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Ji P, Zhang L, Gao Z, Ji Q, Xu J, Chen Y, Song M, Guo L. Relationship between self-esteem and quality of life in middle-aged and older patients with chronic diseases: mediating effects of death anxiety. BMC Psychiatry 2024; 24:7. [PMID: 38166844 PMCID: PMC10763298 DOI: 10.1186/s12888-023-05459-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Many studies have explored the relationship between self-esteem and quality of life. However, few studies have elucidated the mechanisms underlying the relationship between self-esteem and quality of life in middle-aged and older patients with chronic diseases. The present study aimed to explore the mediating role of death anxiety in this relationship. METHODS Middle-old-aged patients with chronic diseases were selected as the respondents by using a multi-stage sampling method, random number table method from October 2021 to February 2022 in the Second Affiliated Hospital of Zhejiang University School of Medicine. The Cumulative Disease Rating Scale, the Self-Esteem Scale (SES), the Chinese version of the Death Anxiety Scale (CT-DAS), and the Simplified version of the Quality of Life Scale (SF-12) were used as the researching tools to conduct the survey. SPSS26.0 was used to analysis data. AMOS 23.0 software was used to construct structural equation modeling. RESULTS 294 valid questionnaires were collected. There were significant differences in quality of life among middle-aged and elderly patients with chronic diseases who have different physical activities, socialization, and chronic pain (P < 0.01); Self-esteem was positively associated with quality of life (r = 0.330, P < 0.01), self-esteem was negatively associated with death anxiety (r = -0.222, P < 0.01), and death anxiety was negatively associated with quality of life (r = -0.263, P < 0.01); Death anxiety partially mediated the relationship between self-esteem and quality of life, with the mediating effect accounting for 18.40% of the total effect. CONCLUSION Death anxiety partially mediates the relationship between self-esteem and quality of life. Interventions to improve self-esteem and reduce death anxiety should be used to improve the quality of life of middle-aged and senior patients with chronic diseases.
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Affiliation(s)
- Pengjuan Ji
- School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, P.R. China
| | - Lin Zhang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P.R. China
| | - Ziyun Gao
- School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, P.R. China
| | - Qiqi Ji
- School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, P.R. China
| | - Jiashuang Xu
- School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, P.R. China
| | - Yian Chen
- School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, P.R. China
| | - Miaojing Song
- School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, P.R. China
| | - Leilei Guo
- School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, P.R. China.
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Hsien-Cheng Xian Zheng L. Roles of self-esteem and socioeconomic status in COVID-19 preventive behaviors. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03326-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Leung HT, Chew PKH, Caltabiano NJ. Mortality Salience Effects of Critical Incidents - A Systematic Literature Review and Research Agenda. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221098890. [PMID: 35491896 DOI: 10.1177/00302228221098890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
Critical incidents (CI) trigger acute stress reactions and psychological trauma because of direct or vicarious exposure. These events include natural disasters, wars, terrorist attacks and pandemics, and usually result in deaths and serious physical injuries. Their life-threatening nature makes them reasonable candidates to induce mortality salience (MS). The current review aims to consolidate Terror Management Theory (TMT) research using CIs as MS. A systematic literature review was conducted. Overall, 74 articles with 113 studies were included. Through this review, strong support for MS effects of CI has been found. Consistent with TMT, CIs tend to trigger worldview defence, self-esteem enhancement and relationship seeking. CIs have also been found to impact negatively on individual well-being and organisational health. Recommendations specific to crisis interventions and well-being will be discussed. The review concludes with potential future research directions to strengthen and expand empirical knowledge in CI salience.
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Affiliation(s)
- Hoi-Ting Leung
- School of Social and Health Sciences, 208640James Cook University, Singapore
| | - Peter K H Chew
- School of Social and Health Sciences, 208640James Cook University, Singapore
| | - Nerina J Caltabiano
- College of Healthcare Sciences, 208640James Cook University, Cairns Campus, Singapore
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Chang B, Cheng J, Fang J, Dang J. The Indirect Effect of Death Anxiety on Experienced Meaning in Life via Search for Meaning and Prosocial Behavior. Front Psychol 2021; 12:673460. [PMID: 34122268 PMCID: PMC8194697 DOI: 10.3389/fpsyg.2021.673460] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 04/12/2021] [Indexed: 11/13/2022] Open
Abstract
This study investigated the relationship between death anxiety and experienced meaning in life. Six hundred and forty-eight Chinese college students were surveyed using the Death Anxiety Scale, the Prosocial Behavior Scale, and the Meaning in Life Scale. The results showed that death anxiety predicted experienced meaning through three pathways: the first one was through search for meaning singly; the second one was through prosocial behavior singly; and the third one was through search for meaning and prosocial behavior serially, which accounted for the highest proportion of the total effect. This study highlights the positive side of death anxiety.
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Affiliation(s)
- Baorui Chang
- Department of Psychology, Faculty of Education, Guangxi Normal University, Guilin, China
| | - Jiaxin Cheng
- Department of Psychology, Faculty of Education, Guangxi Normal University, Guilin, China
| | - Jiandong Fang
- Department of Psychology, Faculty of Education, Guangxi Normal University, Guilin, China
| | - Junhua Dang
- Department of Neuroscience, Faculty of Medicine, Uppsala University, Uppsala, Sweden
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Spitzenstätter D, Schnell T. Effects of mortality awareness on attitudes toward dying and death and meaning in life-a randomized controlled trial. DEATH STUDIES 2020; 46:1219-1233. [PMID: 32845800 DOI: 10.1080/07481187.2020.1808737] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
A randomized controlled trial was carried out to investigate effects of heightened mortality awareness on meaning in life and attitudes toward dying and death. An intervention group (n = 51) completed questionnaires and participated in interventions to increase mortality awareness; a control group (n = 47) only completed the questionnaires. Longitudinal analyses revealed a decrease in the intervention group's fear of dying and an increase in their acceptance of dying, but no effects on attitudes toward death. Changes in meaningfulness were contingent on participants' religiousness. Unexpected cross-sectional results and the study's implications for theory and further empirical work are discussed.
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Affiliation(s)
| | - Tatjana Schnell
- Institute of Psychology, University of Innsbruck, Innsbruck, Austria
- MF Norwegian School of Theology, Religion and Society, Oslo, Norway
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Fairlamb S, Juhl J. Death thoughts predict increased depression for those with low self-worth. DEATH STUDIES 2020; 46:1021-1026. [PMID: 32673184 DOI: 10.1080/07481187.2020.1793432] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Terror management theory specifies that a sense of self-worth is necessary to prevent the awareness of death from undermining psychological well-being. We tested the theory's claims about well-being within the context of depression, by measuring self-worth, death-thought accessibility, and depression in an online study (N = 365). Consistent with the theory, death-thought accessibility predicted increased depression, but only among those with low, not high, self-worth. Our findings support existential clinical theorists' claims for psychological therapies to appreciate the underlying reasons for the need for self-worth.
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Affiliation(s)
- Samuel Fairlamb
- Psychology Department, Royal Holloway University of London, Surrey, UK
| | - Jacob Juhl
- School of Psychology, University of Southampton, Southampton, UK
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Hubley C, Hayes J, Harvey M, Musto S. To the Victors Go the Existential Spoils: The Mental-Health Benefits of Cultural Worldview Defense for People WHO Successfully Meet Cultural Standards and Valued Goals. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2020. [DOI: 10.1521/jscp.2020.39.4.274] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Introduction: Research in support of terror management theory suggests that mortality concerns will activate symbolic defenses associated with cultural worldviews, and when these defenses are activated, mental health will benefit. However, no study to date has examined this process in full. We filled this gap, while testing the moderating effect of feeling successful vis-à-vis cultural value-standards. Method: In two studies, we hypothesized that participants who feel successful at meeting cultural standards would engage cultural worldview defense (WVD) following mortality salience (MS), and as a consequence of their defensiveness, would experience greater mental health. Results: In Study 1, MS increased pro-American WVD only among relatively wealthy participants, which in turn reduced death-thought accessibility. In Study 2, MS increased pro-American WVD only among participants primed with felt success (vs. failure), which in turn reduced anxiety and depression. Conclusions: Culture can relieve death-related distress and promote mental health to the extent that it provides feelings of success.
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Affiliation(s)
| | | | - Mary Harvey
- University of Waterloo, Waterloo, ON, Canada
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Pelletier P, Drozda-Senkowska E. Meaning-making and rumour-mongering in the shadow of terrorism: The case of the Charlie Hebdo attack in Paris. JOURNAL OF SOCIAL AND POLITICAL PSYCHOLOGY 2019. [DOI: 10.5964/jspp.v7i2.1127] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The January 7, 2015 Charlie Hebdo terrorist attack in Paris shattered French civilians’ sense of security and also their sense of the surrounding world. This quasi-longitudinal study investigates the temporal dynamics of meaning-making and rumour-mongering processes of French civilians (N = 161) in a real-world, post-terrorist context. The present study was conducted via questionnaire at three points in time (i.e. one week, one month and two months) following the January 7, 2015 terrorist attack in Paris. In line with the social stage model of collective coping with disasters (Pennebaker & Harber, 1993), the main results suggest that participants’ coping process of searching for meaning decreased progressively over the two-month period. However, participants’ finding the presence of meaning as an outcome did not differ across time. Moreover, participants’ belief in rumours and official information was stable over the two-month period. Such findings point to the importance of considering the temporal perspective in order to provide a better understanding of laypeople’s symbolic responses to terrorism.
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Howell JL, Sosa N, Osborn HJ. Self‐esteem as a monitor of fundamental psychological need satisfaction. SOCIAL AND PERSONALITY PSYCHOLOGY COMPASS 2019. [DOI: 10.1111/spc3.12492] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Juhl J, Routledge C. Putting the Terror in Terror Management Theory. CURRENT DIRECTIONS IN PSYCHOLOGICAL SCIENCE 2016. [DOI: 10.1177/0963721415625218] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Rooted in the writings of existentialists, terror management theory states that the awareness of death has the potential to create debilitating anxiety and compromise psychological well-being and that psychological buffers (e.g., self-worth) protect against these adverse effects. Hundreds of studies have supported the theory. However, until recently, little work has focused on the central assertion that the awareness of death causes anxiety and undermines well-being. We review a recent program of research that fills this critical void in the literature. This work has demonstrated that experimentally heightening the awareness of death increases anxiety and decreases well-being for individuals who lack appropriate psychological buffers.
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Affiliation(s)
- Jacob Juhl
- School of Psychology, University of Southampton
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Boucher HC, Bloch T, Pelletier A. Fluid compensation following threats to self-concept clarity. SELF AND IDENTITY 2015. [DOI: 10.1080/15298868.2015.1094405] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Wisman A, Heflick N, Goldenberg JL. The great escape: The role of self-esteem and self-related cognition in terror management. JOURNAL OF EXPERIMENTAL SOCIAL PSYCHOLOGY 2015. [DOI: 10.1016/j.jesp.2015.05.006] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Sedikides C, Wildschut T, Routledge C, Arndt J, Hepper EG, Zhou X. To Nostalgize. ADVANCES IN EXPERIMENTAL SOCIAL PSYCHOLOGY 2015. [DOI: 10.1016/bs.aesp.2014.10.001] [Citation(s) in RCA: 148] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
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