Death Anxiety Research Articles

Death awareness and psychological resilience in adults aged 50 plus

This study examines the relationship between death awareness and psychological resilience in adults aged 50 and above, focusing on the roles of religious activity, recent death experiences, and educational background. A total of 52 participants completed surveys measuring death awareness (TBS-5) and resilience (RS-10). Results indicated that religiously active individuals reported significantly lower death anxiety and higher resilience compared to non-religious participants. Additionally, individuals who had experienced the death of a loved one in the past 12 months showed a tendency toward greater openness in discussing death. No significant effects were found for educational background. While the small sample size limits the generalizability of the findings, the study highlights the importance of religious and experiential factors in shaping attitudes toward mortality and offers practical implications for end-of-life care and counseling. The results also suggest that fostering open dialogue about death and enhancing spiritual support may increase psychological resilience among older adults.

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.

The Mediating Role of Cancer Self-Efficacy in the Relationship Between Mindfulness and Death Anxiety in Patients with Cancer

Background: Investigating the relationship between mindfulness, cancer self-efficacy, and death anxiety in patients with cancer is crucial for understanding how these factors influence emotional well-being. Insights from such research can guide the development of psychological interventions aimed at enhancing quality of life for cancer patients. Objectives: The primary objective of this study was to explore the relationship between mindfulness and death anxiety in cancer patients, focusing on the mediating role of cancer self-efficacy. Methods: This study employed a descriptive correlational design and utilized structural equation modeling (SEM) to examine the relationships. A convenience sample of 302 cancer patients from Tehran (2023) completed three questionnaires: The Death Anxiety Scale, the Mindfulness Questionnaire, and the Cancer Behavior Inventory. Structural equation modeling was used to evaluate the proposed model, while the bootstrap method assessed the indirect effects. Results: The study found a significant negative relationship between mindfulness and cancer self-efficacy, and between cancer self-efficacy and death anxiety (P < 0.001). There was no direct relationship between mindfulness and death anxiety; however, cancer self-efficacy was found to mediate this relationship (P < 0.001). The model demonstrated a good fit with indices: RMSEA = 0.065, CFI = 0.96, and TLI = 0.95. Conclusions: These findings suggest that mindfulness indirectly reduces death anxiety in cancer patients by enhancing cancer self-efficacy. This highlights the potential effectiveness of mindfulness-based interventions in improving the emotional and psychological health of individuals diagnosed with cancer

Death acceptance among Lodha older adults: their perceptions of ‘good death’ during the COVID-19 pandemic

ABSTRACT A ‘good death’, one that is natural and involves lesser suffering and distress, is elusive in the present time. Indiscriminate uses of life-sustaining medical technologies in present times only lead older people and their families to frantically search for ‘good death’. On the other hand, there is little information on ageing and dying in folk and indigenous societies. In response to the huge information deficit, this article attempts to explore perceptions about death in old-age among Lodhas, a Mundari-speaking tribal community of eastern India. Interacting with only living 15 elderly members in a hamlet let us know their beliefs like, 1. Death being inevitable, they do not seek medical interventions to postpone it; 2. Close connection with nature till death brings peace; 3. No compromise with personal autonomy; and 4. Filial piety in moments of dying. The study theorises their indigenous beliefs are keys to ageing and dying well in the Lodha community. Hopefully, the insights from the ethnic group will be a lesson for modern societies to overcome death anxiety in old-age.

The Effect of Depression and Hopelessness Level on Death Anxiety in Earthquake Survivor Students One Year After the Earthquake.

It is important to reveal the long-term psychological effects of the earthquake in earthquake-exposed individuals. The aim of this study was to determine the levels of depression, hopelessness and death anxiety in students who experienced the earthquake one year after the earthquake and to examine the effects of depression and hopelessness on death anxiety. This is a descriptive and correlational study. Data were collected from 155 Emergency Relief and Disaster Management students who experienced the Kahramanmaras earthquake in Türkiye in 2023. Data were collected using Personal Information Form, Beck Depression Scale, Beck Hopelessness Scale, Thorson-Powell Death Anxiety Scale. In the study, a moderate positive correlation was found, indicating that as levels of depression and hopelessness increased, so did death anxiety (p < .05). Depression and hopelessness explained 18.1% of the variance in death anxiety. Death anxiety was found to be higher in males and in students whose relatives or close friends died.

THE EFFECT OF SPIRITUALITY ON DEATH-RELATED DEPRESSION, DEATH ANXIETY, AND LONELINESS AMONG YOUNG ADULTS

There has been a significant increase in research focusing on the healing role of spirituality in recent years. In this context, the purpose of the current study is to examine the effect of spirituality on death-related depression, death anxiety, and loneliness in young adults. A total of 539 young adults, 315 (58.4%) women and 224 (41.6%) men, participated in the study. The participants' ages ranged from 18 to 32 (M = 28.23, SD = 2.63). Personal Information Form, Spirituality Scale, Death Distress, and Loneliness Scale were used in the study. The data of the study were analyzed with SPSS 24. The results of the study show that there is a significant and negative relationship between spirituality and death related depression, death anxiety, and loneliness. The simple linear regression analysis revealed that spirituality explained 7% of the variance in death related depression, 12% of the variance in death anxiety, and 6% of the variance in loneliness. These results can be concluded that spirituality has a protective function against destructive factors such as death related depression, death anxiety, and loneliness. This study once again reveals the importance of carrying out studies to strengthen the spirituality of young adults in particular.

Be not afraid?: death anxiety and religious residue in Christian and non-religious participants

Be not afraid?: death anxiety and religious residue in Christian and non-religious participants

The Association Between Death Anxiety and Ageism Among Nursing Students: The Influence of Terror Management Theory Defense Mechanisms.

Ageism and death anxiety are still underrecognized and not well-examined among nursing students despite the high prevalence in nursing education and clinical practice. According to terror management theory (TMT), older adults are a potent reminder of mortality and disability, imposing a sense of death anxiety among nursing students who may exhibit ageist behaviors toward older adults in an attempt to control that sense of death anxiety. This study aims to examine the moderating effect of TMT defense mechanisms on the relationship between death anxiety and ageism among nursing students. This correlational, cross-sectional study used a convenience sample of 371 nursing students and validated tools. Self-esteem was found to be a significant moderator, with higher levels mitigating the impact of death anxiety on ageism. However, symbolic immortality and interpersonal relationships did not significantly moderate this relationship. Enhancing self-esteem among nursing students would reduce death anxiety and associated ageist behaviors.

Evaluation of the death anxiety beliefs and behaviors scale in Iranian adolescents

Numerous tools assess death anxiety, but many have questionable psychometric properties. The Death Anxiety Beliefs and Behaviors Scale (DABBS) addresses these shortcomings, assessing death-related maladaptive affect, beliefs, and behaviors that could be foundational to fears associated with death. We translated the DABBS into Persian and examined its psychometric properties among Iranian adolescents (n = 598, M age = 14.80, range = 12-18 years old). Confirmatory factor analyses supported the intended three-factor structure that comprises death-related affect, beliefs, and behaviors. Furthermore, the DABBS demonstrated good internal consistency, as well as expected associations with other measures of death anxiety and psychopathology measures, except that the Behaviors subscale unexpectedly did not relate to theoretically relevant constructs. Our findings indicate that the DABBS affect and belief subscales have strong psychometric properties among Iranian adolescents. However, further research is needed to elucidate whether the overall DABBS score demonstrates improved validity when used with other populations.

Managing Cancer and Living Meaningfully (CALM) in Adults with Brain Metastases: A NIH ORBIT Model Phase II Feasibility and Proof-of-Concept Trial

Abstract Background Managing Cancer and Living Meaningfully (CALM) is a brief, evidence-based psychotherapy designed to help patients with advanced cancer cope with the practical and profound challenges of their illness. However, no study has systematically examined CALM in adults with brain metastases, despite the well-documented incidence of distress in this growing population. The primary aim of this trial was to assess the feasibility and acceptability of CALM in adults with brain metastases. Methods Patients with brain metastases (N=13) and elevated symptoms of depression and/or death anxiety enrolled in this single-arm trial. CALM was administered in six biweekly sessions, with outcomes assessed at baseline and post-intervention. Feasibility was assessed based on established metrics including enrollment and retention rates. Acceptability was measured by post-session surveys and post-intervention interviews. Preliminary signal change on measures of psychological distress was explored. Results Of the 13 enrolled participants, 11 completed baseline assessments and initiated treatment: 73% female, Mage=58 years (SD=12.9; range=37-75). Nine completed the study (81% retention rate). Overall, participants reported high perceived benefit and would recommend the program to others. Baseline to post-intervention assessments indicated improvements in depression, death anxiety, generalized anxiety, post-traumatic stress, suicidal ideation, and spiritual well-being. Life quality, substance use, and fear of cancer recurrence remained relatively stable. Conclusions CALM is feasible and acceptable and may improve psychological distress in adults with brain metastases. The findings of this study align with our previous trial of patients with malignant glioma and support a future NIH ORBIT Phase II randomized pilot trial of CALM in neuro-oncology.

Group training based on acceptance and commitment therapy for death anxiety and mental health in the older adults: A randomized clinical trial

Group training based on acceptance and commitment therapy for death anxiety and mental health in the older adults: A randomized clinical trial

Mortality salience and helping behavior amidst public crisis: cross-sectional evidence during COVID-19.

As a real mortality salience, a public crisis would have a major impact on individual minds, behaviors, and lifestyles. COVID-19 provides us with a stark real-world example to understand these implications. Previous research has revealed that some individuals become more willing to help the infected at the risk of their own lives, while others become more self-centered and indifferent during COVID-19. To explain this paradoxical phenomenon, our study used two rival mediators in the relationship between mortality salience and helping behavior during COVID-19: death anxiety and death reflection. A cross-sectional survey was conducted among Chinese college students (N = 684) during the pandemic. We used a parallel mediation model to explore the mediating roles of death anxiety and death reflection in the relationship between mortality salience and helping behavior during COVID-19. The results of our study indicate two key findings. First, mortality salience is negatively related to helping behavior during COVID-19 via death anxiety. This suggests that individuals with higher levels of mortality salience experienced increased death anxiety, which in turn led to a decrease in helping behavior. Second, mortality salience is positively related to helping behavior during COVID-19 via death reflection. This indicates that individuals with higher levels of mortality salience engaged in deeper reflection on death, which subsequently resulted in an increase in helping behavior. Our study provides valuable insights into the complex relationship between mortality salience and helping behaviors in the time of public crisis, and can help lead to more positive attitudes toward public crisis events such as COVID-19.

Fear of Death and Sleep Quality in the Aftermath of an Earthquake.

To examine fear of death and disruption in sleep patterns in individuals who have experienced an earthquake. A descriptive and relationship-oriented study was performed with 322 individuals who experienced the February 6, 2023, earthquake in Turkey. Data were collected between February 20 and May 15, 2023. A personal information form, the Pittsburgh Sleep Quality Index (PSQI), and Death Anxiety Scale (DAS) were used for data collection. Participants' mean DAS score was 7.96 (SD = 1.05), and mean PSQI score was 8.74 (SD = 4.06). Statistically significant relationships were found between sex, marital status, and mean DAS score, and these variables accounted for 11.7% of the total variance. Similarly, statistically significant relationships were found among economic status, relationship to person trapped under the rubble, financial loss from the earthquake, and mean PSQI score, accounting for 11.3% of the total variance. Women and married people had greater fear of death, and those with good economic status, whose family members were buried under rubble, and who experienced financial loss as a result of the earthquake had lower sleep quality. The earthquake led to moderate fear of death and poor sleep quality among participants. Findings highlight the need for targeted support for vulnerable groups following disasters. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

Death anxiety among the oldest old in Germany. Evidence from the nationally representative 'Old Age in Germany (D80+)'.

There is a lack of studies investigating death anxiety among the oldest old based on a large, nationally representative sample during the pandemic. Thus, our aim was to investigate the prevalence and determinants of death anxiety among the oldest old in Germany during the Covid-19 pandemic. Cross-sectional data were taken from the 'Old Age in Germany' (D80+) study. This is a large, nationwide representative study including individuals 80 years and over living at home and individuals in institutionalised settings (N = 9542 individuals in the analytic sample). Overall, 30% of the respondents reported the absence of death anxiety, 45.5% reported a rather not strong death anxiety, 20.2% reported a rather strong death anxiety, and 4.3% reported a very strong death anxiety. Linear regressions revealed that higher death anxiety was significantly associated with being female (β = 0.21, P < 0.01), younger age (β = -0.02, P < 0.001), being married (β = 0.09, P < 0.001), high education (compared to low education, β = 0.07, P < 0.05), the presence of meaning in life (β = 0.13, P < 0.001), higher loneliness levels (β = 0.18, P < 0.001), the presence of multimorbidity (β = 0.07, P < 0.05), and poorer self-rated health (β = -0.07, P < 0.001). A further analysis showed that probable depression (β = 0.31, P < 0.001) is also associated with higher death anxiety. About one in four individuals had a strong or very strong fear of death during the pandemic. Several sociodemographic, psychosocial, and health-related factors are associated with higher death anxiety. This better understanding of the determinants of death anxiety can be relevant for, among others, the affected individuals, informal and professional carers, as well as friends and relatives.

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.

Number of Chronic Conditions and Death Anxiety Among Older Adults in Rural China: A Longitudinal Study in Anhui Province.

Objectives: Death anxiety is feelings of worry and fear regarding death. This study explored the effect of number of chronic conditions on death anxiety in older adults and the moderating effect of age. Methods: This study used the fifth, sixth, seventh, and eighth waves of longitudinal data (2012-2021) collected in Anhui, China (5014 person-year observations). A mixed linear model was used to examine the effect of number of chronic conditions on death anxiety and the moderating effect of age. Results: The number of chronic conditions showed an inverted U-shaped relationship with death anxiety, with death anxiety being lower in older adults with older age. As age increased, the U-shaped curve became flatter, and the extremes shifted to the right. Discussion: Particular attention should be given to younger older adults with chronic conditions to help them recover earlier from the negative impact by providing information and counseling about their chronic conditions.

Fear of Death Among the Youth: Gender Perspective in Nepalese Context

Background &amp; Objective: Death is an inevitable truth though people perceive it differently. The study investigates the attitudes of Nepalese youth towards death, addressing a significant research gap in understanding how cultural, religious, and social factors shape their perceptions. Methods: A quantitative cross-sectional study was conducted with 196 college students using a random sampling technique. The Death Attitude Profile-Revised (DAP-R) was employed to measure attitudes toward death, utilizing a five-point Likert scale. The reliability and validity of the instrument were assessed through KMO and Bartlett's Test, factor loading values, and Cronbach’s Alpha. Key Findings: The results indicated a notable difference (p &lt; 0.05) in death anxiety between genders, with females exhibiting higher levels of anxiety compared to males. The study found that a significant percentage of respondents expressed discomfort and anxiety regarding the concept of death, highlighting the need for targeted interventions. Conclusion &amp; Recommendation: The findings underscore the necessity for educational programs that address death anxiety, particularly among young women. Future research should explore the underlying reasons for gender differences in death attitudes and consider cross-cultural comparisons to enhance the generalizability of the results. Implementing support programs could contribute to improved mental health and quality of life for the youth.

Play therapy: An effective approach to reduce anxiety in children with cancer

Cancer poses a significant challenge to public health worldwide and ranks as the second most common cause of death in children. Approximately 300,000 cases of cancer are diagnosed among children aged 0 to 19 every year [1]. The incidence of childhood cancer is increasing all over the world. A cancer diagnosis can cause serious psychological problems because cancer and admission to the hospital increase the feeling of pain, anxiety, and fear of death [2]. Children diagnosed with cancer often experience severe and persistent anxiety, which can have long-term effects on their well-being. The stress of being hospitalized, coupled with the limited understanding of their illness by medical professionals, the lack of effective coping strategies, and the pain resulting from invasive procedures and treatment regimens, all contribute to the anxiety experienced by these young patients [3].

Death Anxiety and Depression among Nurses: The Mediating Role of Empathy

Background: The COVID-19 pandemic significantly affected life all over the world. Death anxiety has a significant impact on the mental health of individuals, especially in the health care professionals. The fear and apprehension surrounding mortality has significantly affected nurses, leading to various mental health challenges, including depression. While the awareness of death can impose substantial psychological strain, it can also foster positive traits essential for patient care, such as empathy. Objective: The study identifies the relationship between death anxiety, depression and empathy. It also explores the mediating role of empathy in the relationship between death anxiety and depression among nurses. Method: A cross-sectional research design and a purposive sampling strategy were used to collect data from nurses (N=200) working at different government and private hospitals in Lahore, Pakistan, during the COVID-19 pandemic. The participants' ages ranged from 23 to 52. The Siddiqui-Shah Depression Scale, Urdu-translated versions of the Death Anxiety Scale, and Jefferson Scale of Empathy were administered to nurses. Results: The results reveal a positive relation between death anxiety with depression (r= .43**) and empathy (r = .31**). Death anxiety and empathy were found to be significant predictors of depression. Furthermore, empathy was found to be a significant mediator between death anxiety and depression. Conclusion: Based on the findings, clinical psychologists may devise various interventions/management plans to manage death anxiety and depression among nurses.