Volume 16, Issue 2 (Summer 2021)                   Salmand: Iranian Journal of Ageing 2021, 16(2): 152-171 | Back to browse issues page


XML Persian Abstract Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Khalvati M, Babakhanian M, Khalvati M, Nafei A, Khalvati M, Ghafuri R. Death Anxiety in the Elderly in Iran: A Systematic Review and Meta-analysis. Salmand: Iranian Journal of Ageing 2021; 16 (2) :152-171
URL: http://salmandj.uswr.ac.ir/article-1-2028-en.html
1- Department of Social Work, Faculty of Paramedical, Mashhad University of Medical Sciences, Mashhad, Iran.
2- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran. , babakhanian.m@gmail.com
3- Department of English Literature, Faculty of Human Sciences, University of South Africa, Pretoria, South Africa.
4- Department of Social Welfare Management, University of Social Welfare and Rehabilitation Science (USWR), Tehran, Iran.
5- Department of French Literature, Faculty of Foreign Languages, Central Tehran Branch, Islamic Azad University, Tehran, Iran.
6- Education Organization of District 9, Tehran, Iran.
Abstract:   (8102 Views)
Objectives: Aging is one of the most critical stages of human development that has its own characteristics and conditions. One of the most common issues in old age is the mental health whose achievement requires special attention from both health system policymakers and service providers to the elderly. Death anxiety is one of the most common mental health issues in old age, because this period is full of feelings of shortcomings and disabilities. Since death anxiety is a multidimensional factor, it is expected to affect many aspects of the elderly. The present study aims to review and analyze published studies in the field of death anxiety in the elderly in Iran. 
Methods & Materials: This is a systematic review and meta-analysis conducted on the studies related to the death anxiety of the elderly in Iran published in Persian from 2011 to 2019. A search was conducted in national databases, including SID, IranDoc, MagIran, IDML, and CIVILICA using the keywords: Death anxiety, elderly, and older adult. Initial search yielded 61 articles. After screening, 33 studies that met the entry and exit criteria were selected for the final review. We used Stata v. 14 and SPSS v. 22 applications to perform meta-analysis.
Results: In the studies, 40.35% of the participants were older women and the rest were older men with a mean age of 67.80±6.44 years. The mean score of death anxiety was higher in men than in women, and the elderly living in nursing homes had the highest score (11.8). Studies were categorized into three sections: comparison (3 studies), intervention (11 studies), and factors affecting the death anxiety (18 studies). The results of meta-analysis showed no significant relationship between spiritual therapy and reduction of death anxiety in the elderly (P>0.05). In studies with spiritual and behavioral therapies, the heterogeneity was significant and, thus, a significant positive relationship was observed between the reduction of death anxiety and these treatments methods.
Conclusion: The death anxiety level of the elderly in Iran is low. Religious beliefs, hopes for the intercession of imams and religious leaders, and hopes for freedom from the hardships of worldly life seem to have contributed to low death anxiety in Iran. Different death anxiety scores have been reported for older men and women in Iran may be due to the effect of culture, religion, and traditions, the difference in the roles of men and women, and even the expression of fear and anxiety. Most of men have less tendency to express their emotions, including fear, while women are more likely to express their feelings. Behavioral and spiritual interventions lead to a decrease in the elderly’s death anxiety through affecting their finding meaning in life.
Full-Text [PDF 7775 kb]   (4431 Downloads) |   |   Full-Text (HTML)  (5979 Views)  
Type of Study: Research | Subject: Psychology
Received: 2020/05/25 | Accepted: 2020/11/02 | Published: 2021/07/01

References
1. Nations U. World population ageing 2013. Department of Economic and Social Affairs PD; 2013.
2. Salehi F, Mohsenzade F, Arefi M. Prevalence of death anxiety in patients with breast cancer in Kermanshah, 2015. Iranian Quarterly Journal Of Breast Disease. 2016;8(4):34-40.
3. Templer DI. The construction and validation of a death anxiety scale. The Journal of general psychology. 1970;82(2):165-77. [DOI:10.1080/00221309.1970.9920634]
4. Lehto RH, KF. S. Death anxiety: An analysis of an evolving concept. Research and Theory for Nursing Practice. 2009;23(1):23-41. [DOI:10.1891/1541-6577.23.1.23]
5. Belsky J. Developmental origins of attachment styles. Attachment & human development. 2002;4(2):166-70. [DOI:10.1080/14616730210157510]
6. Thiemann P, Quince T, Benson J, Wood D, Barclay S. Medical students' death anxiety: Severity and association with psychological health and attitudes toward palliative care. Journal of pain and symptom management. 2015;50(3):335-42. e2. [DOI:10.1016/j.jpainsymman.2015.03.014]
7. Caplan H. Psychiatry Tehran: Baraye Farda; 2002.
8. Brody CM, VG. S. Strategies for therapy with the elderly: Living with hope and meaning. New York: Springer Publishing Company; 2005.
9. Shafaii M, Payami M, Amini K, S. P. [The relationship between death anxiety and quality of life in hemodialysis patients]. J Hayat. 2017;22(4):325-38.
10. Yoo YS, Cho OH, Cha KS, YJ. B. Factors influencing post-traumatic stress in Korean forensic science investigators. Asian Nursing Research. 2013;7(3):136-41. [DOI:10.1016/j.anr.2013.07.002]
11. Valikhani A, A. F. [Examining death anxiety within the framework of attachment styles in cancer patients: A comparative study]. Health Psychol. 2016;5(18):119-30.
12. Geurtsen L. A multidimensional approach of death anxiety: physical health, gender and psychosocial correlates in a community sample and a clinical sample of Dutch elderly people. Utrecht: Utrecht University; 2010.
13. Khaki S, Khesali Z, Farajzadeh M, Dalvand S, Moslemi B, Ghanei Gheshlagh R. The relationship of depression and death anxiety to the quality of life among the elderly population. Journal of hayat. 2017;23(2):152-61.
14. Khodabakhshi-Koolaee A, Heidari F, Motlagh FZ. The effect of mixed prayer and positive psychology group therapy on life meaning and death anxiety among elderly women with physical-motor disabilities. Journal of Research on Religion & Health. 2018;4(2):16-28.
15. Varaee P, Momeni K, Moradi A. Prediction of psychological well-being based on attitude toward religion and death anxiety in the elderly men of Kermanshah's part-time elderly care center. Journal of Research on Religion & Health. 2018;4(2):54-68.
16. Majidi A, Moradi O. Effect of Teaching the Components of Spiritual Intelligence on Death Anxiety in the Elderly. Iranian Journal of Ageing. 2018;13(1):110-23. [DOI:10.21859/sija.13.1.110]
17. Bitarafan L, Kazemi M, Yousefi Afrashte M. Relationship between styles of attachment to god and death anxiety resilience in the elderly. Iranian Journal of Ageing. 2018;12(4):446-57. [DOI:10.21859/sija.12.4.446]
18. Samadifard H, Narimani M. Prediction of Death Anxiety of Elderly Based on Mindfulness and Irrational Beliefs. Iran J Psychiatr Nurs. 2017;5(3):15-21. [DOI:10.21859/ijpn-05033]
19. Ghadampour E, Moshrefi S. Relationship Between Spiritual Health, Mental Well-Being And Quality Of Life With Death Anxiety In The Elderly. aging psychology. 2017;3(2):97-106.
20. Hajiazizi AH, Bahmani B, Mahdi N, Manzari Tavakoli V, Barshan A. Effectiveness of Group Logotherapy on Death Anxiety and Life Expectancy of the Elderly Living in Boarding Houses in Kerman. Iranian Journal of Ageing. 2017;12(2):220-31. [DOI:10.21859/sija-1202220]
21. Hashemi Razini H, Baheshmat Juybari S, Ramshini M. Relationship Between Coping Strategies and Locus of Control With the Anxiety of Death in Old People. Iranian Journal of Ageing. 2017;12(2):232-41. [DOI:10.21859/sija-1202232]
22. Aqajani S, Samadifard H. The role of cognitive fusion, locus of control and cognitive avoidance in the prediction of death anxiety in the elderly. Journal of Health and Care. 2017;19(1):62-74.
23. Mehri Nejad SA, Ramezan Saatchi L, Paydar S. Death anxiety and its relationship with social support and adherence to religion in the elderly. Iranian journal of Ageing. 2017;11(4):494-503. [DOI:10.21859/sija-1104494]
24. Golmohammadian M, Nazari H, Parvaneh A. Effectiveness of group logo therapy on death anxiety and social adjustment of elderly men. Journal of Aging Psychology. 2017;2(3):175-67.
25. Dashtbozorgi Z, Sevari K, Safarzadeh S. Effectiveness of Islamic Spiritual Therapy on The Feeling of Loneliness and Death Anxiety in Elderly People. aging psychology. 2016;3(3):177-86.
26. Moradi A, Shariatmadari A. The Comparison Between Death Anxiety and Loneliness Among the Elderly With Optimistic and Pessimistic Life Orientation. aging psychology. 2017;2(2):133-41.
27. Gholmi M, hafezi F, Askari P, Naderi f. The Comparison between the Effectiveness of Mindfulness and Spiritual/Religious Coping Skills on Death Anxiety and Blood pressure of the Elderly Patients with Hypertension. aging psychology. 2017;2(2):143-51.
28. Zeraati M, Haghani Zemeidani M, J KS. The comparison of depression and death anxiety among nursing home resident and non-resident elderlies. Iran Journal of Nursing. 2016;29(102):4554. [DOI:10.29252/ijn.29.102.45]
29. Sadri De, S. R. Effectiveness Of Existential Therapy On Loneliness And Death Anxiety In The Elderly. aging psychology. 2016;2(1):1-12.
30. Kakabaraei K, Moazinejad M. The Relationship Between Finding Meaning in Life and Demographic Characteristics with Death Anxiety in the Elderly. aging psychology. 2016;2(1):37-47.
31. Dehghan K, Shariatmadar A, Kalantar Hormozi A. effectiveness of life review therapy on death anxiety and life satisfaction of old women of Tehran. ounseling Culture and Psychotherapy. 2015;6(22):15-39.
32. Moetamedi A, Pajouhinia S, Fatemi A. The Impact of Spiritual Wellbeing and Resiliency in Predicting Death Anxiety among Elderly People in Tehran. Shefaye Khatam. 2015;3(2):19-26. [DOI:10.18869/acadpub.shefa.3.2.19]
33. Valaei N, Zalipoor S. The Effectiveness of Logo Therapy on Death Anxiety in the Elderly. aging psychology. 2015;1(1):49-55.
34. Ghorbanalipur M, Esmaeili A. Determining the Efficacy of Logo Therapy in Death Anxiety among the Older Adults. Counseling Culture and Psycotherapy. 2012;3(9):53-68.
35. Roushani K, Naderi F. Spiritual Intelligence, Social Intelligence And Death Anxiety Associations In Ahwas Metropolitan Senile. Quarterly Journal Of Health Psychology. 2011;1(2):115-29.
36. Aliakbari DM, Oraki M, Barghi IZ. Relation betweereligious orientation with anxiety about death, and alienation in aged peoples (seniors) in Tehran. social psychology research. 2011;2(1):140-59.
37. Varaee P, Momeni K, Moradi A. Prediction of psychological well-being based on attitude toward religion and death anxiety in the elderly men of Kermanshah's part-time elderly care center Journal of Research on Religion & Health. 2018;4(2):54-68.
38. Hosseini RS, Ebrahimi I, Khalkhali V. The Relationship Between Elderly's Fear of Death and Religious Beliefs and Mental Disorders in Karaj Nursing Homes Salmand: Iranian Journal of Ageing. 2019;14(2):144-61.
39. Poordad S, Momeni KM, Karami J. Death Anxiety and its Relationship with Social Support and gratitude in the Elderly. Iranian Journal of Ageing. 2019;14(1):26-39.
40. Varaee P, Momeni K, Morad A. Structural Equation Modeling a Study on the Effect of Religious Orientation on Psychological Well-Being With Respect to the Mediating Role of Death Anxiety and Self- Compassion in the Elderly Man of Kermanshah in 2017 Iranian Journal of Ageing 2019;14(2):162-77. [DOI:10.32598/sija.13.10.360]
41. Nouhi E, Karimi T, Iranmanesh S. Comparing Fear of Death of the Elderly Settled in Elderly's Home and Inhabited in City Houses of Isfahan. Salmand: Iranian Journal of Ageing. 2014;8(4):24-31.
42. Etemad J, Dehghan Manshadi Z, Mozafari N. Investigation on psychometric properties of Existential Anxiety Questionnaire in elderly. Journal of Gerontology. 2017;1(3):39-48. [DOI:10.18869/acadpub.joge.1.3.39]
43. Khodabakhsh Pirkalani R, Ramezan Saatchi L, Maleki Majd M. The Effectiveness of Mindfulness-Based Cognitive Therapy (MBCT( on Depression, Death Anxiety and Life Expectancy in Elderly Women. Journal of Gerontology. 2019;3(2):11-20. [DOI:10.29252/joge.3.2.11]
44. Salaripour SM, Maktabi G, Alipour S. Relationship between emotional intelligence and religious orientation with death anxiety in retired male employees of Khuzestan Steel Industries of Ahvaz. Counseling Culture and Psycotherapy. 2018;9(33):99-117.
45. Hasanali; V, Barzeghar; bM, yousefvand leila. The Relationship Between Religious Orientation and Death Anxiety in the Elderly: The Mediation Role of Aging Perception and Spiritual Well-Being. aging psychology. 2018;3(4):281-91.
46. Zhang J, Peng J, Gao P, Huang H, Cao Y, Zheng L, et al. Relationship between meaning in life and death anxiety in the elderly: self-esteem as a mediator. BMC geriatrics. 2019;19(1):308. [DOI:10.1186/s12877-019-1316-7]
47. Assari S, Lankarani MM. Race and gender differences in correlates of death anxiety among elderly in the United States. Iranian journal of psychiatry and behavioral sciences. 2016;10(2). [DOI:10.17795/ijpbs-2024]
48. Wu AM, Tang CS, Kwok TC. Death anxiety among Chinese elderly people in Hong Kong. Journal of Aging and Health. 2002;14(1):42-56. [DOI:10.1177/089826430201400103]
49. Schumaker JF, Warren WG, Groth-Marnat G. Death anxiety in Japan and Australia. The Journal of social psychology. 1991;131(4):511-8. [DOI:10.1080/00224545.1991.9713881]
50. Cicirelli VG. Personality and demographic factors in older adults' fear of death. The Gerontologist. 1999;39(5):569-79. [DOI:10.1093/geront/39.5.569]
51. Depaola SJ, Griffin M, Young JR, Neimeyer RA. Death anxiety and attitudes towardthe elderly among older adults: The Role of gender and ethnicity. Death studies. 2003;27(4):335-54. [DOI:10.1080/07481180302904]
52. Abdel-Khalek AM. Love of life and death distress: Two separate factors. OMEGA-Journal of Death and Dying. 2007;55(4):267-78. [DOI:10.2190/OM.55.4.b]
53. Suhail K, Akram S. Correlates of death anxiety in Pakistan. Death studies. 2002;26(1):39-50. [DOI:10.1080/07481180210146]
54. Azaiza F, Ron P, Shoham M, Gigini I. Death and dying anxiety among elderly Arab Muslims in Israel. Death Studies. 2010;34(4):351-64. [DOI:10.1080/07481181003613941]
55. Sharma P, Asthana H, Gambhir I, Ranjan JK. Death Anxiety among Elderly People: Role of Gender, Spirituality and Mental Health. Indian Journal of Gerontology. 2019;33(3).
56. Fortner BV, Neimeyer RA. Death anxiety in older adults: A quantitative review. Death studies. 1999;23(5):387-411. [DOI:10.1080/074811899200920]
57. Comstock GW, Partridge KB. Church attendance and health. Journal of chronic diseases. 1972;25(12):665-72. [DOI:10.1016/0021-9681(72)90002-1]
58. Busari AO. Relationship between Emotional Intelligence, Self-Esteem, Anxiety and Academic Stress of the Gifted Children in Oyo State, Nigeria. Global Journal of Human Social Science. 2016;XVI (V):22-34.
59. Espinoza M, Sanhueza O. Fear of death and its relationship with emotional intelligence of nursing students in Concepción. Acta Paulista de Enfermagem. 2012;25(4):607-13. [DOI:10.1590/S0103-21002012000400020]
60. Wnuk M, Marcinkowski JT. Do existential variables mediate between religious-spiritual facets of functionality and psychological wellbeing. Journal of religion and health. 2014;53(1):56-67. [DOI:10.1007/s10943-012-9597-6]
61. Lau RW, Cheng S-T. Gratitude lessens death anxiety. European Journal of Ageing. 2011;8(3):169. [DOI:10.1007/s10433-011-0195-3]
62. Tajvar M, Fletcher A, Grundy E, Arab M. Social support and health of older people in M iddle E astern countries: A systematic review. Australasian journal on ageing. 2013;32(2):71-8. [DOI:10.1111/j.1741-6612.2012.00639.x]
63. Khawar M, Aslam N, Aamir S. Perceived social support and death anxiety among patients with chronic diseases. Pakistan Journal of Medical Research. 2013;52(3):75.
64. Wu AM, Tang CS, Yogo M. Death anxiety, altruism, self‐efficacy, and organ donation intention among J apanese college students: A moderated mediation analysis. Australian Journal of Psychology. 2013;65(2):115-23. [DOI:10.1111/ajpy.12003]
65. Jans-Beken L, Lataster J, Peels D, Lechner L, Jacobs N. Gratitude, psychopathology and subjective well-being: Results from a 7.5-month prospective general population study. Journal of Happiness Studies. 2018;19(6):1673-89. [DOI:10.1007/s10902-017-9893-7]
66. Davis DE, Choe E, Meyers J, Wade N, Varjas K, Gifford A, et al. Thankful for the little things: A meta-analysis of gratitude interventions. Journal of counseling psychology. 2016;63(1):20. [DOI:10.1037/cou0000107]
67. Ramírez E, Ortega AR, Chamorro A, Colmenero JM. A program of positive intervention in the elderly: Memories, gratitude and forgiveness. Aging & mental health. 2014;18(4):463-70. [DOI:10.1080/13607863.2013.856858]
68. Yalom Irvin D. Existential psychiatrist. Tehran Nashre Ney; 2013.
69. Gillanders DT, Sinclair AK, MacLean M, Jardine K. Illness cognitions, cognitive fusion, avoidance and self-compassion as predictors of distress and quality of life in a heterogeneous sample of adults, after cancer. Journal of Contextual Behavioral Science. 2015;4(4):300-11. [DOI:10.1016/j.jcbs.2015.07.003]
70. Trindade IA, Ferreira C. The impact of body image-related cognitive fusion on eating psychopathology. Eating Behaviors. 2014;15(1):72-5. [DOI:10.1016/j.eatbeh.2013.10.014]
71. Kashdan TB, Breen WE, Afram A, Terhar D. Experiential avoidance in idiographic, autobiographical memories: Construct validity and links to social anxiety, depressive, and anger symptoms. Journal of anxiety disorders. 2010;24(5):528-34. [DOI:10.1016/j.janxdis.2010.03.010]
72. Dickson KS, Ciesla JA, Reilly LC. Rumination, worry, cognitive avoidance, and behavioral avoidance: Examination of temporal effects. Behavior therapy. 2012;43(3):629-40. [DOI:10.1016/j.beth.2011.11.002]
73. Rajagopal D, Mackenzie E, Bailey C, Lavizzo-Mourey R. The effectiveness of a spiritually-based intervention to alleviate subsyndromal anxiety and minor depression among older adults. Journal of Religion and Health. 2002;41(2):153-66. [DOI:10.1023/A:1015854226937]
74. Gire JT. How death imitates life: Cultural influences on conceptions of death and dying. Online Readings in Psychology and Culture. 2002;3(2):2.
75. Kang K, Im J, Kim H, Kim S, Song M, Sim S. The Effect Of Logotherapy on The Suffering, Finding Meaning, and Spiritual Well-Being of Adolescents with Terminal Cancer. Journal of Current Directions in Psychological Science. 2009;15(2):136-44. [DOI:10.4094/jkachn.2009.15.2.136]
76. Kastenbaum R. Death anxiety. Encyclopedia of Stress ed. New York: Academic Press; 2007. [DOI:10.1016/B978-012373947-6.00113-6]

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2024 CC BY-NC 4.0 | Iranian Journal of Ageing

Designed & Developed by : Yektaweb