been thrust onto the front lines in the battle against this disease, resulting in heightened psychological distress and anxiety. Addressing these issues promptly and effectively is crucial during these challenging times. Therefore, this study aims to investigate the impact of telenursing training in reducing death anxiety among nurses with a history of COVID-19.Material and Methods: This quasi-experimental study involved two groups of 20 nurses with a history of COVID-19 and higher levels of death anxiety. Data were collected using Templer's death anxiety questionnaire and a demographic information questionnaire. In the test group, the intervention was conducted through WhatsApp groups over five sessions. Training methods to reduce death anxiety were presented through explanatory text, PowerPoint presentations, and audio files, with five-day intervals between sessions. The control group did not receive any intervention. Twenty days after the sessions, both groups completed the death anxiety questionnaire again. Data were analyzed using t-tests and chi-square tests.Results: The findings indicated a significant difference in the average score of death anxiety between the test and control group after telenursing training (p&lt;0.05).Conclusion: Telenursing training effectively reduces death anxiety among nurses with a history of COVID-19. Telenursing proves to be a cost-effective and organized intervention for managing symptoms, early diagnosis of complications, ensuring post-care quality, exchanging information, and providing health education.

Hipertansiyon ve ST Elevasyon’lu Akut Miyokard İnfarktüsü Hastalarında Ölüm Anksiyetesi ve Etkileyen Faktörler

Objective: Death Anxiety in Patients with Hypertension and ST-Elevation Acute Myocardial Infarction and the Affecting Factors Materials and Methods: This study was conducted between February and March 2022, with 195 patients with hypertension, ST-Elevation Acute Myocardial Infarction and healthy individuals. Patients who were admitted to the city hospital’s cardiology outpatient clinic and were followed up in the outpatient clinic with the diagnosis of hypertension and ST-Elevation Acute Myocardial Infarction for the last one year were included in the study. The research data were collected using a Patient Information Form and the "Abdel Khalek Death Anxiety Scale". Results: The mean death anxiety scale score was 46.38±16.72 in hypertension patients, 38.27±12.84 in patients with ST-Elevation Acute Myocardial Infarction, and 48.93±16.83 in healthy individuals. A significant difference was found between the death anxiety scores of patients with hypertension compared to patients with ST-Elevation Acute Myocardial Infarction (p=0.007). Death anxiety scores of the groups were found to be correlated with some sociodemographic characteristics (p

A Systematic Review and Meta-Analysis on Death Anxiety During COVID-19 Pandemic.

This systematic review was conducted to estimate the pooled score of death anxiety during the COVID-19 pandemic. All eligible articles from January 2020 to May 2022 reporting the death anxiety score were included in the analysis b.y searching the Scopus, PubMed, Embase, and ISI databases. The standard score of death anxiety in the COVID-19 pandemic was 50%. The highest score of death anxiety was related to patients with COVID-19 (59.4%), other chronic patients (58.9%), and the elderly (56.4%). The lowest death anxiety score was related to the general population (42.9%) and health care workers (48.2%). The death anxiety score in the studies whose data was collected in 2020 and 2021 was 51% and 62%, respectively. During the COVID-19 pandemic, people experienced high death anxiety, which had terrible effects on their lives. Therefore, it seems necessary to provide training courses to deal with death anxiety for other possible pandemics.

Evaluating the Correlation of Death Anxiety With Spirituality, Religious Attitude, and Resilience in Patients With Cardiovascular Diseases.

This study aimed to determine the correlation between spirituality, religious attitude, and resilience with death anxiety in cardiovascular patients in Sanandaj, Iran. This study was conducted on 414 cardiovascular patients, who were selected by convenience sampling method. Demographic information forms, Spiritual Well Being Scale, Golriz and Burhani's Religious Attitude, Connor-Davidson Resilience Questionnaire, and Templer's Death Anxiety Scale were used to collect data. Results indicated that compared to urban areas, living in rural areas significantly increased the average score of death anxiety by 0.55 points (p = 0.026). Additionally, a one-unit increase in religious attitude and resilience significantly reduced the mean score of death anxiety by 0.05 (p = 0.003) and 0.13 (p <0.001) on average, respectively. Spearman rank correlation indicated that religious attitudes and resilience were inversely and significantly correlated with death anxiety. Therefore, providing counseling sessions with psychologists and clergy seems necessary for a favorable change in the state of death anxiety in these patients.

Relationship between resilience and death anxiety of the older adults during the coronavirus disease 2019 (COVID-19) pandemic

BackgroundThe outbreak of coronavirus disease 2019 (COVID-19) caused an increase in the incidence of physical and psychological problems, particularly in the older adult. Considering the special physical and mental health conditions of the older adult, they were more exposed to psychological problems associated with the pandemic, such as death anxiety. Therefore, assessing the psychological status of this group is necessary in order to implement appropriate interventions. The present study aimed to investigate the relationship between resilience and death anxiety in the older adult during the COVID-19 pandemic.MethodsThis descriptive-analytical study was conducted on 283 older adult people over the age of 60 years. The older adult population was selected from 11 municipal districts of Shiraz, Iran, using the cluster sampling method. The resilience and death anxiety scales were used for data collection. Data analysis was performed in SPSS version 22, using Chi-square test, t-test, and Pearson’s correlation coefficient test. A P-value less than 0.05 was considered statistically significant.ResultsThe mean and standard deviation of the older adult’s resilience and death anxiety scores were 64.16 ± 9.59 and 6.3 ± 2.95, respectively. There was a significant correlation between resilience and death anxiety scores (P < 0.01, r=-0.290). Also, sex (P = 0.00) and employment status (P = 0.00) were significantly associated with the older adult’s resilience. Besides, sex (P = 0.010) and employment status (P = 0.004) were significantly related to death anxiety.ConclusionsOur findings showcase levels of resilience and death anxiety in older adults during the covid-19 pandemic and suggest that resilience and death anxiety are inversely linked. This has implications on policy planning for future major health events.

Self-Transcendence as a Mediator of the Relationship Between Reminiscence Functions and Death Anxiety: Implications for Psychiatric Nurses.

Jordan's population of older adults is growing due to improved health care and lifestyle, but the country has limited mental health care resources, causing challenges for the health care system. Reminiscence is a point of nursing intervention and a way for psychiatric nurses to help people improve their mental health by expanding their personal boundaries (self-transcendence). The study aimed to examine the mediating effects of self-transcendence on the relationship between reminiscence functions and death anxiety in a sample of Jordanian older adults. Psychiatric nurses can refine reminiscence therapy by targeting aspects of self-transcendence to reduce death anxiety. An online cross-sectional survey was employed to collect the data. A total of 319 older adults participated in the study. The sample was recruited using convenience and snowball sampling strategies through social media and personal contacts. The reminiscence function of "Bitterness Revival," gender, the presence of a life-threatening disease, a history of psychiatric disorder, and the work sector were statistically significant predictors of death anxiety. This model accounts for 24% of the death anxiety score (F = 7.789, p < .001). Reminiscence functions 1, 2, and 5 predicted self-transcendence. This model explained 25% of the variance in the self-transcendence score (F = 6.548, p < .001). Self-transcendence exerts a positive, partial mediating effect between "Bitterness Revival" and death anxiety, controlling for other covariates in the death anxiety model (p = .016). The study is informative for understanding the role of self-transcendence in buffering death anxiety, notwithstanding "Bitterness Revival" reminiscences. This knowledge reveals practical implications for psychiatric nurses about the importance of developing reminiscence interventions to promote self-transcendence and ease death anxiety.

COPING WITH DEATH ANXIETY AND AWARENESS: EXPERIENCE WITH COVID-19 PATIENTS IN NEW YORK

Introduction: The global challenge that the Covid-19 pandemic represented for humanity, included local experiences and encounters from which helpful lessons may be drawn.&#x0D; Objectives: The primary objective was to assess and document death anxiety and death awareness among hospitalized intensive care unit (ICU) patients diagnosed with COVID-19 in a community-based teaching hospital. The secondary one was to reflect on mental health clinicians’ therapeutic styles and skills when caring for patients in critical care settings.&#x0D; Methods: A series of hospitalized ICU patients diagnosed with COVID-19 at the height of the pandemic in New York City were evaluated in this study. Patients’ psychological distress symptoms, death awareness, and death anxiety were measured using the Revised Death Anxiety Scale. Seventeen COVID-19 positive patients with various comorbidities who had been admitted to the ICU at Staten Island University Hospital were compared with seventeen COVID-19 negative patients with various comorbidities who had been seen and evaluated on the same ward over the same time period. The Revised Death Anxiety Scale (25 items) was used on all subjects by the deployed psychiatrists. The clinicians’ experiences as recorded through diaries during this time were examined and reflected on.&#x0D; Results: Out of seventeen COVID-19 positive patients who participated in this case series, eleven responded with heigh death anxiety scores as compared to the seventeen COVID-19 negative patients in which only three subjects were observed to have high scores. From the very beginning, the COVID-19 pandemic brought to the forefront massive challenges for both psychiatrists and patients. These challenges immediately affected rapport-building, often leading to an atmosphere of trust, but also exposing patients to additional distress. Prior to furthering and facilitating therapeutic dialogue, psychiatrists had to “anesthetize the therapeutic situation,” decrease the arousal level and be attentive throughout the encounter. This attentiveness had to be individually organized and modulated as patients displayed different personality styles, with variations in their internal world and severity of medical condition. In due course, individual patterns of reactions were observed such as fantasies concerning isolation and separation, contrasting attachment styles, need for punishment and guilt feelings and activation of panic and helplessness. The latter was particularly challenging as both patient and physician could become easily trapped in feeling helpless and confused, with strong interpersonal and relational overlays. Compassionate gestures and sensibility in connectedness conveyed vitality and much needed hope.&#x0D; Discussion and Conclusions: Although death anxiety and death awareness seemed overwhelmingly prevalent among the COVID-19 positive patients in comparison to COVID-19 negative patients, differences have been observed in terms of being age-specific, having multiple comorbidities compounding on COVID-19 positive status (e.g., obesity and COPD). In general, the acute psychological distress of patients improved with medical treatment and when stabilized they were moved out of the ICU. Patients with high scores who had a COVID-19 positive status tended to have increased stay in the ICU. Future studies should assess the long-term consequences of COVID-19 on patients’ general mental health and particularly death awareness and death anxiety. Additionally, health systems may use similar studies to understand the labor and costs borne by mental health clinicians as well as other clinicians working in such settings. In terms of medical education and liaison work, such research may inform training of clinicians in internal medicine, critical care, and mental health.

The Death Anxiety and Demoralization in Patients With Acute Myocardial Infarction Admitted to Post Cardiac Care Units of Iran University of Medical Sciences in 2021

Background &amp; Aims It is essential to pay attention to the psychological complications after a heart attack in line with other physiological complications. The proximity of these patients to death has caused death anxiety, which can weaken their morale. This study aims to determine death anxiety and demoralization in patients with acute myocardial infarction admitted to post-cardiac care units of the Iran University of Medical Sciences in 2021. Materials &amp; Methods The present study is a descriptive cross-sectional study that was performed on 206 patients with myocardial infarction admitted to the educational-medical centers of Iran University of Medical Sciences in the first half of 2021. Data collection tools included the demographic profile form, Templer death anxiety questionnaire, and Kissane demoralization. Data were analyzed using SPSS software, version 20 and Pearson correlation coefficient, independent t test, and analysis of variance. Results Most patients in the study were male, married, and self-employed with a mean age of 57.97±12.49 years. The mean score of death anxiety in patients with myocardial infarction was 6.26±1.62 (moderate). Most patients (43.7%) had moderate death anxiety. The mean score of demoralization syndrome was 11.88±5.34 (severe). Most patients (60.7%) had severe demoralization syndrome. Conclusion The death anxiety of patients after myocardial infarction was moderate and their demoralization syndrome was severe, therefore it is necessary to pay attention to them and recognize the factors affecting nurses working in intensive care units and recommend being included in the training of care for these patients.