The Relationship Between Loneliness, Spiritual Intelligence and General Health with Death Anxiety in the Elderly: The Mediating Role of Mindfulness

Death anxiety can increase the negative attitude towards aging and even leads to anxiety and fear of aging. Therefore, it seems very important to know the psychological factors which affect death anxiety in the elderly. In this regard, the aim of this study was to examine the relationship between loneliness, spiritual intelligence and general health with death anxiety through the mediating role of mindfulness in the elderly. The research method was correlational, of path analysis type. The statistical population of the present study included all community-dwelling elderly living in three districts of 3, 8 and 20 of Tehran, Iran in 2021, among whom 250 were selected as the sample of the study using convenience sampling method. The research instruments included Templer’s death anxiety, Russell’s loneliness, King's spiritual intelligence, Goldberg & Hillier’s general health and Baer’s mindfulness questionnaires. The results indicated that the hypothesized model has a good fit with the research data. The results of the path analysis to examine the role of the mediator variable also revealed that mindfulness mediates the relationship between loneliness, spiritual intelligence and general health with death anxiety in the elderly. Accordingly, it can be concluded that the increased level of mindfulness results in reduction of death anxiety in the elderly and it is necessary to provide solutions to increase it in the society.
References
Abdel-Khalek, A. M. (2005). Death anxiety in clinical and non-clinical groups. Death Studies, 29, 251-259.
Afshari, A., Rezaei, R., Dadras, F. (2019). The effectiveness of structured reminiscence on reducing anxiety and depression in the elderly. Journal of Aging Psychology, 5 (3), 215-201. [Persian]
Aghajani, M.J., Mousavi, S.S., Akbari, B., & Abolghasemi, Sh. (2020). The relationship between attachment to God and psychological hardiness with death anxiety in retired older men. Religion and Health, 8 (1), 19-29. [Persian]
Ahmadvand, Z. (2011). Cheking the validity and reliability of the five-fact mindfulness questionnaire (FFMQ) in non-clinical iranian sampels. Master thesis in Clinical Psychology, Shahed University. [Persian]
AzadMarzabadi, A., Moqtadaei, K., & ArianPouran, S. (2013). The effectiveness of mindfulness training on psychological symptoms of veterans with post-traumatic stress disorder. Journal of Behavioral Sciences, 7 (1), 74-67. [Persian]
Baer, P. A., Smith, G. T., Hopkins, J., Krietemeyer, J., & Toney, L. (2006). Using Self-Report Assessment Methods to Explore Facets of Mindfulness. Assessment, 13, 27-45.
Baer, R. A. (2003). Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology: Science and Practice, 10, 125-143
Bahrami, L., Salianeh, M.A., Farsi, A., and Nikurvan, A. (2017). The effect of mindfulness exercises and motor working memory on the quality of life of active elderly. Sports Psychology Studies, 6 (21), 1-16. [Persian]
Çakar, F. S. (2020). The levels predicting the death anxiety of loneliness and meaning in life in youth. European Journal of Education Studies, 6(11), 97-121.‏
Davarpanah, F. (1995). Standardization of Revised Version of UCLA Loneliness Scale for Yousef 18-8 Girls in Tehran. Master thesis in Educational Psychology, Faculty of Psychology and Educational Sciences, Alameh Tabatabaee University. [Persian]
De Jong Gierveld, J., & Van Tilburg, T. (2010). The De Jong Gierveld short scales for emotional and social loneliness: Tested on data from 7 countries in the UN generations and gender surveys. European Journal of Ageing, 7 (2), 121-130.
Elhageen, A. (2004). Effect of interaction between parental treatment style and peer relations in classroom on the feeling of loneliness among deaf children in Egyptian schools. PhD Dissertation, Egypt University.
Ertekin Pinar, Ş., & Demirel, G. (2020). The Relation of Adaptation Difficulty to Death Anxiety and Depression Among Individuals Living in a Nursing Home. Turkiye Klinikleri Hemsirelik Bilimleri, 12 (1).
Fortner, B. V., Neimeyer, R. A, & Rybarczyk, B. (2000). Correlates of death anxiety in older adults: A comprehensive review. Death attitudes and the older adult: Theories, concepts, and applications. Series in death, dying, and bereavement. New York, NY, US: Brunner-Routledge.
Ghadampour, E., Moradizadeh, S., & Shakarami, M. (2019). The Study of effectiveness of training of mind consciousness on reduction of the elderly 's feeling of loneliness and death anxiety in Sedigh Center of Khoramabad City. Razi Journal of Medical Sciences, 26 (4), 44-53.
Gholmi, M., hafezi, F., Askari, P., Naderi, F. (2016). 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, 2(2), 143-151. [Persian]
Gire, J. T. (2021). How death imitates life: Cultural influences on conceptions of death and dying. In Online Readings in Psychology and Culture.
Goldberg, D. P. & Hillier, V. F. (1979). A scaled version of the General Health Questionnaire. Psychological Medicine, 9, 139-145.
Golpour Chamarkoohi, R., & Mohammad Amini, Z. (2012). The effectiveness of mindfulness-based stress reduction on improving mindfulness and increasing assertiveness in students with test anxiety. School and School Psychology, 1 (3), 100-82. [Persian]
Guner, T. A., Erdogan, Z., & Demir, I. (2021). The Effect of Loneliness on Death Anxiety in the Elderly During the COVID-19 Pandemic. OMEGA-Journal of Death and Dying, 0(0), 1-21.
Harrefors, C., Sävenstedt, S., & Axelsson, K. (2009). Elderly people’s perceptions of how they want to be cared for: An interview study with healthy elderly couples in Northern Sweden. Scandinavian Journal of Caring Sciencesm, 23(2), 353-360.
Hashemi, Z., & Eini, S. (2019). Perceived stress in the elderly: The role of spiritual intelligence, self-compassion and psychological toughness. Psychology of Aging, 5 (4), 289-299. [Persian]
Honarsa, P., & ZarrinKolah, F. (2020). Feeling lonely in Farhangian University student boys and girls during the Covid-19 pandemic. First National Congress of University and Covid-19, Counseling and Psychological Services Center of Sharif University of Technology, Tehran. [Persian]
Imanzadeh, A., Hamrahzadeh, M. (2017). Identification of facilitators and inhibitors of quality of life in elderly men and women (phenomenological research). Elderly: Iranian Journal of Aging, 12 (4), 430-445. [Persian]
Jenaabadi H. (2018). The Role of Spiritual Intelligence and Mindfulness in predicting Death Anxiety among Students at Zahedan Faculty of Nursing. Health, Spiritual and Medical Ethics, 5(2), 2-8.
Kabat-Zinn, J. (2003). Mindfulness-Based Interventions in context: Past, Present and Future. Clinical Psychology: Science and practice, 10(2), 144-156.
Keshmiri, M., & Arab Ahmadi, F. (2007). Preliminary standardization of spiritual intelligence test in students of Gorgan University of Natural Resources. Master's Thesis, Payamnoor University, Behshahr. [Persian]
Khanahmadi, A., Ettefaqi, M., & Ghaderi Bege Jan, K. (2016). A comparative study of loneliness and source of control (internal and external) between female-headed households and non-female-headed households. Third International Conference on Science and Technology Research, Berlin, Germany. [Persian]
King DB. (2008). Rethinking claims of spiritual intelligence: A definition, model, and measure. Ontario (CA): Trent University.
Kristeller, J., & Hallet, C. B. (1997). An exploratory study of binge eating disorder. Journal of Health Psychology, 4, 357-363.
Langlois F, Vu TT, Chasse K, Dupuis G, Kergoat MJ, Bherer L. (2013). Benefits of physical exercise training on cognition and quality of life in frail older adults. Journal of Gerontology Series B Psychological Sciences Social Sciences, 68(3), 400-404.
Laurin, K., Kay, A., & Mosovitch, D. (2008). On the belief in God: Towards an understanding of the emotional substrates of compensatory control. Journal of Experimental Social Psychology, 44(6), 1559-62.
Letho, R.H & Stein, K.F (2009). Death anxiety: an evolving concept. Research and theory for nursing practice: an international journal, 23(1), 23-41.
Lindsay, E. K., Young, S., Brown, K. W., Smyth, J. M., & Creswell, J. D. (2019). Mindfulness training reduces loneliness and increases social contact in a randomized controlled trial. Proceedings of the National Academy of Sciences, 116(9), 3488–3493.
Linehan, M.M. (1993). Cognitive behavioral treatment of borderline personality disorder. New York: Guilford Press.
Malakoutikhah, A., Zakeri, M. A., & Dehghan, M. (2022). A Comparison Between the Relaxation/Meditation/Mindfulness Tracker t Inventory and the Freiburg Mindfulness Inventory for Predicting General Health, Anxiety, and Anger in Adult General Population. Frontiers of Psychology, 13, 1-10.
Masoumian, S., Shairi, M., Shams, J., Momenzadeh, S. (2013). The effect of mindfulness-based stress reduction therapy on self-efficacy in women with chronic low back pain. Research in Medicine, 37 (3), 158-163. [Persian]
Missler, M., Stroebe, M., Geurtsen, L., Mastenbroek, M., Chmoun, S., & Van der Houwen, K. (2012). Exploring death anxiety among elderly people: A literature review and empirical investigation. Omega, 64(4), 357–379
Nejati, W., Amini, R., Zabihzadeh, A., Masoumi, M., Maleki, Q., & Shoaei, F. (2011). Mindfulness is an effective indicator on the quality of life of blind veterans. Veteran Medicine, 3 (11), 1-7. [Persian]
Nemati, E., Habibi, M., Ahmadian Vargahan, F., Soltan Mohamadloo, S., & Ghanbari, S. (2017). The role of mindfulness and spiritual intelligence in students' mental health. Journal of Research and Health, 7 (1), 594-602.
Rajabi, Gh., & Bahrani, M. (2001). Factor analysis of Death Anxiety Scale. Journal of Pyschology, 20, 331-344. [Persian]
Rezaei Adriani, M. Azadi, A. Ahmadi, F.A. & Vahedian Azimi, a. (2007). Comparison of depression, anxiety, stress and quality of life of male and female students living in dormitories. Nursing Research, 7 (4-5), 38-31. [Persian]
Rice, J. (2009). The relationship between humor and death anxiety. Department of psychology, copy right 2009 Missouri Western state university.
Rokach, A., & Venegas, G. (2012). Can religiosity affect how we cope with loneliness? European Psychiatry, 27 (1), 1-10.
Rosenblum, S., & Elimelech, O. C. (2021). Gender Differences in State Anxiety Related to Daily Function Among Older Adults During the COVID-19 Pandemic: Questionnaire Study. JMIR aging, 4(2), e25876.
Russell, D., Peplau, L. A., & Cutrona, C. E. (1980). The Revised UCLA Loneliness Scale: Concurrent and discriminate validity evidence. Journal of Personality and Social Psychology, 39, 472-480.
Saeedi, A. (2012). Comparison of spiritual intelligence and resilience of addicts and ordinary people in Ahvaz. Master's Thesis, Islamic Azad University, Ahvaz Branch, Ahvaz. [Persian]
Soori, A., Shabani Moghadam, K., & Soori, R. (2016). Relationship between physical activity and quality of life of elderly women in Kermanshah province. Journal of Applied Research in Sports Management, 4 (4), 84-75. [Persian]
Tabatabai, Sh., & Rasouli, Z. (2018). Assessing the validity and reliability of the Persian version of the General Health Questionnaire (GHQ-60) in the staff of the industrial sector. Iranian Occupational Health, 15 (3), 54-45. [Persian]
Teasdale, J. D., Segal, Z., Williams, J. M. (1995). How does cognitive therapy prevent depressive relapse and why should attentional control (mindfulness) training help? Behaviour Research and Therapy, 33(1), 25-39.
Templer, D.I. (1970). The construction and validation of a Death Anxiety Scale. Journal of General Psychoogyl, 82 (2d Half), 165-77. doi: 10.1080/00221309.1970.9920634
ValiKhani, A., & Firoozabadi, A. (2018). Evaluation of death anxiety in the context of attachment patterns in cancer patients: a comparative study. Health Psychology, 5 (18), 130-119. [Persian]
Vuong, Q.-H., Le, T.-T., La, V.-P., Nguyen, H. T. T., Ho, M.-T., Van Khuc, Q., et al. (2022). Covid-19 vaccines production and societal immunization under the serendipity-mindsponge-3D knowledge management theory and conceptual framework. Humanities and Social Sciences Communications, 9, 1–12.
Wong, P.T.P., Reker, G.T, Gesser, G. (2004). Death attitude profile-Revised: A multidimensional measure of attitudes toward death. In: Neimeyer RA., editors. Death Anxiety Handbook: Research, Instrumentation, and Application. Routledge: Taylor & Francis.
Yurliani, R. N., Yusuf, E. A., & Nazriani, D. (2022). Correlation between mindfulness and death anxiety among the eldery. Psikologia: Jurnal Pemikiran dan Penelitian Psikologi, 15(2), 55-61.
Zanjari, N., Bahrami, G., Nouri Koochi, M., & Aliakbarzade Arani, Z. (2021). Factors Affecting the Elderly's Quality of Life in the Middle East: A Systematic Review. Journal of Education and Community Health, 8 (2), 143-158.