Factors influencing death anxiety among Chinese patients with cancer: a cross-sectional study

Abstract

ObjectiveThe purpose of this study was to investigate death anxiety status among Chinese patients with cancer and identify factors that affect death anxiety.DesignCross-sectional study.SettingChangsha, Hunan Province, China.ParticipantsA total of 286 inpatients diagnosed with cancer were randomly recruited from a tertiary cancer centre and completed the questionnaires between January and June 2021.Primary and secondary outcome measuresThe primary outcome was the status of death anxiety. The secondary outcomes were the factors that affect death anxiety among Chinese patients with cancer.MethodsA total of 286 Chinese patients with cancer were recruited from a tertiary cancer hospital to complete the demographic and clinical characteristics questionnaire, Templer’s Death Anxiety Scale, Acceptance and Action Questionnaire-second edition, and Meaning in Life Questionnaire from January to June 2021. Data were analysed using t-test, analysis of variance, Kruskal-Wallis H test, Pearson correlation analysis and multiple linear regression analysis.ResultsOn average, patients with cancer scored 7.72±4.17 for death anxiety, 25.71±9.69 for experiential avoidance and 45.19±8.22 for meaning in life. Ultimately, the statistically significant factors influencing death anxiety were education levels, insurance, pain scores, experiential avoidance and meaning in life. These factors explained 40.6% of the difference in death anxiety.ConclusionsPatients with cancer in China experienced a high level of death anxiety. This study showed that experiential avoidance and meaning in life were important factors that affected death anxiety in patients with cancer. Further studies should be conducted to explore effective interventions to prevent experiential avoidance and increase meaning in life for patients with cancer. Attention should be paid to patients without insurance but with lower education levels and higher pain scores to ultimately relieve death anxiety and improve their quality of life.

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

“…Consistent with previous findings (Ding et al, 2015;Gong et al, 2022), we found that education level was negatively correlated with cancer death anxiety. This may be related to the lower education level of patients who are less well informed about their diagnosis and medical procedures and thus show intense fear.…”

“…Conversely, higher self-esteem (Yang et al, 2022), spiritual wellbeing (Scheffold et al, 2019), resilience (Gong et al, 2022) and quality of life (Soleimani et al, 2016) are related to lower levels of death anxiety.…”

“…At present, many studies have evaluated the factors related to cancer patients' death anxiety, including sociodemographic characteristics, disease factors and psychosocial factors (Emanuel et al., 2023; Hong et al., 2022). For example, younger age (Abbas et al., 2022), female (Abbas et al., 2022), lower education level (Gong et al., 2022), more severe symptom burden (Scheffold et al., 2018), higher depression levels (Afrashteh & Masoumi, 2021), higher anxiety levels (Afrashteh & Masoumi, 2021), greater fear of recurrence (Curran et al., 2020) and greater psychological distress (Gonen et al., 2012) are related to higher levels of death anxiety. Conversely, higher self‐esteem (Yang et al., 2022), spiritual well‐being (Scheffold et al., 2019), resilience (Gong et al., 2022) and quality of life (Soleimani et al., 2016) are related to lower levels of death anxiety.…”

“…For example, younger age (Abbas et al., 2022), female (Abbas et al., 2022), lower education level (Gong et al., 2022), more severe symptom burden (Scheffold et al., 2018), higher depression levels (Afrashteh & Masoumi, 2021), higher anxiety levels (Afrashteh & Masoumi, 2021), greater fear of recurrence (Curran et al., 2020) and greater psychological distress (Gonen et al., 2012) are related to higher levels of death anxiety. Conversely, higher self‐esteem (Yang et al., 2022), spiritual well‐being (Scheffold et al., 2019), resilience (Gong et al., 2022) and quality of life (Soleimani et al., 2016) are related to lower levels of death anxiety.…”

Eudaimonic Well-Being of Italian Young Adults during the COVID-19 Pandemic: The Role of Psychological Inflexibility and Fear of Death

“…Nonetheless, the findings of the only existing empirical study are coherent with the hypothesis that fear of death and psychological inflexibility might be positively associated. Gong et al [80], indeed, have recently investigated this subject in patients with cancer, showing a significant positive correlation, with a large magnitude (i.e., > .50), between experiential avoidance and death anxiety. Besides, research has highlighted the interplay between experiential avoidance, anxiety, and fear, showing that individuals who often employ experiential avoidance are more at risk for developing anxiety disorders [68], experience fear of intense emotions, and endorse more frequent worry [81].…”