Volume 13, Issue 1 (4-2018)                   Salmand: Iranian Journal of Ageing 2018, 13(1): 110-123 | Back to browse issues page


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Majidi A, Moradi O. Effect of Teaching the Components of Spiritual Intelligence on Death Anxiety in the Elderly. Salmand: Iranian Journal of Ageing 2018; 13 (1) :110-123
URL: http://salmandj.uswr.ac.ir/article-1-1346-en.html
1- Department of Psychology, Faculty of Education and Psychology, Sanandaj Branch, Islamic Azad University, Sanandaj, Iran.
2- Department of Psychology, Faculty of Education and Psychology, Sanandaj Branch, Islamic Azad University, Sanandaj, Iran. , moradioma@gmail.com
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Extended Abstract
1. Objectives

One of the most common mental disorders of old age is death anxiety, which means predicting your death and fear of the death of important people in life [1]. Such feelings can lead to helplessness, physical changes, loss of control, feeling lonely and guilty and can affect the functions of ordinary life of the individuals [2]. Therefore, it is necessary to identify the factors responsible for reducing death anxiety. Given this background, this study aimed to investigate the effect of teaching the components of spiritual intelligence on the amount of death anxiety in the elderly living in Sanandaj's nursing homes.  To achieve this goal, two questions were considered and examined: 1) Is the training of spiritual intelligence components effective in reducing death anxiety?; and 2) Does learning the components of spiritual intelligence reduce the dimensions of death anxiety (death of yourself, seeing you are dying, death of your neighbors, seeing dying relatives)?
2. Methods and Materials
This study is applied research in terms of purpose, and it is semi-pilot with pre-test-post-test and control group in terms of implementation method. The statistical population of the research was all people living in nursing homes in Sanandaj in the first half of 2016.  The sample selection process was as follows. After obtaining the necessary legal permissions, 100 Death Anxiety Inventory questionnaires were distributed among the elderly people with the aim of screening. Those who had an average score for their death anxiety in two higher deciles were recognized as eligible subjects. Eventually, these 20 subjects were placed randomly in two experimental and control groups. The inclusion criteria were having reading and writing skills, lack of organ defects in the auditory, speaking and visionary organs, not having acute cognitive impairment, the desire to participate in the training component of spiritual intelligence, and a high score on death anxiety. It should be noted that during the sample selection, ethical considerations such as freedom of participation or non-participation in research, anonymous questionnaire, obtaining legal licenses, and obtaining moral confirmation were observed. This research was approved by the Ethics Committee of Islamic Azad University, Sanandaj Branch.
After selecting the sample subjects, the Collett–Lester’s Fear of Death Scale (1969) was distributed as a pre-test on subjects. This scale included 32 questions and 4 subscales of death of the self, seeing own death, the death of surroundings, and seeing neighbors dying. Then the experimental intervention group received the training approach on spiritual intelligence concepts in 8 sessions for 90 minutes. During this time, the control group did not receive any intervention. After the end of the intervention sessions, the posttest was performed on subjects. Using one-way covariance analysis and multimode analysis and SPSS22 software, the collected data were analyzed.
3. Results
The mean and standard deviation of the age of the experimental group was 62.5±5.62 years and for the control group was 63.1±4.3 years. In Table 1, the mean and standard deviation of the subjects' death anxiety scores are presented in the pre-test and post-test phase.
After providing the descriptive findings, inferential analysis of data is presented. The normal distribution of data was examined through Shapiro-Wilk's test. Accordingly, the amount of Shapiro-Wilk's statistic on the death anxiety score in the pre-test equaled to 0.927, and the level of significance was 0.136. The amount of Shapiro-Wilk's statistic on Death Anxiety Rating in post-test equaled to 0.922, and the level of significance was 0.109. Due to the lack of significant results and confirmation of zero assumption, it was ensured that data distribution is normal. Therefore, parametric tests were used for data analysis (Table 1).
To check the first research question, one-way covariance analysis was used. The results of the first question showed that the effect of independent variables on the training of spiritual intelligence components on the reduction of the total death score of the elderly was statistically significant (F=27.053 and Sig.=0.001). The post-test mean scores of the experimental group were found to be decreased compared to the control group. Therefore, it can be said that learning the components of spiritual intelligence could significantly reduce the total death anxiety in the experimental group compared to the control group. 
Multivariate covariance analysis was used to investigate the second question. Based on the results, the values of F calculated in the case of 4 tests of Piley effect, Wilks Lambda, Hoteling effect, and the Roy’s Largest Root Test were significant at the level of 0.01. Therefore, it was found that there is at least a significant difference between the two pairs. The main results of the covariance analysis also showed that the values of F calculated in group variables in the dimensions of death of relatives and seeing dying companions (F=6.727, 27.675) are significant at the level of P≤0.05. But these values were not significant in terms of death of the self and seeing themselves dying. Significance in subscales of death of relatives and seeing dying companions means that the training of spiritual intelligence components has been successful. These two subscales in the test group are reduced compared to the control group. 
4. Conclusion 
The results of this study showed that learning the components of spiritual intelligence reduces the extent of death anxiety (deaths of companions and seeing relatives dying) in the elderly. However, there were no significant results in reducing the dimensions of death anxiety such as death of the self and seeing themselves dying. These results were consistent with previous research findings [3-7]. 
The limitation of this research was the lack of long-term follow-up of the training results because of the time limit for the research. Therefore, it is recommended that future studies should focus on long-term implications of interventions based on spiritual intelligence training. Overall, considering the findings of the research, it is recommended that training courses on spiritual intelligence components should be held in nursing homes, hospitals, and similar environments where patients and helpless people reside.
Acknowledgments
This research was extracted from the second author's MA thesis in the Department of Psychology, Faculty of Education and Psychology, Sanandaj Branch, Islamic Azad University, Sanandaj, Iran.
Conflict of Interest
The authors declared no conflicts of interest.

References 
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  2. Riedel Heller SG, Busse A, Angermeyer MC. The state of mental health in old age across the ‘old’European :::union:::–a systematic review. Acta Psychiatrica Scandinavica. 2006; 113(5):388-401. doi: 10.1111/j.1600-0447.2005.00632.x
  3. Parmar D, Williams G, Dkhimi F. Enrolment of older people in social health protection programs in West Africa e Does social exclusion play a part. Social Science & Medicine. 2014; 119:36-44.
  4. Statistical Center of Iran. [General census of population and housing (Persian)]. Tehran: Statistical Center of Iran; 2016. 
  5. Tsai FJ, Motamed S, Rougemont A. The protective effect of taking care of grandchildren on elders’ mental health? Associations between changing patterns of intergenerational exchanges and the reduction of elders’ loneliness and depression between 1993 and 2007 in Taiwan. BMC Public Health. 2013; 13(1). doi: 10.1186/1471-2458-13-567
  6. Bøen H, Dalgard OS, Johansen R, Nord E. A randomized controlled trial of a senior centre group programme for increasing social support and preventing depression in elderly people living at home in Norway. BMC Geriatrics. 2012; 12(1). doi: 10.1186/1471-2318-12-20
  7. Phabphal K, Geater A, Limapichat K, Sathirapanya P, Setthawatcharawanich S. Risk factors of recurrent seizure, co-morbidities, and mortality in new onset seizure in elderly. Seizure. 2013; 22(7):577–80. Doi: 10.1016/j.seizure.2013.04.009
  8. Bährer-Kohler S, Hemmeter U. Aspects of mental health care provision of the elderly in Switzerland. Geriatric Mental Health Care. 2013; 1(1):11–9. doi: 10.1016/j.gmhc.2012.11.002
  9. Berk, LE. Child development [Seyed Mohammadi Y, Persian trans]. Tehran: Arasbaran; 2008.
  10. Salehi F, Mohsenzade F, Arefi M. [Prevalence of death anxiety in patients with breast cancer in Kermanshah (Persian)]. Iranian Journal of Breast Disease. 2016; 8(4):34-41.
  11. Caplan H. Psychiatry [M. Sadeghi, M. Sadeghi, S. Mohsenifar, V. Shariat, A. Farhoodian, V. Sharifi, Persian Trans]. Tehran: Baraye Farda; 2002.
  12. Abbasi Z, Naderi F. [The relationship between spiritual intelligence, meaningful life and death anxiety and depression in cancer patients in Ahvaz (Persian)]. Paper presented at the 2nd National Conference and the 1st International Conference on New Research in the Humanities. 12 June 2015, Tehran, Iran.
  13. Naderi F, Roshani Kh. [The relationship between spiritual intelligence, social intelligence and death anxiety in the elderly (Persian)]. Woman and Culture. 2011; 2(6):55-67.
  14. Gobarybonab B, Salimi M, Sliani L, noorimoghadam S. [Spiritual intelligence (Persian)]. Research Quarterly in Islamic Theology (Kalam) and Religious Studies. 2007; 3(10):125-47.
  15. Abedini Y, Brat Dastjerdi N. [The relation between religiosity and spiritual intelligence and their effect on students' academic achievement (Persian)]. New Educational Approaches. 2014; 9(1):37-52.
  16. King DB. Rethinking claims of spiritual intelligence: A definition, model, & measure (MA thesis). Peterborough, Ontario: Trent university; 2008.
  17. Alavi S. [The relationship between spiritual intelligence and attitude to love and orientation to the relationship before marriage in Isfahan Industrial University (Persian)] [MA thesis]. Isfahan: Islamic Azad University; 2011. 
  18. Abdollahzadeh H. [Construction and standardization of spiritual intelligence questionnaire (Persian)]. Tehran: Psychometric; 2009.
  19. Salajegheh S, Raghibi M. [The effect of combined therapy of spiritual-cognitive group therapy on death anxiety in patients with cancer (Persian)]. Journal of Shahid Sadoughi University of Medical Sciences. 2014; 22(2):1130-9.
  20. Bairami M, Mohammad Panah Ardakan A, Faroughi P, Ghanei M. [Prediction of death anxiety based on spiritual intelligence of students in Ardakan university and seminary (Persian)]. Culture in the Islamic University. 2015; 5(1):21-37. 
  21. Jani S, Molaee M, Jangi S, Pooresmaili A. [Effectiveness of cognitive therapy based on religious believes on death anxiety, social adjustment and subjective well-being in the cancer patients (Persian)]. Journal of Medical Sciences. 2014; 22(5):94-103.
  22. Henrie J, Patrick JH. Religiousness, religious doubt, and death anxiety. The International Journal of Aging and Human Development. 2014; 78(3):203–27. doi: 10.2190/ag.78.3.a
  23. Amjad A. Death anxiety as a function of age and religiosity. Journal of Applied Environmental and Biological Sciences. 2014; 4(9):333-41.
  24. Naderi F, Esmaeli E. [The association Between Death Anxiety, Suicide ideation and wellbeing in Ahvaz I.A.U Students (Persian)]. Journal of Social Psychology. 2009; 2(8):35-52.
  25. Naderi F, Esmaeli E. [The association between death anxiety, suicide ideation and wellbeing in Ahvaz I.A.U students (Persian)]. Journal of Social Psychology. 2009; 2(8):35-52.
  26. Qorbanalipoor M, Esmaeili A. [The effectiveness of the therapy on the anxiety of death in the elderly (Persian)]. Counseling Culture and Psychotherapy. 2012; 3(9):53-68.
  27. Wong LP, Fung HH, Jiang D. Associations between religiosity and death attitudes: Different between Christians and Buddhists. Psychology of Religion and Spirituality. 2015; 7(1):70–9. doi: 10.1037/a0037993
  28. Sajid Ali Khan K, Vijayshri R, Farooqi FS. A study of religiosity in relation to spirituality and anxiety. International Journal of Advancements in Research Technology. 2014; 3(4):269-85.
  29. Pyne DA. A model of religion and death. The Journal of Socio-Economics. 2010; 39(1):46–54. doi: 10.1016/j.socec.2009.08.003
  30. Elmer LD, MacDonald DA, Friedman HL. Transpersonal psychology, physical health, and mental health: Theory, research, and practice. The Humanistic Psychologist. 2003; 31(2-3):159–81. doi: 10.1080/08873267.2003.9986929
  31. Azar M, Nohee S, Shafiee Kandjani AR. [Suicide (Persian)]. Tehran: Arjmand; 2006.
  32. Mabe PA, Josephson AM. Child and adolescent psychopathology: Spiritual and religious perspectives. Child and Adolescent Psychiatric Clinics of North America. 2004; 13(1):111–25. doi: 10.1016/s1056-4993(03)00091-9 
  33. Carr A. Positive psychology: The science of happiness and human strengths. New York: Routledge; 2011.
  34. Mabe PA, Josephson AM. Child and adolescent psychopathology: spiritual and religious perspectives. Child and Adolescent Psychiatric Clinics of North America. 2004; 13(1):111–25. doi: 10.1016/s1056-4993(03)00091-9
  35. Sim TN, Loh BSM. Attachment to god: Measurement and dynamics. Journal of Social and Personal Relationships. 2003; 20(3):373–89. doi: 10.1177/0265407503020003006
  36. Smucker CJ. Nursing, healing and spirituality. Complementary Therapies in Nursing and Midwifery. 1998; 4(4):95–7. doi: 10.1016/s1353-6117(98)80040-1
  37. Ziapour S S, Dusti Y, AbbasiAsfajir A. Correlation between religious orientation and death anxiety. Journal of Psychology & Behavioral Studies. 2014; 2(1):20-29. 
Type of Study: Research | Subject: Psychology
Received: 2017/09/07 | Accepted: 2018/01/08 | Published: 2018/04/01

References
1. Hojati H, Sharifnia H, Hoseinalipour S, Akhundzade G, Asayesh H. [The effect of reminiscence on the amount of group self-esteem and life satisfaction of the elderly (Persian)]. Journal of Nursing and Midwifery Urmia University of Medical Sciences. 2011; 9(5):350-6.
2. Riedel Heller SG, Busse A, Angermeyer MC. The state of mental health in old age across the 'old'European :union:–a systematic re-view. Acta Psychiatrica Scandinavica. 2006; 113(5):388-401. doi: 10.1111/j.1600-0447.2005.00632.x [DOI:10.1111/j.1600-0447.2005.00632.x]
3. Parmar D, Williams G, Dkhimi F. Enrolment of older people in social health protection programs in West Africa e Does social ex-clusion play a part. Social Science & Medicine. 2014; 119:36-44. [DOI:10.1016/j.socscimed.2014.08.011] [PMID]
4. Statistical Center of Iran. [General census of population and housing (Persian)]. Tehran: Statistical Center of Iran; 2016.
5. Tsai FJ, Motamed S, Rougemont A. The protective effect of taking care of grandchildren on elders' mental health? Associations be-tween changing patterns of intergenerational exchanges and the reduction of elders' loneliness and depression between 1993 and 2007 in Taiwan. BMC Public Health. 2013; 13(1). doi: 10.1186/1471-2458-13-567 [DOI:10.1186/1471-2458-13-567]
6. Bøen H, Dalgard OS, Johansen R, Nord E. A randomized controlled trial of a senior centre group programme for increasing social support and preventing depression in elderly people living at home in Norway. BMC Geriatrics. 2012; 12(1). doi: 10.1186/1471-2318-12-20 [DOI:10.1186/1471-2318-12-20]
7. Phabphal K, Geater A, Limapichat K, Sathirapanya P, Setthawatcharawanich S. Risk factors of recurrent seizure, co-morbidities, and mortality in new onset seizure in elderly. Seizure. 2013; 22(7):577–80. Doi: 10.1016/j.seizure.2013.04.009 [DOI:10.1016/j.seizure.2013.04.009]
8. Bährer-Kohler S, Hemmeter U. Aspects of mental health care provision of the elderly in Switzerland. Geriatric Mental Health Care. 2013; 1(1):11–9. doi: 10.1016/j.gmhc.2012.11.002 [DOI:10.1016/j.gmhc.2012.11.002]
9. Berk, LE. Child development [Seyed Mohammadi Y, Persian trans]. Tehran: Arasbaran; 2008.
10. Salehi F, Mohsenzade F, Arefi M. [Prevalence of death anxiety in patients with breast cancer in Kermanshah (Persian)]. Iranian Jour-nal of Breast Disease. 2016; 8(4):34-41.
11. Caplan H. Psychiatry [M. Sadeghi, M. Sadeghi, S. Mohsenifar, V. Shariat, A. Farhoodian, V. Sharifi, Persian Trans]. Tehran: Baraye Farda; 2002.
12. Abbasi Z, Naderi F. [The relationship between spiritual intelligence, meaningful life and death anxiety and depression in cancer pa-tients in Ahvaz (Persian)]. Paper presented at the 2nd National Conference and the 1st International Conference on New Research in the Humanities. 12 June 2015, Tehran, Iran.
13. Naderi F, Roshani Kh. [The relationship between spiritual intelligence, social intelligence and death anxiety in the elderly (Persian)]. Woman and Culture. 2011; 2(6):55-67.
14. Gobarybonab B, Salimi M, Sliani L, noorimoghadam S. [Spiritual intelligence (Persian)]. Research Quarterly in Islamic Theology (Kalam) and Religious Studies. 2007; 3(10):125-47.
15. Abedini Y, Brat Dastjerdi N. [The relation between religiosity and spiritual intelligence and their effect on students' academic achievement (Persian)]. New Educational Approaches. 2014; 9(1):37-52.
16. King DB. Rethinking claims of spiritual intelligence: A definition, model, & measure (MA thesis). Peterborough, Ontario: Trent uni-versity; 2008.
17. Alavi S. [The relationship between spiritual intelligence and attitude to love and orientation to the relationship before marriage in Is-fahan Industrial University (Persian)] [MA thesis]. Isfahan: Islamic Azad University; 2011.
18. Abdollahzadeh H. [Construction and standardization of spiritual intelligence questionnaire (Persian)]. Tehran: Psychometric; 2009.
19. Salajegheh S, Raghibi M. [The effect of combined therapy of spiritual-cognitive group therapy on death anxiety in patients with can-cer (Persian)]. Journal of Shahid Sadoughi University of Medical Sciences. 2014; 22(2):1130-9.
20. Bairami M, Mohammad Panah Ardakan A, Faroughi P, Ghanei M. [Prediction of death anxiety based on spiritual intelligence of students in Ardakan university and seminary (Persian)]. Culture in the Islamic University. 2015; 5(1):21-37.
21. Jani S, Molaee M, Jangi S, Pooresmaili A. [Effectiveness of cognitive therapy based on religious believes on death anxiety, social ad-justment and subjective well-being in the cancer patients (Persian)]. Journal of Medical Sciences. 2014; 22(5):94-103.
22. Henrie J, Patrick JH. Religiousness, religious doubt, and death anxiety. The International Journal of Aging and Human Develop-ment. 2014; 78(3):203–27. doi: 10.2190/ag.78.3.a [DOI:10.2190/AG.78.3.a]
23. Amjad A. Death anxiety as a function of age and religiosity. Journal of Applied Environmental and Biological Sciences. 2014; 4(9):333-41.
24. Naderi F, Esmaeli E. [The association Between Death Anxiety, Suicide ideation and wellbeing in Ahvaz I.A.U Students (Persian)]. Journal of Social Psychology. 2009; 2(8):35-52.
25. Naderi F, Esmaeli E. [The association between death anxiety, suicide ideation and wellbeing in Ahvaz I.A.U students (Persian)]. Journal of Social Psychology. 2009; 2(8):35-52.
26. Qorbanalipoor M, Esmaeili A. [The effectiveness of the therapy on the anxiety of death in the elderly (Persian)]. Counseling Culture and Psychotherapy. 2012; 3(9):53-68.
27. Wong LP, Fung HH, Jiang D. Associations between religiosity and death attitudes: Different between Christians and Buddhists. Psychology of Religion and Spirituality. 2015; 7(1):70–9. doi: 10.1037/a0037993 [DOI:10.1037/a0037993]
28. Sajid Ali Khan K, Vijayshri R, Farooqi FS. A study of religiosity in relation to spirituality and anxiety. International Journal of Ad-vancements in Research Technology. 2014; 3(4):269-85.
29. Pyne DA. A model of religion and death. The Journal of Socio-Economics. 2010; 39(1):46–54. doi: 10.1016/j.socec.2009.08.003 [DOI:10.1016/j.socec.2009.08.003]
30. Elmer LD, MacDonald DA, Friedman HL. Transpersonal psychology, physical health, and mental health: Theory, research, and practice. The Humanistic Psychologist. 2003; 31(2-3):159–81. doi: 10.1080/08873267.2003.9986929 [DOI:10.1080/08873267.2003.9986929]
31. Azar M, Nohee S, Shafiee Kandjani AR. [Suicide (Persian)]. Tehran: Arjmand; 2006.
32. Mabe PA, Josephson AM. Child and adolescent psychopathology: Spiritual and religious perspectives. Child and Adolescent Psy-chiatric Clinics of North America. 2004; 13(1):111–25. doi: 10.1016/s1056-4993(03)00091-9 [DOI:10.1016/S1056-4993(03)00091-9]
33. Carr A. Positive psychology: The science of happiness and human strengths. New York: Routledge; 2011.
34. Mabe PA, Josephson AM. Child and adolescent psychopathology: spiritual and religious perspectives. Child and Adolescent Psy-chiatric Clinics of North America. 2004; 13(1):111–25. doi: 10.1016/s1056-4993(03)00091-9 [DOI:10.1016/S1056-4993(03)00091-9]
35. Sim TN, Loh BSM. Attachment to god: Measurement and dynamics. Journal of Social and Personal Relationships. 2003; 20(3):373–89. doi: 10.1177/0265407503020003006 [DOI:10.1177/0265407503020003006]
36. Smucker CJ. Nursing, healing and spirituality. Complementary Therapies in Nursing and Midwifery. 1998; 4(4):95–7. doi: 10.1016/s1353-6117(98)80040-1 [DOI:10.1016/S1353-6117(98)80040-1]
37. Ziapour S S, Dusti Y, AbbasiAsfajir A. Correlation between religious orientation and death anxiety. Journal of Psychology & Behav-ioral Studies. 2014; 2(1):20-29.

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