رابطه معنای زندگی و کیفیت زندگی در سالمندان: نقش میانجی اضطراب مرگ

One of the critical periods of life is aging, during which people face various physical and mental problems that affect their quality of life. Therefore, the purpose of this research was to examine the relationship between meaning in life and quality of life through the mediating role of death anxiety. This was a descriptive correlational study using structural equation modeling (SEM). The statistical population of the present study included employees and retirees aged 60 to 65 years of various offices and organizations of Tehran, Iran in 2023-2024, among whom 354 people were selected as the sample. Participants answered the Templer’s death anxiety, WHO quality of life, and Steger et al.’s meaning in life questionnaires. The collected data were analyzed by SEM using SPSS-24 and AMOS-24 software. The results showed that there is a significant negative relationship between meaning in life and quality of life with death anxiety, and a significant positive relationship between meaning in life and quality of life. In addition, the mediating role of death anxiety in the relationship between meaning in life and quality of life was confirmed (P=.001). In general, given that death anxiety affects the quality of life of older adults, addressing the issue of meaning in life in the field of counseling for older adults can help improve their quality of life.
EXTENDED ABSTRACT
 Introduction
 One of the crucial stages of life is aging, during which individuals face various physical and psychological challenges that may affect their quality of life. With the advancement of healthcare and social conditions, the aging population is increasing, leading to a rise in psychological issues and a decline in their quality of life. Therefore, identifying the factors that influence their psychological aspects seems to be crucial. Older people who have a higher sense of meaning in life experience better health outcomes in various situations, as they can make choices that reduce their anxiety. Lack of meaning in life causes individuals to suffer greatly in life’s challenges, leading to a fear of aging and psychological decay. Additionally, death anxiety negatively impacts the quality of life. However, it can be said that individuals who have or seek meaning in life, by anticipating, understanding, and controlling their death anxiety, can set goals for their future that improve their quality of life. Thus, the aim of this study was to investigate the relationship between meaning in life and quality of life in older adults, with the mediating role of death anxiety.
Method
This research utilized a correlational design using structural equation modeling (SEM). The statistical population included individuals aged 60 to 65 years living in Tehran during the years 2023-2024. The participants included employees and retirees from various organizations in Tehran. The sample was made up of 267 people, selected using the convenience sampling method. The inclusion criteria were (1) age range of 60 to 65 years and (2) willingness to participate in the study. The exclusion criteria included (1) having concurrent psychological disorders such as epilepsy diagnosed by a psychiatrist and taking psychiatric medications, and (2) having physical illnesses that impaired concentration. Data were collected by visiting four health centers in District 13 of East Tehran. Before distributing the questionnaires, participants were informed about the research objectives in a way that would not cause bias. All participants voluntarily and with informed consent took part in the study. They completed the Templer’s death anxiety scale, WHO quality of life questionnaire, and the Steger et al.’s meaning in life questionnaire. The collected data were analyzed using SEM in SPSS-24 and AMOS-24 software.
Results
The current study examined the correlation coefficients between meaning in life (search for meaning and presence of meaning), death anxiety (integration units’ item 1, 2, and 3), and quality of life (physical health, psychological health, social relationships, and environmental health). The findings indicated significant correlations among these variables. To evaluate the assumption of normality for univariate distributions, skewness and kurtosis values were considered, which fell within the ±2 range, affirming the normality assumption. Multicollinearity assumptions were evaluated using Variance Inflation Factor (VIF) and tolerance values. The results showed that VIF values were less than 10 and tolerance values were greater than 0.1, indicating no multicollinearity issues. Furthermore, the Mahalanobis distance analysis for multivariate normality assumptions identified six outliers, which were subsequently removed.
The goodness-of-fit indices for the model were as follows: X2= 24.19, df= 12, X2/df =2.02, GFI=.98, AGFI =.95, CFI =.98, RMSEA =.054, indicating a good fit for the model. The path analysis results showed that coefficient between the search for meaning and death anxiety (P=0.001, β=0.225) was positive and significant, while the path coefficient between the presence of meaning and death anxiety (P=0.001, β=−0.256) was negative and significant. The path coefficient between death anxiety and quality of life (P=0.001, β=−0.441) was negative and significant. In contrast to the search for meaning, the direct path coefficient between the presence of meaning and quality of life (P=0.005, β=0.201) was positive and significant. Table 5 also indicates that the indirect path coefficient between the search for meaning and quality of life (P=0.001, β=−0.099) was negative, while the path coefficient between the presence of meaning and death anxiety (P=0.001, β=0.113) was positive and significant. Based on these findings, it can be concluded that death anxiety positively and significantly mediates the relationship between the presence of meaning and quality of life, while it negatively and significantly mediates the relationship between the search for meaning and quality of life among older adults.
Conclusion
The presence or absence of meaning in life can have significant effects on the quality of life, particularly in later adulthood. However, it seems that other mediating variables may either enhance or weaken this effect on quality of life. According to the results of the present study, one of the variables that can mediate this relationship is death anxiety, which is a common phenomenon in adulthood, especially in the transition to old age. Based on the findings, it appears that individuals who have meaning and purpose in life experience lower death anxiety and thus higher quality of life. Conversely, individuals who perceive life as meaningless and empty experience greater death anxiety when faced with the idea of death, as this anxiety stems from unresolved existential concerns requiring further reflection. Consequently, as death anxiety increases due to a lack of meaning in life, individuals become less patient and resilient in facing challenges, leading to a lower quality of life. The presence of meaning gives direction to individuals' lives and can serve as a source of support in the face of challenges. Without this support, individuals face heightened anxiety that disrupts their mental well-being.
Ethical Consideration
Ethical Code
This article is extracted from a doctoral dissertation in psychology at Islamic Azad University, Roudehen Branch.
Financial Support
This research did not receive any financial support.
Authors’ Contributions
M.A.: Software, Data Curation, Writing-Original Draft; S.B.: Conceptualization, Validation; M.M.: Project Administration
Conflict of Interest
The author had no conflicts of interest.
Acknowledgments
Special thanks to the University's Vice Chancellor for Research for their moral support and cooperation in conducting this research.
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