Death Anxiety in the Elderly: The Role of Spiritual Health and Perceived Social Support

Document Type : Original Article

Authors

1 Assistant Professor, Department of Counseling, Faculty of Literature and Humanities, Shahrekord University, Shahrekord, I.R. Iran.

2 Bachelor of Counseling, Faculty of Literature and Humanities, Shahrekord University, Shahrekord, I.R. Iran

Abstract

Aging as one of the most important periods of life is associated with many challenges including death anxiety. Therefore, the aim of the current study was to investigate the role of spiritual health and perceived social support in predicting death anxiety in the elderly. The present study was a descriptive-correlational one. The study population consisted of the elderly living in Shahrekord in 2020, among whom 385 were selected using convenience sampling method and were assessed by the scales of Templer Death Anxiety, Zemen Perceived Social Support and Paloutzian & Ellison spiritual health. Data were analyzed using correlation coefficient and linear regression analysis in SPSS software version 22. The results indicated that there is a significant relationship between spiritual health (r=-0.51), perceived social support by family (r=-0.37), friends (r=-0.30) and significant other (r=-0.16) with death anxiety in the elderly. The results of linear regression analysis releaved that spiritual health (P=0.001, β=-0.46) and perceived social support by the family (P=0.001, β=-0.29) can predict negatively the death anxiety in the elderly and explain 26.7% of the variance of death anxiety in the elderly. Consequently, counselors and psychologists in the field of aging are suggested to reduce death anxiety in the elderly, using strategies to promote spiritual health and social support.
References

Abdel-Khalek, A. M. (2001). Death, anxiety, and depression in Kuwaiti undergraduates. OMEGA-Journal of Death and Dying, 42(4), 309-320.
Abdel-Khalek, A. M. (2005). Death anxiety in clinical and non-clinical groups. Death Studies, 29(3), 251-259.
Alipour, A., Aliakbari Dehkord, D. M., Amini, F., & Hashemi Jashni, J. A. (2016). Relationship between perceived social support and adherence of treatment in Diabetes Mellitus type 2: mediating role of resiliency and rope. Journal of Research in Psychological Health, 10(2), 53-67. [Persian]
Andreas, S., Schulz, H., Volkert, J., Dehoust, M., Sehner, S., Suling, A., Ausín, B., Canuto, A., Crawford, M., Da Ronch, C. & Grassi, L. (2017). Prevalence of mental disorders in elderly people: the European MentDis_ICF65+ study. The British Journal of Psychiatry, 210(2), 125-131.
Aslani, Y., Hosseini, R., Alijanpour Aghamaleki, M., Javanbakhtian Ghahfarokhi, R., & Borhaninejad, V. (2018). Spiritual health and life satisfaction in older adults in Shahrekord hospitals, 2013. Journal of Clinical Nursing and Midwifery, 6(4), 1-10. [Persian].


Atadokht, A., Rahimi, S., Valinejad, S. (2018). The Role of health promoting lifestyle and religious orientation in predicting quality of life and death anxiety in elders. Aging Psychology, 4(2), 143-154. [Persian].
Bagheri, H., Sadeghi, M., Esmaeili, N., & Naeimi, Z. (2016). Relationship between spiritual health and depression and quality of sleep in the older adults in Shahroud. Journal of Gerontology, 1(1), 55-62.  [Persian].
Basharpoor, S., Rahimi, S., Sedaghat, M. (2019). The Role of psychological flexibility and emotional processing styles in predicting death anxiety in the elderly. Aging Psychology, 5(2), 131-141. [Persian].
Becker, E. (1973). The denial of death. Free Press.
Berkman, L. F., Glass, T., Brissette, I., & Seeman, T. E. (2000). From social integration to health: Durkheim in the new millennium. Social science & medicine, 51(6), 843-857.
Bufford, R. K., Paloutzian, R. F., & Ellison, C. W. (1991). Norms for the spiritual weil-being scale. Journal of psychology and theology, 19(1), 56-70.
Chukwuorji, J. C., Uzuegbu, C. N., Chukwu, C. V., Ifeagwazi, C. M., & Ugwu, C. (2020). Social support serves emotion regulation function in death anxiety among people living with HIV/AIDS. South African Journal of Psychology, 50(3), 395-410.
Cochran, W. G. (1940). Note on an approximate formula for the significance levels of z. The Annals of Mathematical Statistics, 11(1), 93-95.
Dos Santos, S. B., Rocha, G. P., Fernandez, L. L., de Padua, A. C., & Reppold, C. T. (2018). Association of lower spiritual well-being, social support, self-esteem, subjective well-being, optimism and hope scores with mild cognitive impairment and mild dementia. Frontiers in psychology, 9, 1-10.
Ebrahimi, B., Hosseini, M., & Rashedi, V. (2018). The Relationship between social support and death anxiety among the elderly. Elderly Health Journal, 4(2), 37-42.
Emamirad, A., Amiri, H. (2018). The Relationship between spiritual health and meaning of life with death anxiety in elders. Aging Psychology, 4(3), 251-261. [Persian]
Esmaeilishad, B. (2020). The Effectiveness of self-care training on quality of life, self-care behaviors and blood sugar in elderly lacking self-Care behaviors. Aging Psychology, 6(1), 1-11. [Persian].
Fortner, V., Robert A. Neimeyer, B. (1999). Death anxiety in older adults: A quantitative review. Death studies, 23(5), 387-411.
Ghasempour, A., Sooreh, J., & Seid Tazeh Kand., M.T (2017). Predicting death anxiety on the basis of emotion cognitive regulation strategies. Knowledge & Research in Applied Psychology, 13(48), 63-70. [Persian].
Han, A. R., Park, S. A., & Ahn, B. E. (2018). Reduced stress and improved physical functional ability in elderly with mental health problems following a horticultural therapy program. Complementary Therapies in Medicine, 38, 19-23.
Hwang, H. (2019). Factors influencing death anxiety among rural elderly. Journal of Health Informatics and Statistics, 44(2), 111-116.
Jose, S., George, N., & Dante, G. (2018). Life satisfaction as a predictor of death anxiety among the elderly people. Indian Journal of Health and Wellbeing, 9(6), 829-832.
Kim, K. H., Kwon, H. J., Choi, M. H., Park, Y. J., & Kim, S. K. (2010). Psychological and spiritual factors associated with death anxiety of elderly people living at home. Journal of Korean Academy of Psychiatric and Mental Health Nursing, 19(1), 96-105.
Kim, Y., & Kim, M. (2019). Factors influencing death anxiety in community-dwelling elderly: based on the ecology theory. The Korean Journal of Hospice and Palliative Care, 22(1), 30-38.
Krause, N., Pargament, K. I., & Ironson, G. (2018). In the shadow of death: Religious hope as a moderator of the effects of age on death anxiety. The Journals of Gerontology: Series B, 73(4), 696-703.
Kübler-Ross, E. (2002). On death and dying; Questions and answers on death and dying; on life after death. Quality Paper Book Club.
Kurtulan, M. H., & Karaırmak, Ö. (2016). Examination of the relationship among death anxiety, spirituality, religious orientation and existential anxiety. Spiritual Psychology and Counseling, 1(2), 206-217.
Lehto, R. H., & Stein, K. F. (2009). Death anxiety: an analysis of an evolving concept. Research and theory for nursing practice, 23(1), 23–41.
López‐Cerdá, E., Carmona‐Torres, J. M., & Rodríguez‐Borrego, M. A. (2019). Social support for elderly people over 65 years in Spain. International nursing review, 66(1), 104-111.
Mahbobi, M., Etemadi, M., Khorasani, E., & Ghiasi, M. (2012). The Relationship between spiritual health and social anxiety in chemical veterans. Journal of Military Medicine, 14(3), 186-91
Mehri Nejad, S. A., Ramezan Saatchi, L., & Paydar, S. (2017). Death anxiety and its relationship with social support and adherence to religion in the elderly. Salmand: Iranian Journal of Ageing, 11(4), 494-503. [Persian].
Menzies, R. E., & Dar-Nimrod, I. (2017). Death anxiety and its relationship with obsessive-compulsive disorder. Journal of Abnormal Psychology, 126(4), 367.
Michaelson, V., Brooks, F., Jirásek, I., Inchley, J., Whitehead, R., King, N., Walsh, S., Davison, C., Mazur, J., & Pickett, W. (2016). Developmental patterns of adolescent spiritual health in six countries. SSM-population health, 2, 294-303.
Moser, S., Luxenberger, W., & Freidl, W. (2017). The influence of social support and coping on quality of life among elderly with age-related hearing loss. American Journal of Audiology, 26(2), 170-179.
Poordad, S., Momeni, K., & karami, J. (2019). Death anxiety and its relationship with social support and gratitude in older adults. Salmand: Iranian Journal of Ageing, 14(1), 26-39. [Persian].
Rajabi, G.R., & Bahrani, M. (2001). Factor analysis of death anxiety scale questions. Journal of Psychology, 5 (4), 331-341. [Persian].
Razavi, V. (2015). Relationship between social support and hope and death anxiety among the old people of Tehran Omid Cultural Center. International Journal of Life Sciences, 9(2), 65-70.
Rocha, A. C. A. L. D., & Ciosak, S. I. (2014). Chronic disease in the elderly: spirituality and coping. Revista da Escola de Enfermagem da USP, 48(2), 87-93.
Rostami, M., nosrati, K., Mahdinejad Gorji, G., kabiri, M. (2020). Death anxiety in the elderly: the role of psychological hardiness and practical commitment to prayer. Aging Psychology, 5(4), 309-320. [Persian]
Russac, R. J., Gatliff, C., Reece, M., & Spottswood, D. (2007). Death anxiety across the adult years: An examination of age and gender effects. Death studies, 31(6), 549-561.
Saber, F. M., & Nusratabadi, M. (2014). Social support and quality of life related to health in the elderly covered by the welfare of Kerman city. Journal of Health and Development, 3 (3), 189-199. [Persian].
Saini, P., Patidar, A. B., Kaur, R., Kaur, M., & Kaur, J. (2016). Death anxiety and its associated factors among elderly population of Ludhiana city, Punjab. Indian Journal of, 30(1), 101-10.
Sarason, B. R., Sarason, I. G., & Pierce, G. R. (1990). Social support: An interactional view. John Wiley & Sons.
Seo, J. H., & Noh, Y. G. (2019). Influences of social support and health promotion behavior on aging anxiety among middle-aged women. Journal of Digital Convergence, 17(11), 339-347.
Seyedfatemi N., Rezaie M., Givari A., & Hosseini F. (2006). Prayer and spiritual well-being in cancer patients. Health Monitor Journal of the Iranian Institute for Health Sciences Research, 5(4), 0-0. [Persian].
Sharma, P., Asthana, H. S., Gambhir, I. S., & Ranjan, J. K. (2019). Death anxiety among elderly people: role of gender, spirituality and mental health. Indian Journal of Gerontology, 33(3), 240-254.
Sheykholeslami, A., & Samadifard, H. (2017). Death Anxiety in the Elderly: The Role of Cognitive Failures, Flexibility and Distortion. Journal of Geriatric Nursing, 4(1), 48-58. [Persian].
Solaimanizadeh, F., Mohammadinia, N., & Solaimanizadeh, L. (2020). The relationship between spiritual health and religious coping with death anxiety in the elderly. Journal of religion and health, 59(4), 1925-1932.
Stroebe, W., Zech, E., Stroebe, M. S., & Abakoumkin, G. (2005). Does social support help in bereavement? Journal of social and Clinical Psychology, 24(7), 1030-1050.
Taghiabadi, M., Kavosi, A., Mirhafez, S. R., Keshvari, M., & Mehrabi, T. (2017). The association between death anxiety with spiritual experiences and life satisfaction in elderly people. Electronic physician, 9(3), 3980–3985.
Tamanaifar, M.R., Lis, H., & Mansouri, N. (2013). The Relationship Between Perceived Social Support and Self-efficacy in Students. Social Psychology, 8(28), 31-39. [Persian]
Templer, D. I. (1970). The construction and validation of a death anxiety scale. The Journal of general psychology, 82(2), 165-177.
Trivedi, S. C., Subramanyam, A. A., Kamath, R. M., & Pinto, C. (2016). Study of spirituality in elderly with subjective memory complaints. Journal of geriatric psychiatry and neurology, 29(1), 38-46.
Vaughan, F. E. (1986). The inward arc: Healing and wholeness in psychotherapy and spirituality. Shambhala.
Wu, A. M., Tang, C. S., & Kwok, T. C. (2002). Death anxiety among Chinese elderly people in Hong Kong. Journal of Aging and Health, 14(1), 42-56.
Yonker, J. E., Schnabelrauch, C. A., & DeHaan, L. G. (2012). The relationship between spirituality and religiosity on psychological outcomes in adolescents and emerging adults: A meta-analytic review. Journal of Adolescence, 35(2), 299-314.
Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988). The multidimensional scale of perceived social support. Journal of personality assessment, 52(1), 30-41.

Keywords

References

References
Abdel-Khalek, A. M. (2001). Death, anxiety, and depression in Kuwaiti undergraduates. OMEGA-Journal of Death and Dying, 42(4), 309-320.
Abdel-Khalek, A. M. (2005). Death anxiety in clinical and non-clinical groups. Death Studies, 29(3), 251-259.
Alipour, A., Aliakbari Dehkord, D. M., Amini, F., & Hashemi Jashni, J. A. (2016). Relationship between perceived social support and adherence of treatment in Diabetes Mellitus type 2: mediating role of resiliency and rope. Journal of Research in Psychological Health, 10(2), 53-67. [Persian]
Andreas, S., Schulz, H., Volkert, J., Dehoust, M., Sehner, S., Suling, A., Ausín, B., Canuto, A., Crawford, M., Da Ronch, C. & Grassi, L. (2017). Prevalence of mental disorders in elderly people: the European MentDis_ICF65+ study. The British Journal of Psychiatry, 210(2), 125-131.
Aslani, Y., Hosseini, R., Alijanpour Aghamaleki, M., Javanbakhtian Ghahfarokhi, R., & Borhaninejad, V. (2018). Spiritual health and life satisfaction in older adults in Shahrekord hospitals, 2013. Journal of Clinical Nursing and Midwifery, 6(4), 1-10. [Persian].
Atadokht, A., Rahimi, S., Valinejad, S. (2018). The Role of health promoting lifestyle and religious orientation in predicting quality of life and death anxiety in elders. Aging Psychology, 4(2), 143-154. [Persian].
Bagheri, H., Sadeghi, M., Esmaeili, N., & Naeimi, Z. (2016). Relationship between spiritual health and depression and quality of sleep in the older adults in Shahroud. Journal of Gerontology, 1(1), 55-62.  [Persian].
Basharpoor, S., Rahimi, S., Sedaghat, M. (2019). The Role of psychological flexibility and emotional processing styles in predicting death anxiety in the elderly. Aging Psychology, 5(2), 131-141. [Persian].
Becker, E. (1973). The denial of death. Free Press.
Berkman, L. F., Glass, T., Brissette, I., & Seeman, T. E. (2000). From social integration to health: Durkheim in the new millennium. Social science & medicine, 51(6), 843-857.
Bufford, R. K., Paloutzian, R. F., & Ellison, C. W. (1991). Norms for the spiritual weil-being scale. Journal of psychology and theology, 19(1), 56-70.
Chukwuorji, J. C., Uzuegbu, C. N., Chukwu, C. V., Ifeagwazi, C. M., & Ugwu, C. (2020). Social support serves emotion regulation function in death anxiety among people living with HIV/AIDS. South African Journal of Psychology, 50(3), 395-410.
Cochran, W. G. (1940). Note on an approximate formula for the significance levels of z. The Annals of Mathematical Statistics, 11(1), 93-95.
Dos Santos, S. B., Rocha, G. P., Fernandez, L. L., de Padua, A. C., & Reppold, C. T. (2018). Association of lower spiritual well-being, social support, self-esteem, subjective well-being, optimism and hope scores with mild cognitive impairment and mild dementia. Frontiers in psychology, 9, 1-10.
Ebrahimi, B., Hosseini, M., & Rashedi, V. (2018). The Relationship between social support and death anxiety among the elderly. Elderly Health Journal, 4(2), 37-42.
Emamirad, A., Amiri, H. (2018). The Relationship between spiritual health and meaning of life with death anxiety in elders. Aging Psychology, 4(3), 251-261. [Persian]
Esmaeilishad, B. (2020). The Effectiveness of self-care training on quality of life, self-care behaviors and blood sugar in elderly lacking self-Care behaviors. Aging Psychology, 6(1), 1-11. [Persian].
Fortner, V., Robert A. Neimeyer, B. (1999). Death anxiety in older adults: A quantitative review. Death studies, 23(5), 387-411.
Ghasempour, A., Sooreh, J., & Seid Tazeh Kand., M.T (2017). Predicting death anxiety on the basis of emotion cognitive regulation strategies. Knowledge & Research in Applied Psychology, 13(48), 63-70. [Persian].
Han, A. R., Park, S. A., & Ahn, B. E. (2018). Reduced stress and improved physical functional ability in elderly with mental health problems following a horticultural therapy program. Complementary Therapies in Medicine, 38, 19-23.
Hwang, H. (2019). Factors influencing death anxiety among rural elderly. Journal of Health Informatics and Statistics, 44(2), 111-116.
Jose, S., George, N., & Dante, G. (2018). Life satisfaction as a predictor of death anxiety among the elderly people. Indian Journal of Health and Wellbeing, 9(6), 829-832.
Kim, K. H., Kwon, H. J., Choi, M. H., Park, Y. J., & Kim, S. K. (2010). Psychological and spiritual factors associated with death anxiety of elderly people living at home. Journal of Korean Academy of Psychiatric and Mental Health Nursing, 19(1), 96-105.
Kim, Y., & Kim, M. (2019). Factors influencing death anxiety in community-dwelling elderly: based on the ecology theory. The Korean Journal of Hospice and Palliative Care, 22(1), 30-38.
Krause, N., Pargament, K. I., & Ironson, G. (2018). In the shadow of death: Religious hope as a moderator of the effects of age on death anxiety. The Journals of Gerontology: Series B, 73(4), 696-703.
Kübler-Ross, E. (2002). On death and dying; Questions and answers on death and dying; on life after death. Quality Paper Book Club.
Kurtulan, M. H., & Karaırmak, Ö. (2016). Examination of the relationship among death anxiety, spirituality, religious orientation and existential anxiety. Spiritual Psychology and Counseling, 1(2), 206-217.
Lehto, R. H., & Stein, K. F. (2009). Death anxiety: an analysis of an evolving concept. Research and theory for nursing practice, 23(1), 23–41.
López‐Cerdá, E., Carmona‐Torres, J. M., & Rodríguez‐Borrego, M. A. (2019). Social support for elderly people over 65 years in Spain. International nursing review, 66(1), 104-111.
Mahbobi, M., Etemadi, M., Khorasani, E., & Ghiasi, M. (2012). The Relationship between spiritual health and social anxiety in chemical veterans. Journal of Military Medicine, 14(3), 186-91
Mehri Nejad, S. A., Ramezan Saatchi, L., & Paydar, S. (2017). Death anxiety and its relationship with social support and adherence to religion in the elderly. Salmand: Iranian Journal of Ageing, 11(4), 494-503. [Persian].
Menzies, R. E., & Dar-Nimrod, I. (2017). Death anxiety and its relationship with obsessive-compulsive disorder. Journal of Abnormal Psychology, 126(4), 367.
Michaelson, V., Brooks, F., Jirásek, I., Inchley, J., Whitehead, R., King, N., Walsh, S., Davison, C., Mazur, J., & Pickett, W. (2016). Developmental patterns of adolescent spiritual health in six countries. SSM-population health, 2, 294-303.
Moser, S., Luxenberger, W., & Freidl, W. (2017). The influence of social support and coping on quality of life among elderly with age-related hearing loss. American Journal of Audiology, 26(2), 170-179.
Poordad, S., Momeni, K., & karami, J. (2019). Death anxiety and its relationship with social support and gratitude in older adults. Salmand: Iranian Journal of Ageing, 14(1), 26-39. [Persian].
Rajabi, G.R., & Bahrani, M. (2001). Factor analysis of death anxiety scale questions. Journal of Psychology, 5 (4), 331-341. [Persian].
Razavi, V. (2015). Relationship between social support and hope and death anxiety among the old people of Tehran Omid Cultural Center. International Journal of Life Sciences, 9(2), 65-70.
Rocha, A. C. A. L. D., & Ciosak, S. I. (2014). Chronic disease in the elderly: spirituality and coping. Revista da Escola de Enfermagem da USP, 48(2), 87-93.
Rostami, M., nosrati, K., Mahdinejad Gorji, G., kabiri, M. (2020). Death anxiety in the elderly: the role of psychological hardiness and practical commitment to prayer. Aging Psychology, 5(4), 309-320. [Persian]
Russac, R. J., Gatliff, C., Reece, M., & Spottswood, D. (2007). Death anxiety across the adult years: An examination of age and gender effects. Death studies, 31(6), 549-561.
Saber, F. M., & Nusratabadi, M. (2014). Social support and quality of life related to health in the elderly covered by the welfare of Kerman city. Journal of Health and Development, 3 (3), 189-199. [Persian].
Saini, P., Patidar, A. B., Kaur, R., Kaur, M., & Kaur, J. (2016). Death anxiety and its associated factors among elderly population of Ludhiana city, Punjab. Indian Journal of, 30(1), 101-10.
Sarason, B. R., Sarason, I. G., & Pierce, G. R. (1990). Social support: An interactional view. John Wiley & Sons.
Seo, J. H., & Noh, Y. G. (2019). Influences of social support and health promotion behavior on aging anxiety among middle-aged women. Journal of Digital Convergence, 17(11), 339-347.
Seyedfatemi N., Rezaie M., Givari A., & Hosseini F. (2006). Prayer and spiritual well-being in cancer patients. Health Monitor Journal of the Iranian Institute for Health Sciences Research, 5(4), 0-0. [Persian].
Sharma, P., Asthana, H. S., Gambhir, I. S., & Ranjan, J. K. (2019). Death anxiety among elderly people: role of gender, spirituality and mental health. Indian Journal of Gerontology, 33(3), 240-254.
Sheykholeslami, A., & Samadifard, H. (2017). Death Anxiety in the Elderly: The Role of Cognitive Failures, Flexibility and Distortion. Journal of Geriatric Nursing, 4(1), 48-58. [Persian].
Solaimanizadeh, F., Mohammadinia, N., & Solaimanizadeh, L. (2020). The relationship between spiritual health and religious coping with death anxiety in the elderly. Journal of religion and health, 59(4), 1925-1932.
Stroebe, W., Zech, E., Stroebe, M. S., & Abakoumkin, G. (2005). Does social support help in bereavement? Journal of social and Clinical Psychology, 24(7), 1030-1050.
Taghiabadi, M., Kavosi, A., Mirhafez, S. R., Keshvari, M., & Mehrabi, T. (2017). The association between death anxiety with spiritual experiences and life satisfaction in elderly people. Electronic physician, 9(3), 3980–3985.
Tamanaifar, M.R., Lis, H., & Mansouri, N. (2013). The Relationship Between Perceived Social Support and Self-efficacy in Students. Social Psychology, 8(28), 31-39. [Persian]
Templer, D. I. (1970). The construction and validation of a death anxiety scale. The Journal of general psychology, 82(2), 165-177.
Trivedi, S. C., Subramanyam, A. A., Kamath, R. M., & Pinto, C. (2016). Study of spirituality in elderly with subjective memory complaints. Journal of geriatric psychiatry and neurology, 29(1), 38-46.
Vaughan, F. E. (1986). The inward arc: Healing and wholeness in psychotherapy and spirituality. Shambhala.
Wu, A. M., Tang, C. S., & Kwok, T. C. (2002). Death anxiety among Chinese elderly people in Hong Kong. Journal of Aging and Health, 14(1), 42-56.
Yonker, J. E., Schnabelrauch, C. A., & DeHaan, L. G. (2012). The relationship between spirituality and religiosity on psychological outcomes in adolescents and emerging adults: A meta-analytic review. Journal of Adolescence, 35(2), 299-314.
Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988). The multidimensional scale of perceived social support. Journal of personality assessment, 52(1), 30-41.
Aging Psychology
Volume 6, Issue 4 - Serial Number 23
January 2020
Pages 319-309

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History

  • Receive Date: 03 October 2020
  • Revise Date: 22 December 2020
  • Accept Date: 24 December 2020

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