The Effect of Loneliness on Death Anxiety in the Elderly During the COVID-19 Pandemic

Death-is-life-enhancing: Adaptation and validation of the Norwegian Death Mindsets Measure (NDMM)

While existing psychological frameworks and their accompanying measures focus on death as anxiety-inducing and debilitating, we highlight an overlooked perspective of death-that death can be a basis for living with more meaning and presence. The present research adapts and validates the Death Mindsets Measure (DMM), which assesses the mindset that "death-is-life-enhancing," for a Norwegian context. Firstly, we translated the DMM and consulted with Norwegian bereavement experts and bereaved Norwegians on items' clarity and relevance to cultural perspectives of death. Secondly, we validated the Norwegian DMM (NDMM) on a predominantly bereaved community sample of Norwegians (N = 241). Using structural equation modeling, we confirmed the hierarchical two-factor structure of our measure. The NDMM also demonstrated high internal consistency and discriminant validity with existing death anxiety and death attitudinal measures. Finally, our measure explained additional variance in psychological well-being beyond existing death anxiety and attitudinal measures.

The impact of social participation on Subjective Wellbeing in the older adult: the mediating role of anxiety and the moderating role of education

Introduction

The study aims to examine the mediating role of anxiety in the relationship between social participation and Subjective Wellbeing among Chinese older adults. Additionally, it investigates the moderating ed of education in this relationship.

Methods

The data came from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) published by peking University, with a sample size of 10,626 individuals aged 60 years and above. SPSS 21.0 was used for the statistical analysis of the data, and Mplus 8.0 was used for the statistical processing of the mediating and moderating effects analysis.

Results

(1) The social participation significantly and positively predicated Subjective Wellbeing; (2) Anxiety partially mediated the eect between social participation and Subjective Wellbeing. The mediating eect value was 0.103; (3) Education plays a moderating role in the impact of social participation on subjective Wellbeing.

Discussion

In summary, social participation can reduce the anxiety and enhance their Subjective Wellbeing. Meanwhile, the eet of social participation on Subjective Wellbeing was the greatest for the older adult with high education. The findings suggest that community-led activities can be initiated to improve social participation in the older adult. Furthermore, educational courses could be to support the healthy aging of older adults in China.

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

BACKGROUND

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).

AIMS

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.

METHODS

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.

RESULTS

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).

CONCLUSIONS

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.

The relationship between fear of old age, loneliness and death anxiety in adults

BACKGROUND

The increase in the number of elderly people in the world, individuals' perspectives on older adults, and false beliefs and ideas about old age negatively affect adults in terms of ageing. This study was conducted to determine the relationship between fear of old age, loneliness and death anxiety in adults.

METHOD

This study, which was designed in a correlational cross-sectional descriptive model, was conducted with 1074 adult individuals living in one province in eastern Turkey. Data were collected using Personal Information Form, Fear of Old Age Scale, UCLA Loneliness Scale and Turkish Death Anxiety Scale. Data were analyzed using SPSS 25.0, AMOS 24.0, G*Power 3.1 statistical package programs.

RESULTS

In our study, it was determined that the model created in line with the hypotheses was compatible and the model fit indices were within the desired limits as χ2/df = 4.737, root mean square error of approximation = 0.05, comparative fit index = 0.93, goodness-of-fit index = 0.92, adjusted goodness-of-fit index = 0.90, IFI = 0.93. There is a significant relationship between loneliness and death anxiety (P < 0.05). There is a significant relationship between loneliness and fear of old age (P < 0.05). There is a significant relationship between death anxiety and fear of old age (P < 0.05). It was determined that death anxiety has a mediating role in the effect of loneliness on fear of old age (95% confidence interval: 0.112-0.226; P < 0.05).

CONCLUSION

As the level of loneliness increases, the level of death anxiety and fear of old age increases. Fear of old age also increases in the mediating role of death anxiety. It is recommended to conduct intervention studies to reduce fear of old age. Longitudinal study on fear of old age is recommended.

The Effect of Death Anxiety on Work Passion: Moderating Roles of Work Centrality and Work Connection

Fear of death is an emotional manifestation of the instinct for self-preservation. Any threat to our existence induces an anxiety response. Death anxiety can trigger obsessive-compulsive behaviours, such as an obsessive passion for work. Using a sample of 314 participants (68.2% female), with a mean age of 38.97 years (SD = 10.36), this study sought to observe the predictive effect of death anxiety on work passion, as well as the moderating effect of work-family centrality and connection on the relationship between anxiety and passion. The results revealed that death anxiety negatively affects harmonious passion, and positively affects obsessive passion. Work centrality did not moderate the influence of death anxiety on harmonious and obsessive passion. Nonetheless, work connection moderated the influence of death anxiety on harmonious passion. The negative influence of death anxiety on harmonious passion was greater in a group with high work connection than a group with low connection.

Death Anxiety Associated With Coronavirus (COVID-19) Disease: A Systematic Review and Meta-Analysis

Death anxiety is a feeling that exists since birth, continues throughout life, lies at the root of all fears, and develops after the awareness that people will no longer exist and that they can lose themselves and the world. It is associated with death-induced anxiety with many features of the COVID-19 pandemic, which can be seen as a threat to human existence. In this study, it is aimed to compile studies on death anxiety associated with coronavirus disease, list the general characteristics of these studies through descriptive summaries, and combine findings on the level of death anxiety associated with coronavirus disease through meta-analysis. The findings of this study suggest that COVID-19 pandemic process and is affected by socio-demographic factors such as fear of COVID-19, gender, and occupation. As a result of this study, it was determined that death anxiety was relatively high during the COVID-19 pandemic process.

Spiritual-Cultural Needs as the Main Causative Factor of Death Anxiety in Iranian COVID-19 Patients: A Qualitative Study

COVID-19 patients have been reported to more than likely experience a variety of difficult physical and psychological problems. This qualitative study aims to perceive psychological experiences in COVID-19 patients in Iran. The study method is qualitative, with a conventional content analysis approach adopted. Purposive sampling was applied to 20 COVID-19 patients admitted to medical wards at hospitals in Tehran, Iran. Additionally, data were collected using semi-structured interviews. All data were analyzed based on the method proposed by Lindgren et al. (Int J Nurs Stud 108:103632, 2020). Data analysis identified the main theme to be "death fear and anxiety" with five main categories. These categories included the feelings of death panic and apprehension, uncertainty and ambiguity, fear of abandonment, fear of an unknown future for the family, and fear of unmet spiritual-cultural needs. Accordingly, the patients' experiences of COVID-19 contraction were unique. Against this backdrop, understanding COVID-19 patients' complexities, experiences, beliefs, and attitudes about anxiety and death, can lead to an  improved awareness and understanding of the psychological consequences of COVID-19 by executive decision-makers, healthcare personnel and mental health professionals.

Death Anxiety Among Pakistani HCWs: The Role of COVID-19 Vaccine Acceptance and Positive Religious Coping Strategy

Background: The mental health of healthcare workers (HCWs) has been significantly impacted by the COVID-19 pandemic. To address this, spirituality and religious coping mechanisms have been suggested as a way to maintain well-being and reduce anxiety levels. Additionally, vaccination has been shown to play an essential role in lowering anxiety levels, including death anxiety. However, there is a lack of evidence on how positive religious coping strategies and COVID-19 immunization affect death anxiety levels. To fill this gap, this study uses a Pakistani HCWs sample. Methods: This study collected cross-sectional data from 389 HCWs on socio-demographics, positive religious coping strategies, vaccine acceptance, and death anxiety. Hypothesis testing was done using Statistical Package for the Social Sciences (SPSS) and Partial Least Squares (PLS) by adopting the Structural Equation Modeling (SEM) technique. Results: The results showed that the positive religious coping strategy and acceptance of the COVID-19 vaccine reduced death anxiety among HCWs in Pakistan. HCWs practicing the positive religious coping strategy and vaccine acceptance had lower levels of death anxiety symptoms. Thus, the positive religious coping strategy has a direct effect on reducing death anxiety. Conclusion: In conclusion, COVID-19 immunization positively affects individual mental health by reducing death anxiety. Vaccines protect individuals from COVID-19 infection, providing a sense of security that reduces the chance of death anxiety among HCWs attending to COVID-19 patients.

Anxiety, Depression and Death Anxiety in Individuals with COVID-19

This study aimed to determine the death anxiety, anxiety, and depression levels of the individuals staying at the hospital due to COVID-19. The study recruited 300 patients with confirmed COVID-19 who were staying at specialized clinics in the hospital. Three tools - A Patient Information Form, the Death Anxiety Scale (DAS), and the Hospital Anxiety and Depression Scale (HADS)-were used to collect data. The findings of the present study revealed that 28.7% of the participants were at a high risk for developing anxiety and 45.0% were equally at a high risk for developing depression. 33.3% of the participants suffered from high level of death anxiety. There was a positive and highly significant correlation between their death anxiety and their anxiety and depression scores (p < .001). Accordingly, more evidence-based studies need to be conducted that examine how effective non-pharmacological practices are at helping COVID-19 patients by identifying their anxiety, depression, and death anxiety. Furthermore, nurses need to take care of patient care in a holistic manner that would include addressing patients' psychological needs alongside their physical problems.

The impact of the COVID-19 pandemic on well-being of seniors attending online programs at University of the Third Age: a follow-up study

BACKGROUND

Reports on psychological effects of quarantine during past outbreaks and pandemics showed that quarantined people were more likely to experience psychological problems than those who were not. It was also shown that there was an increase in anxiety, depression, and stress in all age groups during the COVID-19 pandemic. So, we investigated emotional states and quality of life as components of general well-being in older participants of University of the Third Age (U3A) attending online programs during the second year of the pandemic, and compared them with the pre-pandemic COVID-19 period.

METHODS

This study was conducted among 27 participants of a U3A program. Data on sociodemographics, Charlson comorbidity index, the Geriatric Depression Scale Short Form (GDS-SF), The Geriatric Anxiety Scale (GAS), and Turkish version of World Health Organization Quality of Life Instrument Older Adults Module (WHOQOL-OLD) were taken in September 2019 and September 2021.

RESULTS

The median age of the participants was 68 (60-75) years (81.5% female). In the COVID-19 pandemic period; 'Death and dying' (except for 'Fear of pain before death' score), 'Intimacy' domain, and 'Social participation' domain scores of WHOQOL-OLD decreased compared to the pre-pandemic period (P < 0.001, P = 0.011, and P < 0.001, respectively) whereas the scores for GAS and GDS-SF were higher (P < 0.001 and P = 0.011). The reason for the decrease in 'Social participation' domain scores was the decrease in 'Satisfaction with opportunity to participate in community'. There was no significant difference in 'Autonomy' domain of WHOQOL-OLD (P = 0.598).

CONCLUSION

Although there was no change in 'Autonomy' domain among the participants of U3A before and during the pandemic period, anxiety and depression scores were higher in the second year of the COVID pandemic. Only a decrease in satisfaction with opportunity to participate in community might have significant impact on social participation.

Death Anxiety in the Iranian Elderly: A Systematic Review and Meta-Analysis Study

The present study aimed to estimate the standard score of death anxiety in the Iranian elderly. In this systematic review and meta-analysis, national and international databases were searched from inception to January 2022. All the observational studies published in Persian and English, which reported a death anxiety score based on the Templer death anxiety scale, were selected. The standard score of death anxiety in the elderly was 50% (95% CI: 45-56). No correlation was observed between the year of publication (p = .092) and sample size (p = .94) with the standard score of death anxiety in the elderly. With increased age, death anxiety scores declined. Publication bias was not significant (p = .340). Iranian seniors achieved half of the total score of death anxiety, which indicated the average level of death anxiety. Providing training to effectively manage death anxiety is essential to preventing the adverse consequences of extreme death anxiety.

The Effect of Fear of COVID-19 on Green Purchase Behavior in Pakistan: A Multi-Group Analysis Between Infected and Non-infected

The coronavirus disease 2019 (COVID-19) pandemic and its effects on an individual's life have altered the consumer behavior. In the context of purchase and consumption, a shift from conventional to green purchase has been noticed. Although the factors underlying this shift were relatively unexplored, the study aimed to identify the factors that influenced a significant role in the green purchases during the outbreak and the relationship of these factors with green purchase behavior (GPB). Subsequently, this study investigates and interprets the role of fear of COVID-19 (FCV), psychological distress (PD), and mortality salience (MS) in predicting consumer's GPB. This research adopted a quantitative methodology using data collected from 432 respondents in various cities across Pakistan. Smart-PLS 3 was used to evaluate the measurement model, structural model, and multi-group analysis (MGA). Despite having the negative psychological and physical impact of the pandemic, a significant proportion of customers have switched to healthier and sustainable products. This research revealed that the FCV, PD, and MS plays a substantial role in adopting GPB. All the direct relationships were positive and significant. In addition, MS and PD partially mediate the effect of FCV on GPB. Furthermore, the MGA revealed that the infected respondents were interested in purchasing green products than uninfected respondents due to their FCV; conversely, the PD and MS were higher in uninfected individuals than infected ones. However, there is a vast literature on GPB, but little has investigated the cumulative impact of FCV, PD, and MS on GPB.

A Cross-Sectional Study on the Cross-Talk of the COVID-19-Related Degree of Loneliness and the Etiological Factors Among the Elderly in Central China

BACKGROUND

The outbreak of COVID-19 has undoubtedly influenced the normal lifestyle of people worldwide, including the Chinese population. This study attempted to do supplementary research to the current situation of loneliness as well as the related risk factors among the elderly in the province in central Chinese during the COVID-19.

METHODS

We conducted a cross-sectional study in one of the central Chinese provinces (Henan Province) from December 2020 to March 2021 using a multistage sampling method, and 568 elderly people without cognitive impairment were interviewed. The UCLA Loneliness Scale, Pittsburgh Sleep Quality Index (PSQI), Physical Activity Rating Scale (PARS-3), and Quality of Life Questionnaire SF-36 were adopted to collect information. We used univariate and multivariate logistic regressions to analyze the factors resulting in severe loneliness among the elderly with seldom or regular participation in physical exercises.

RESULTS

During the epidemic in central China, the elderly suffering from loneliness syndrome accounted for 34.2%, of which 15.5% were severely lonely. Risk factors for severe loneliness were quality of life (OR: 7.129), sleep quality (OR: 3.778), seldom exercise (OR: 4.170), poor economic status (OR: 1.769), and negative attitude toward the prospects for the epidemic control (OR: 4.033). By grouping the participants in terms of physical activity, we found that the quality of life (OR:5.778) was a significant risk factor than sleep quality (OR:2.939) in the seldom exercise group, while the only risk factor in the regular exercise group was the quality of life (OR: 5.021).

CONCLUSION

There was an increase in the degree of loneliness among the elderly during the epidemic, and physical activity played an active role in relieving the severe loneliness of the elderly. Therefore, for the sake of the elderly, regular participation in physical exercises should be encouraged during the duration of the epidemic.

The Role of Immune Cells in Oxi-Inflamm-Aging

Aging is the result of the deterioration of the homeostatic systems (nervous, endocrine, and immune systems), which preserve the organism's health. We propose that the age-related impairment of these systems is due to the establishment of a chronic oxidative stress situation that leads to low-grade chronic inflammation throughout the immune system's activity. It is known that the immune system weakens with age, which increases morbidity and mortality. In this context, we describe how the function of immune cells can be used as an indicator of the rate of aging of an individual. In addition to this passive role as a marker, we describe how the immune system can work as a driver of aging by amplifying the oxidative-inflammatory stress associated with aging (oxi-inflamm-aging) and inducing senescence in far tissue cells. Further supporting our theory, we discuss how certain lifestyle conditions (such as social environment, nutrition, or exercise) can have an impact on longevity by affecting the oxidative and inflammatory state of immune cells, regulating immunosenescence and its contribution to oxi-inflamm-aging.

The effect of physical and social isolation due to the COVID-19 pandemic on the incidence of hip fractures among senior citizens

This study aimed to explore the effects of the lockdown due to the coronavirus disease 2019 pandemic on the incidence and characteristics of hip fracture in older adults. Data from the three-month lockdown period and the corresponding period in the previous year were obtained from the computerized medical records of a large acute-care hospital. No significant differences were observed in the absolute and relative numbers of hip fractures. There were no significant differences in terms of socio-demographic and clinical characteristics, which are considered risk factors for falls. Similarly, there was no difference in the length of time between admission and surgery and the mean length of hospital stay. Compared to the previous year, there was a significantly higher incidence of hip fractures in older adults living alone during the lockdown. Health policy should provide social support and monitoring of healthcare, particularly to older adults living alone.

Health Education as a Means of Addressing Death in the Elderly

Education for death is an emerging field of study in which health education research and proposals are increasingly being made with the aim of acquiring knowledge and skills to promote positive attitudes towards health and preparation for the end of life. The aim of this study is to find out what experience older people have had with death education and the importance they give to health education. A qualitative methodological design was selected using a semi-structured interview. The survey consisted of interviews with 28 participants from the city of Granada (Spain) aged 61 to 78. This qualitative-descriptive study is based on an analysis of older people's experience of education and preparation for death throughout their lives. The results show that, in most cases, the only information received was in childhood and always from a religious perspective. Death and health are closely related, so working on death education helps to improve the quality of life of elderly people. Health education offers ways of coping with the end of life through the transmission of values and practices that make it possible to anticipate and resolve situations of instability or anxiety. Facing death naturally and as just another part of life will help to make healthy ageing possible, through educational proposals related to the integral health of elderly people.