Association of sense of coherence and supernatural beliefs with death anxiety and death depression among Romanian cancer patients

Death Obsession, COVID-19-Related Fear and Religiosity in People Living with Type 2 Diabetes

Patients diagnosed with type 2 diabetes were included among high-risk groups for more severe manifestations in case of COVID-19 infection and higher risk of mortality. The current study aims to (1) examine the relationship between death obsession, religiosity, and fear of COVID-19 among type 2 diabetes patients, and (2) assess if religiosity moderates the relationship between death obsession and fear of COVID-19. This cross-sectional online survey involved 306 type 2 diabetes patients. We found that 35.6 % of the participants were overweight and 14.6 % were suffering from obesity. Results showed that death obsession was positively associated with fear of COVID-19 and more religious individuals experience higher levels of fear. The overall level of religiosity did not moderate the relationship between death obsession and fear of COVID-19 but only the preoccupation with God dimension of the religiosity scale. The practical implications of these findings are discussed.

Correlates of death anxiety for patients with cancer: A systematic review and meta-analysis

OBJECTIVE

A systematic review and meta-analysis was performed to identify the factors related to cancer death anxiety based on available evidence.

DESIGN

This systematic review and meta-analysis followed the PRISMA 2020 guidelines.

METHODS

Seven databases were searched to identify studies on the relationships of cancer death anxiety with demographic characteristics, disease factors and psychosocial factors from inception to May 2023. The Agency for Medical Research and Quality (AHRQ) scale was used to evaluate the quality of the included studies. After two researchers independently completed the literature search, data extraction and quality evaluation, meta-analysis was conducted by using RevMan5.3 and Stata 17.0 software.

RESULTS

In total, 52 studies were included in this review. The results revealed that there were positive correlations of death anxiety with female sex, the symptom burden, anxiety levels, depression levels, fear of recurrence, attachment avoidance, psychological distress, resignation and confrontation coping. Death anxiety was negatively correlated with age, education level, ability to perform daily activities, self-esteem, spiritual well-being, sense of meaning in life, resilience, quality of life, social support and religious beliefs.

CONCLUSIONS

Our results can inform the design of interventions to address death anxiety and improve the overall quality of life of cancer patients. Healthcare professionals should promptly identify and focus on death anxiety in high-risk populations of cancer patients.

RELEVANCE TO CLINICAL PRACTICE

Cancer patients commonly experience death anxiety, and this anxiety has a nonnegligible impact on patients' mental health and overall quality of life. This study can inform the development of interventions by clinical healthcare professionals.

NO PATIENT OR PUBLIC CONTRIBUTION

This was a meta-analysis based on data from previous studies.

Predictors of death anxiety among Iranian cancer patients: Contribution of sense of Coherence

BACKGROUND

Death anxiety is a negative consequence of cancer that influences the quality of life of many patients. This study determined the predictors of death anxiety and the contribution of the sense of coherence to this disorder among Iranians with cancer.

METHODS

The present research was a descriptive-analytical study that examined cancer patients referring to one of the educational hospitals in Tehran, Iran. Two hundred eligible patients selected by purposeful sampling filled out a clinical and demographic questionnaire. The data were analyzed by the SPSS 20 software.

RESULTS

The correlational results revealed a negative and significant relationship between death anxiety and a sense of coherence (r = -0.610). Likewise, age, gender, marital status, occupational and economic circumstances, and cancer type were among the variables that correlated with death anxiety and predicted 85% of this psychological state.

CONCLUSION

The researchers recommend mental assessment in oncological care to identify psychological challenges to realize the ultimate goal of palliative care, i.e. improving patients' quality of life.

The Reliability and Validity Study of Turkish Version of the Death Depression Scale-Revised Among Nurses

The study aimed to establish the reliability and validity of the Turkish version of the Death Depression Scale-Revised (DDS-R) with a sample of 284 nurses. Cronbach's coefficient for the whole scale was .909 and the sub-dimension values were calculated as .934, .798, .715, and .537. The test-retest reliability coefficient was found to be .880. The content validity index (CVI) of the scale was calculated as .86. The results of the exploratory factor analysis showed that 62.254% variance was explained in 4 sub-dimensions of the scale (existential vacuum, death emptiness, other death, death sadness). Confirmatory factor analysis revealed that a four-dimensional structure yielded a good fit (X2/df = 3.124, RMSEA = .087). TDDS-R was found to be a valid and reliable measurement tool in determining the death depression levels of nurses.

The Impact of Place of Residence on the Sense of Coherence of Population Aged 60–89: Evidence from Poland

Place of living is one of the most important socio-demographic factors which characterizes the lives of older people. The importance of with whom and under what conditions older adults live to a large extent determines their health and standard of living. The goal of the study was to find the relationship between the place of residence and housing condition of older adults in Poland and their sense of coherence and health problems. The 29-item Antonovsky SOC questionnaire was used. In the research 303 people (76% women and 24% men) aged 60–89 were evaluated: 158 lived in their own houses/flats, while 145 resided in Daily Homes of Social Assistance (DPS). The overall result for the sense of coherence was 129.65 for older adults living in their own homes and 126.48 for these living in DPS. Statistical dependence between the place of residence and sense of manageability and meaningfulness was found. There is no dependence between gender and the overall score, nor the three components of the sense of coherence. Statistical dependence was determined in the criterion of age. A higher level of meaningfulness was observed in people aged 60–74. Taking into account the place of residents, 52% of the respondents living in their own houses/flats experience loneliness and among the people living in Daily Homes of Social Assistance, 46% experience loneliness. The type of place of residence is one of the most important personal factors affecting the sense of coherence, chronic health problems, and sense of loneliness. The last factor, especially, can adversely affect community sustainability and undermine social cohesion.

"For Years I lived in a Cage. Now the Cage Is Open and I Am Just Learning to Fly." Perspectives of Cancer Survivors on Psychological Resilience

BACKGROUND

Transitioning from treatment to survivorship engenders several challenges that cancer survivors must learn to manage. These challenges are commonly associated with struggling to manage reentry into postcancer life. Thus, balance is restored after cancer, and postcancer experiences should be considered along with all previous life experiences. This balancing process surrounding cancer causes some cancer survivors' life to deteriorate, whereas other cancer survivors begin a psychological resilience process.

OBJECTIVE

The aim of this study was to investigate the way that psychological resilience is experienced by cancer survivors.

METHODS

The present descriptive qualitative design study was conducted from August 2019 through January 2020. A total of 12 cancer survivors were sampled from the follow-up clinics of a hospital. Data were collected through semistructured, pilot-tested, face-to-face interviews using an interview guide.

RESULTS

Three main themes were clarified based on the descriptive analysis of the data on cancer survivors' experiences: "fight vs lose," "balancing uncertainties," and "learned to fly." The results demonstrate the importance and influence of psychological resilience in the overall cancer experience.

CONCLUSION

This study provides insight into the subjective psychological resilience process of cancer survivors. Nurses may use this knowledge in fostering effective strategies enabling cancer survivors to develop psychological resilience.

IMPLICATIONS FOR PRACTICE

The results offer a promising resource for nurses to assess and address the risk and protective factors of cancer survivors to identify unique needs and to provide individualized care. In this context, nurses can develop novel approaches and interventions for cancer survivors in accordance with Kumpfer's resilience framework.

Death anxiety in patients with primary brain tumor: Measurement, prevalence, and determinants

OBJECTIVE

This study investigated death anxiety in patients with primary brain tumor (PBT). We examined the psychometric properties of two validated death anxiety measures and determined the prevalence and possible determinants of death anxiety in this often-overlooked population.

METHODS

Two cross-sectional studies in neuro-oncology were conducted. In Study 1, 81 patients with PBT completed psychological questionnaires, including the Templer Death Anxiety Scale (DAS). In Study 2, 109 patients with PBT completed similar questionnaires, including the Death and Dying Distress Scale (DADDS). Medical and disease-specific variables were collected across participants in both studies. Psychometric properties, including construct validity, internal consistency, and concurrent validity, were investigated. Levels of distress were analyzed using frequencies, and determinants of death anxiety were identified using logistic regression.

RESULTS

The DADDS was more psychometrically sound than the DAS in patients with PBT. Overall, 66% of PBT patients endorsed at least one symptom of distress about death and dying, with 48% experiencing moderate-severe death anxiety. Generalized anxiety symptoms and the fear of recurrence significantly predicted death anxiety.

SIGNIFICANCE OF RESULTS

The DADDS is a more appropriate instrument than the DAS to assess death anxiety in neuro-oncology. The proportion of patients with PBT who experience death anxiety appears to be higher than in other advanced cancer populations. Death anxiety is a highly distressing symptom, especially when coupled with generalized anxiety and fears of disease progression, which appears to be the case in patients with PBT. Our findings call for routine monitoring and the treatment of death anxiety in neuro-oncology.

Perceived Impact of Quarantine on Loneliness, Death Obsession, and Preoccupation With God: Predictors of Increased Fear of COVID-19

Most countries are facing the societal challenging need for a new quarantine period due to the increasing number of COVID-19 infections, indicating a second or even third wave of disease. The COVID-19 pandemic has brought to the surface existential issues that are typically less present in people's focal attention. The first aim of this study was to identify some of these existential struggles such as increased feelings of loneliness, death obsession, and preoccupation with God. Secondly, we explored the association of these factors with the increased fear of coronavirus during the quarantine. Data was collected from 1,340 Romanian adults using a cross-sectional web-based survey design in the midst of the national lockdown period of COVID-19. Participants completed measures of COVID-19 related loneliness, death obsession, and preoccupation with God twice; first, thinking about the period before the pandemic, and second, for the current situation during the quarantine. Then, they completed a fear of COVID-19 measure. Participants perceived an increase in the feelings of loneliness, death obsession, and preoccupation with God during the confinement. Furthermore, gender, knowing someone diagnosed with COVID-19, loneliness, death obsession, and preoccupation with God predicted fear of COVID-19. Interestingly, days in isolation did not predict fear of COVID-19 nor were associated with feelings of loneliness. In line with existential positive psychology, these results highlight the importance of policies and interventions targeting the experience of loneliness, spiritual beliefs, and particularly those aimed to promote death acceptance, in order to alleviate intense fear of COVID-19.

Predictive factors associated with death depression in women with breast cancer

A cross-sectional study with a convenience sample of 241 patients with breast cancer was conducted to investigate death depression and its explanatory factors in Iranian women who were diagnosed and undergoing treatment for breast cancer. Patients with significantly higher death depression were those who were housewives (β = 0.6, p = 0.016), unskilled workers (β = 15.8, p = 0.002), and retired (β = 13.1, p = 0.002) as compared with those who were professionally employed with higher socio-economic status (β = 17.4, p = 0.002); and those receiving combination therapy as compared to surgery only (β = 6.3, p = 0.02). For patients with higher spiritual health scores, death depression was significantly lower (β = -0.2, p < 0.001).

Transcultural adaptation and psychometric properties of Chinese version of Death Depression Scale-Revised among nursing students

The study aimed to determine the psychometric properties of the Chinese version of the Death Depression Scale in a sample of 391 nursing students. The Cronbach's alpha coefficient was 0.91, ranging from 0.65 to 0.91 for each subscale. Test-retest reliability was satisfactory (r = 0.821). Overall content validity index was 0.83. An exploratory factor analysis yielded 5 factors: anergia and anhedonia, death sadness, other death, death emptiness, and death vacuum. The model had an acceptable fit, with all factors loading greater than 0.5. Results provide preliminary support for the reliability and validity of the measure in nursing student populations.

Death-related distress in adult primary brain tumor patients

Background

A diagnosis of cancer may increase mortality salience and provoke death-related distress. Primary brain tumor (PBT) patients may be at particular risk for such distress given the certainty of tumor progression, lack of curative treatments, and poor survival rates. This study is the first to examine the prevalence of death-related distress and its correlates in PBT patients.

Methods

Adult PBT patients (N = 105) enrolled in this cross-sectional study and completed the Death Distress Scale (subscales: Death Depression, Death Anxiety, Death Obsession), Generalized Anxiety Disorder-7, and Patient Health Questionnaire-9. Prevalence and predictors of death-related distress, and the relationships of demographic variables to clusters of distress, were explored.

Results

The majority of PBT patients endorsed clinically significant death-related distress in at least one domain. Death anxiety was endorsed by 81%, death depression by 12.5%, and death obsession by 10.5%. Generalized anxiety was the only factor associated with global death-related distress. Cluster analysis yielded 4 profiles: global distress, emotional distress, resilience, and existential distress. Participants in the resilience cluster were significantly further out from diagnosis than those in the existential distress cluster. There were no differences in cluster membership based on age, sex, or tumor grade.

Conclusions

PBT patients appear to have a high prevalence of death-related distress, particularly death anxiety. Further, 4 distinct profiles of distress were identified, supporting the need for tailored approaches to addressing death-related distress. A shift in clusters of distress based on time since diagnosis also suggest the need for future longitudinal assessment.