Volume 19, Issue 1 (Spring 2024)                   Salmand: Iranian Journal of Ageing 2024, 19(1): 40-53 | Back to browse issues page


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Soleimanpour Manzari R, Moradi M, Sadeghmoghadam L. Effect of Psychological/Spiritual Self-care Education Through Telenursing on Death Anxiety of the Elderly During the COVID-19 Pandemic in Gonabad, Iran: A Randomized Controlled Clinical Trial. Salmand: Iranian Journal of Ageing 2024; 19 (1) :40-53
URL: http://salmandj.uswr.ac.ir/article-1-2508-en.html
1- Student Research Committee, Gonabad University of Medical Sciences, Gonabad, Iran.
2- Nursing Research Center, Gonabad University of Medical Sciences, Gonabad, Iran.
3- Department of Ageing Health, Faculty of Nursing, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran. , ls_moghadam@yahoo.com
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Introduction
The uncertain death rate and the rapid spread of COVID-19 caused a great psychological disorders among people, including depression, suicide and death anxiety [1, 2]. Death anxiety is a common problem among the elderly [3]. Death anxiety can affect the performance of daily tasks and the self-care ability of the elderly [4]. Therefore, appropriate interventions are necessary to reduce it [5]. One of the ways to reduce death anxiety is self-care education. Among the dimensions of self-care education, we can mention psychological and spiritual self-care skills. These skills can reduce anxiety and stress in people [6].
The increase in the use of telecommunication methods to provide health services for people with chronic conditions is one of the most promising developments in health care [7]. Among the methods of telecommunication, telephone calls are frequently used in remote nursing. Some studies have shown that telephone follow-up and distance education by nurses can lead to the improvement of self-care behaviors in patients [8]. The study aims to assess the effect of psychological/spiritual self-care education through telenursing on the death anxiety of healthy older adults in Gonabad, northern Iran, during the COVID-19 pandemic.

Methods
This is a randomized controlled clinical trial. The study population consists of all elderly people ≥60 years old under the coverage of urban community health centers in Gonabad county. The sample size was determined 12 per group using G*Power software based on a similar study [9]at a confidence level of 95% considering a test power of 90%. With a 10% probability of sample drop, it increased to 26 per group (52 in total). The criteria for entering the study were willingness to participate in the study, age 60 years or older, ability to hear and talk, cognitive health, being a Persian speaker, non-participation in any training course to relieve anxiety, having telephone at home, and having death anxiety. Exclusion criteria were psychiatric disorders or mental illnesses based on the medical records, not participating in face-to-face educational sessions, simultaneous participation in other educational programs, hospitalization or emotional trauma in the past 3 months, interruption of telephone communication for 2 weeks, hospitalization during the study, death of relatives and any similar unexpected events during the intervention. The tool used in this research was a two-part questionnaire that included a demographic form and the Templer death anxiety scale.
The participants were divided into two groups of intervention and control. The people in the intervention group were divided into two groups of 9 and one group of 8 (due to the prevention of the spread of COVID-19 and better compliance with health regulations). For each group, a one-hour face-to-face meeting was held in the community health center to provide information on aging, COVID-19 and ways to prevent it, death and fear of it, connection with and trust in God and his role in reducing anxiety, watching religious films, and listening to relaxation music. After providing face-to-face education, telephone follow-up was conducted twice a week in the first month and once a week in the second month. Also, a telephone number was provided to the elderly so that they could ask questions, if any. Each telephone conversation lasted 10-15 minutes. Then, immediately after the follow-up, the post-test assessment was conducted. To comply with ethical issues, after collecting the data, educational materials were provided to the control group. SPSS software was used to analyze the data. The significance level was set at 0.05.

Results
There was no significant difference in the demographic variables between the two groups (P>0.05). According to the independent t-test results, no significant difference was observed in death anxiety between the two groups before the intervention; however, the difference was statistically significant between two groups after the intervention. The difference in death anxiety of the two groups was statistically significant before and after the intervention (Table 1).



Conclusion
The results showed that psychological/spiritual self-care education through telenursing was effective in reducing the death anxiety of the elderly during the COVID-19 pandemic in Iran. It seems that this educational method is a good way to reduce the death anxiety of older adults. 

Ethical Considerations

Compliance with ethical guidelines

The study was approved by the Ethics Committee of Gonabad University of Medical Sciences (Code: IR.GMU.REC.1400.016).

Funding
This article is the result of a master's thesis of Ramin Soleimanpour Manzari, approved by Department of Nursing, Faculty of Nursing, Gonabad University of Medical Sciences.

Authors' contributions
All authors contributed equally to preparing this article.

Conflicts of interest
The authors declared no conflict of interest.

Acknowledgements
The researchers of this study are grateful for the cooperation of the Research and Technology Vice-Chancellor, the Health Vice-Chancellor of Gonabad University of Medical Sciences and the personnel of health centers and the elderly.

 
 
References
  1. Khajavian N, Mokhtari AM, Hosseinpour B, Eslami R, Hosseini Moghaddam F, Saadabadi F, et al. [Sleep quality and its related factors in the elderly of Gonabad city during the COVID-19 pandemic, 2021 (Persian)]. Journal of Gerontology. 2022; 7(3):25-36. [DOI:10.22034/JOGE.7.3.25]
  2. Liu S, Yang L, Zhang C, Xiang YT, Liu Z, Hu S, et al. Online mental health services in China during the COVID-19 outbreak. The Lancet Psychiatry. 2020; 7(4):e17-8. [DOI:10.1016/S2215-0366(20)30077-8] [PMID] [PMCID]
  3. Hosseini Moghaddam F, Amiri Delui M, Sadegh Moghadam L, Kameli F, Moradi M, Khajavian N, et al. [Prevalence of depression and its related factors during the COVID-19 quarantine among the elderly in Iran (Persian)]. Salmand. 2021; 16(1):140-51. [DOI:10.32598/sija.16.1.2850.1]
  4. Hossein Nazari N, Nejat H, Saffarian Tosi M. The comparison of the effectiveness of well-being therapy with acceptance and commitment therapy on death anxiety in the elderly (Persian)]. Aging Psychology. 2022; 8(1):38-25. [DOI:10.22126/JAP.2022.7478.1605]
  5. Sadri Demichi E, Ramezani S. [Effectiveness of existential therapy on loneliness and death anxiety in the elderly (Persian)]. Aging Psychology. 2016; 2(1):1-12. [Link]
  6. Stancliffe RJ, Wiese MY, Read S, Jeltes G, Clayton JM. Knowing, planning for and fearing death: Do adults with intellectual disability and disability staff differ? Research in Developmental Disabilities. 2016; 49-50:47-59. [DOI:10.1016/j.ridd.2015.11.016] [PMID]
  7. Majidi S, Bolourchifard F, Esmaeili R, Zolghadr Z. [The correlation between death anxieties with self-care in elderly patients with chronic obstructive pulmonary disease referring to masih daneshvari hospital, 2018 (Persian)]. Journal of Gerontology. 2019; 4(3):1-8. [DOI:10.29252/joge.4.2.1]
  8. Poordad S, Momeni K, karami J. [Death anxiety and its relationship with social support and gratitude in older adults (Persian)]. Salmand. 2019; 14(1):26-39. [DOI:10.32598/sija.13.10.320]
  9. Mardani Chamazkotih F, Ajam Zibad H, Sadeghmoghadam L. [The effect of psychosocial self-care education on retirement syndrome in educators: A quasi-experimental study (Persian)]. Salmand. 2022; 17(1):16-27. [DOI:10.32598/sija.2021.972.3]
  10. Hemmati Maslak Pak M, Hashemlo L. [Design and psychometric properties of a self-care questionnaire for the elderly (Persian)]. Salmand. 2015; 10(3):120-31. [Link]
  11. Firooz M, Mazlom R, Hoseini J, Hasanzadeh F, Kimiae A. [Comparison between the effect of group education and group counseling on emotional self-care in type II diabetics (Persian)]. Journal of Birjand University of Medical Sciences. 2015; 22(4):293-303. [Link]
  12. Dalir M, Mashouf S, Esmailpourzanjani S. [The effect of spiritual self-care education on the care burden of mothers with children hospitalized in intensive care units for open heart surgery (Persian)]. Complementary Medicine Journal. 2020; 10(1):34-45. [DOI:10.32598/cmja.10.1.866.1]
  13. Puchalski CM, Vitillo R, Hull SK, Reller N. Improving the spiritual dimension of whole person care: Reaching national and international consensus. Journal of Palliative Medicine. 2014; 17(6):642-56. [DOI:10.1089/jpm.2014.9427] [PMID] [PMCID]
  14. Ravari A, Mirzaei T, Salamizadeh A, Askari Majdabadi H. [Effect of the spiritual care training on anxiety reduction in home caregivers of the elderly with Alzheimer disease (Persian)]. Koomesh. 2017; 19(2):467-74. [Link]
  15. Valikhani A, Yarmohammadi-Vasel M. [The relationship between attachment styles and death anxiety among cardiovascular patients (Persian)]. Journal of Kerman University of Medical Sciences. 2014; 21(4):355-67. [Link]
  16. Moradi M, Ebrahimi H, Goli S, Khajeh M. [The effect of sleep health education program based on continuous care model on sleep quality in the elderly (Persian)]. Iranian Journal of Health Education and Health Promotion. 2022; 10(2):171-84. [DOI:10.52547/ijhehp.10.2.6]
  17. Weinert C, Cudney S, Hill WG. Rural women, technology, and self-management of chronic illness. The Canadian Journal of Nursing Research. 2008; 40(3):114-34. [PMID] [PMCID]
  18. Berkhof FF, van den Berg JW, Uil SM, Kerstjens HA. Telemedicine, the effect of nurse-initiated telephone follow up, on health status and health-care utilization in COPD patients: A randomized trial. Respirology. 2015; 20(2):279-85. [DOI:10.1111/resp.12437] [PMID]
  19. Zakerimoghadam M, Bassampour S, Rjab A, Faghihzadeh S, Nesari M. [Effect of nurse-led telephone follow ups (tele-nursing) on diet adherence among type 2 diabetic patients (Persian)]. Journal of Hayat. 2008; 14(2):63-71. [Link]
  20. Ahmadi Babadi S, Sadeghmoghadam L, Delshad Noghabi A. [Comparing the effectiveness of telenursing with in-person follow up on the feeling of loneliness among the elderly in community health centers in Ahvaz in 2017 (Persian)]. Journal of Gerontology. 2017;2(2):58-65. [DOI:10.29252/joge.2.2.58]
  21. Barbosa Ide A, Silva KC, Silva VA, Silva MJ. [The communication process in Telenursing: Integrative review (English, Portuguese)]. Revista Brasileira de Enfermagem. 2016; 69(4):765-72. [DOI:10.1590/0034-7167.2016690421i] [PMID]
  22. Bani Ardalan H, Motalebi SA, Shahrokhi A, Mohammadi F. [Effect of education and telephone follow-up on care burden of caregivers of older patients with stroke (Persian)]. Salmand. 2022; 17(2):290-303 [DOI:10.32598/sija.2022.2183.3]
  23. Mamashli L, Bekmaz K, Mohammad pour Y. [Telenursing In Cardiovascular Diseases: A critical review of systematic reviews of evidence (Persian)]. Sciences Medical in Review Systematic of Journal Iranian. 2022; 2(2):20-32. [Link]
  24. Moradi M, Mohammadzadeh H, Noori R, Basiri Moghadam K, Sadeghmoghadam L. [Effect of a sleep hygiene education program using telephone follow-up method on the sleep quality of the elderly (Persian)]. Salmand. 2021; 15(4):484-95. [DOI:10.32598/sija.15.4.2895.1]
  25. Shirazi Khah M, Mousavi M, Sahaf R. [Study of health and social indicators of elderly women in Iran (Persian)]. Salmand. 2012; 6(S1):66-78. [Link]
  26. Mirhosseini S, Nouhi S, Janbozorgi M, Mohajer H, Naseryfadafan M. [The role of spiritual health and religious coping in predicting death anxiety among patients with coronavirus (Persian)]. Studies in Islam and Psychology. 2020; 14(26):29-42. [DOI:10.30471/psy.2020.6545.1701]
  27. Aloustani S, Mamashli L. [The effect of spiritual group therapy on death anxiety in the elderly (Persian)]. Journal of Hayat. 2020; 26(1):46-57. [Link]
  28. Kakabaraei K, Moazinejad M. [The relationship between finding meaning in life and demographic characteristics with death anxiety in the elderly (Persian)]. Aging Psychology. 2016; 2(1):47-37. [Link]
  29. Hodkinson HM. Evaluation of a mental test score for assessment of mental impairment in the elderly. Age and Ageing. 1972; 1(4):233-8. [DOI:10.1093/ageing/1.4.233] [PMID]
  30. Bakhtiyari F, Foroughan M, Fakhrzadeh H, Nazari N, Najafi B, Alizadeh M, et al. [Validation of the persian version of abbreviated mental test (AMT) in elderly residents of Kahrizak charity foundation (Persian)]. Iranian Journal of Diabetes and Lipid Disorders. 2014; 13(6):487-94. [Link]
  31. Mirhosseini S, Dadgari A, Basirinezhad MH, Mohammadpourhodki R, Ebrahimi H. The proportion of death anxiety and its related factors during the COVID-19 pandemic in the Iranian population. Family Medicine & Primary Care Review. 2021; 23(1):36-40. [DOI:10.5114/fmpcr.2021.103154]
  32. Guner TA, Erdogan Z, Demir I. The effect of loneliness on death anxiety in the elderly during the COVID-19 pandemic. OMEGA-Journal of Death and Dying. 2023; 87(1):262-82. [DOI:10.1177/00302228211010587]
  33. Özgüç S, Kaplan Serin E, Tanriverdi D. Death anxiety associated with coronavirus (COVID-19) disease: A systematic review and meta-analysis. Omega. 2024; 88(3):823-56. [DOI:10.1177/00302228211050503] [PMID] [PMCID]
  34. Kim S, Park KS. A meta analysis on variables related to death anxiety of elderly in Korea. Korean Journal of Adult Nursing. 2016; 28(2):156-68. [DOI:10.7475/kjan.2016.28.2.156]
  35. Budhiraja A, Midha P. Buffering power of spirituality against death anxiety. International Journal of Indian Psychology. 2017; 4(2):59-65. [DOI:10.25215/0402.146]
  36. Henrie J, Patrick JH. Religiousness, religious doubt, and death anxiety. International Journal of Aging & Human Development. 2014; 78(3):203-27. [DOI:10.2190/AG.78.3.a] [PMID]
  37. Safouraei Parizi S, Naderi F, Safouraei Pariz M. جThe moderating role of spiritual intelligence in the relationship between social support and death anxiety in COVID-19 patients (Persian)]. Islam and Psychological Research. 2020; 2(2):137-59. [Link]
  38. Rezaei J. [Effect of cognitive-behavioral group therapy with emphasis on islamic-based spiritual beliefs on increasing the spirituality and mental health of multiple sclerosis patients; A case study of Markazi province, Iran (Persian)]. Islamic Life Journal. 2018; 2(1):5-12. [Link]
  39. Reyhani T, Pourghaznain T, Mousavi Z, Ghorbani S. [The effects of presence and guidance of a teacher on the anxiety of hospitalized children (Persian)]. Evidence Based Care Journal. 2014; 4(3):15-22. [DOI:10.22038/ebcj.2014.2395]
  40. Ghorbanalipur M, Esmaeili A. [Determining the efficacy of logo therapy in death anxiety among the older adults (Persian)]. Counseling Culture and Psycotherapy. 2012; 3(9):53-68. [DOI:10.22054/qccpc.2012.6063]
  41. Dashtbozorgi Z, Sevari K, Safarzadeh S. [Effectiveness of Islamic spiritual therapy on the feeling of loneliness and death anxiety in elderly people (Persian)]. Aging Psychology. 2016; 2(3):177-86. [Link]
  42. Hermans H, Beekman AT, Evenhuis HM. Comparison of anxiety as reported by older people with intellectual disabilities and by older people with normal intelligence. The American Journal of Geriatric Psychiatry. 2014; 22(12):1391-8. [DOI:10.1016/j.jagp.2013.0qr4.017] [PMID]
  43. Majidi A, Moradi O. [Effect of teaching the components of spiritual intelligence on death anxiety in the elderly (Persian)]. Salmand. 2018; 13(1):110-23. [DOI:10.21859/sija.13.1.110]
  44. Abdel-Khalek A, Lester D. Religiosity and death anxiety: No association in Kuwait. Psychological Reports. 2009; 104(3):770-2.[DOI:10.2466/PR0.104.3.770-772] [PMID]
  45. Hajatnia B, Tajeri B, Haji Alizadeh K. [The effectiveness of spiritual therapy on the quality of sleep, resilience, and death anxiety of the elderly (Persian)]. Journal of Preventive Medicine. 2021; 8(2):26-17. [Link]
  46. Mostafapour V, Motamedi A, Farrokhi H. [The effectiveness of group logo-therapy on the sense of loneliness and death anxiety in elderly women (Persian)]. Scientific Research Quarterly of Woman and Culture. 2018; 10(36):23-36. [Link]
  47. Khodabakhshi-Koolaee A, Heidari F, Zangeneh Motlagh F. [The effect of mixed prayer and positive psychology group therapy on life meaning and death anxiety among elderly women with physical-motor disabilities (Persian)]. Journal of Research on Religion & Health. 2018; 4(2):16-28. [Link]
  48. Pahlavan A, Ahi G. [Effectiveness of positive psychology interventions on death anxiety and sleep quality of female patients with multiple sclerosis (MS) (Persian)]. Research in Clinical Psychology and Counseling. 2020; 9(2):28-42. [DOI:10.22067/ijap.v9i2.73050]
Type of Study: Research | Subject: gerontology
Received: 2022/09/21 | Accepted: 2023/06/20 | Published: 2024/04/01

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