Abstract
This systematic review aimed to summarize the evidence regarding the relationship between spirituality and religiosity with death anxiety (DA) among cancer patients. This systematic review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) checklist. An extensive search was conducted on electronic databases such as Scopus, PubMed, Web of Science, Iranmedex, and Scientific Information Database (SID) via keywords extracted from Medical Subject Headings from the earliest to February 9, 2022. The quality of the included studies was assessed using the appraisal tool for cross-sectional studies (AXIS tool). Fifteen studies were selected for inclusion in this systematic review. Nine and six studies assessed the relationship between spirituality and religiosity with DA in cancer patients, respectively. Most studies had a negative relationship between spirituality (n = 8) and religiosity (n = 4) with DA. In sum, most studies showed that religion and spirituality are negatively related to DA in patients with cancer.
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References
Abbas, Q., Kanwal, U., Saeed, W., Khan, M. U., Shahzadi, M., & Faran, M. (2021). Relationship of Muslim religiosity and death anxiety with the mediating effect of optimism and depression among cancer patients in Pakistan. Journal of Religion and Health, 61(2), 1418–1436. https://doi.org/10.1007/s10943-021-01415-2
Acklin, M. W., Brown, E. C., & Mauger, P. A. (1983). The role of religious values in coping with cancer. Journal of Religion and Health, 22(4), 322–333. https://doi.org/10.1007/BF02279928
Ahmad, A. A., & Gaber, O. H. (2019). The relationship between death anxiety, level of optimism and religiosity among adult cancer patients: A predictive study. International Journal of Psychological Studies, 11(1), 26–35. https://doi.org/10.5539/ijps.v11n1p26
Bassett, J. F., & Bussard, M. L. (2021). Examining the complex relation among religion, morality, and death anxiety: Religion can be a source of comfort and concern regarding fears of death. OMEGA-Journal of Death and Dying, 82(3), 467–487. https://doi.org/10.1177/0030222818819343
Chen, J., You, H., Liu, Y., Kong, Q., Lei, A., & Guo, X. (2021). Association between spiritual well-being, quality of life, anxiety and depression in patients with gynaecological cancer in China. Medicine, 100(1), e24264. https://doi.org/10.1097/MD.0000000000024264
Corlett, R. T. (2011). Trouble with the gray literature. BIOTROPICA, 43(1), 3–5. https://doi.org/10.1111/j.1744-7429.2010.00714.x
Curtis, A., Brown, L., & Sagong, H. (2023). Nursing students’ perceptions of older adults, confidence, and anxiety level changes with their first clinical rotation: A descriptive pilot study. Journal of Nursing Reports in Clinical Practice, 1(3), 1–5. https://doi.org/10.32598/JNRCP.23.102
Downes, M. J., Brennan, M. L., Williams, H. C., & Dean, R. S. (2016). Development of a critical appraisal tool to assess the quality of cross-sectional studies (AXIS). British Medical Journal Open, 6(12), e011458. https://doi.org/10.1136/bmjopen-2016-011458
Ellis, L., & Wahab, E. A. (2013). Religiosity and fear of death: A theory-oriented review of the empirical literature. Review of Religious Research, 55(1), 149–189. https://doi.org/10.1007/s13644-012-0064-3
Erdoğan, T. K., & Koç, Z. (2021). Loneliness, death perception, and spiritual well-being in adult oncology patients. Cancer Nursing, 44(6), 503–512. https://doi.org/10.1097/NCC.0000000000000930
Feng, Y., Liu, X., Lin, T., Luo, B., Mou, Q., Ren, J., & Chen, J. (2021). Exploring the relationship between spiritual well-being and death anxiety in patients with gynecological cancer: A cross-section study. BMC Palliative Care, 20(1), 1–10. https://doi.org/10.1186/s12904-021-00778-3
Hedayatizadeh-Omran, A., Janbabaei, G., Faraji Emafti, M., Noroozi, A., Kolagari, S., & Modanloo, M. (2018). Relationship between spirituality and death anxiety in patients with cancer undergoing chemotherapy. Journal of Mazandaran University of Medical Sciences, 27(156), 98–108.
Hong, Y., Yuhan, L., Youhui, G., Zhanying, W., Shili, Z., Xiaoting, H., & Wenhua, Y. (2022). Death anxiety among advanced cancer patients: A cross-sectional survey. Supportive Care in Cancer, 30(4), 3531–3539. https://doi.org/10.1007/s00520-022-06795-z
Jong, J. (2021). Death anxiety and religion. Current Opinion in Psychology, 40, 40–44. https://doi.org/10.1016/j.copsyc.2020.08.004
Jong, J., Ross, R., Philip, T., Chang, S.-H., Simons, N., & Halberstadt, J. (2018). The religious correlates of death anxiety: A systematic review and meta-analysis. Religion, Brain & Behavior, 8(1), 4–20. https://doi.org/10.1080/2153599X.2016.1238844
Karaoglu, G., Kurcer, M. A., & Erdogan, Z. (2021). Death anxiety of doctors and nurses with levels of depression related to death and the factors affecting them. Annals of Medical Research, 28(8), 1572–1576. https://doi.org/10.5455/annalsmedres.2020.09.928
Karkhah, S., Jafari, A., Paryad, E., Kazemnejad Leyli, E., Ghazanfari, M. J., Osuji, J., & Javadi-Pashaki, N. (2021). Death anxiety and related factors among iranian critical care nurses: A multicenter cross-sectional study. OMEGA-Journal of Death and Dying. https://doi.org/10.1177/00302228211062368
Khezri, L., Bahreyni, M., Ravanipour, M., & Mirzaee, K. (2015). The relationship between spiritual wellbeing and depression or death anxiety in cancer patients in Bushehr 2015. Nursing of the Vulnerables, 2(2), 15–28.
Kim, S. Y., & Lee, J. I. (2013). Self-transcendence, spiritual well-being, and death anxiety of the elderly. Journal of Korean Public Health Nursing, 27(3), 480–489. https://doi.org/10.5932/JKPHN.2013.27.3.480
Mahdavi, A., Jenaabadi, H., Mosavimoghadam, S. R., Langari, S. S. S., Lavasani, M. G., & Madani, Y. (2019). Relationship between mental, existential, and religious well being and death anxiety in women with breast cancer. Archives of Breast Cancer, 45, 29–34. https://doi.org/10.32768/abc.20196129-34
Mansori, Y. K., Dolatian, M., Shams, J., & Nasiri, M. (2017). Relationship between death anxiety and spiritual well-being in patients with gynecologic cancer. Advances in Nursing & Midwifery, 27(3), 28–34.
Masror Roudsary, D., Lehto, R. H., Sharif Nia, H., & Kohestani, D. (2022). The relationship between religious orientation and death anxiety in Iranian Muslim patients with cancer: the mediating role of hope. Journal of Religion and Health, 61(2), 1437–1450. https://doi.org/10.1007/s10943-021-01487-0
Nazari, F., Khoshnood, Z., & Shahrbabaki, P. M. (2023). The relationship between authenticity and death anxiety in cancer patients. OMEGA-Journal of Death and Dying, 86(3), 966–979. https://doi.org/10.1177/0030222821997603
Neel, C., Lo, C., Rydall, A., Hales, S., & Rodin, G. (2015). Determinants of death anxiety in patients with advanced cancer. BMJ Supportive & Palliative Care, 5(4), 373–380. https://doi.org/10.1007/s00520-022-06795-z
Nezami, N., Dashti, F., Alilu, L., & Heidari, S. (2020). Comparing relationship between spiritual well-being and death anxiety among women with breast and cervical cancers and women with gastric and colorectal cancers. Journal of Education and Health Promotion, 9, 263. https://doi.org/10.4103/jehp.jehp_287_20
Norouzi, M., Ghorbani Vajargah, P., Falakdami, A., Mollaei, A., Takasi, P., Ghazanfari, M. J., Miri, S., Javadi-Pashaki, N., Osuji, J., & Soltani, Y. (2022). A systematic review of death anxiety and related factors among nurses. OMEGA-Journal of Death and Dying. https://doi.org/10.1177/00302228221095710
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., & Brennan, S. E. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71
Pandya, A.-K., & Kathuria, T. (2021). Death anxiety, religiosity and culture: Implications for therapeutic process and future research. Religions, 12(1), 61–74. https://doi.org/10.3390/rel12010061
Parvaresh Maryan, M., Baghaee, M., Kazemnejad Leyli, E., Janipour, M., & Sedghi Sabet, M. (2023). Nurses’ knowledge and related factors towards professional ethics: A cross-sectional study. Journal of Nursing Reports in Clinical Practice, 2(1), 9–15. https://doi.org/10.32598/JNRCP.23.93
Rababa, M., Hayajneh, A. A., & Bani-Iss, W. (2021). Association of death anxiety with spiritual well-being and religious coping in older adults during the COVID-19 pandemic. Journal of Religion and Health, 60(1), 50–63. https://doi.org/10.1007/s10943-020-01129-x
Reisi, S., Ahmadi, S. M., Sadeghi, K., Reisi, S., & Ahmadi, S. M. (2021). The effect of religion and spirituality on anxiety and depression in cancer patients: A review article. Medicine, 6(1), 75–86.
Rybarski, R., Bartczuk, R. P., Śliwak, J., & Zarzycka, B. (2023). Religiosity and death anxiety among cancer patients: the mediating role of religious comfort and struggle. International Journal of Occupational Medicine and Environmental Health, 36(4), 450–464. https://doi.org/10.13075/ijomeh.1896.02094
Safdar, F., & Rahman, N. K. (2016). Quality of life and death anxiety among patients with cancer and non-cancer participants. Pakistan Journal of Professional Psychologists, 7(1), 1–14.
Saleem, T., & Saleem, S. (2020). Religiosity and death anxiety: A study of Muslim dars attendees. Journal of Religion and Health, 59(1), 309–317. https://doi.org/10.1007/s10943-019-00783-0
Salehi Zahabi, S., & Mahmoudi, S. (2017). The relationship between religious orientation and death anxiety in patients with breast cancer. Health, Spirituality and Medical Ethics, 4(1), 22–27.
Sánchez, R., Sierra, F., & Zárate, K. (2014). Are religiosity and spirituality different dimensions? Revista Colombiana de Cancerología, 18(2), 62–68. https://doi.org/10.1016/j.rccan.2014.04.002
Shakeri, B., Abdi, K., Bagi, M., Dalvand, S., Shahriari, H., Sadeghi, S., & Ghanei Gheshlagh, R. (2022). A systematic review and meta-analysis of death anxiety among Iranian patients with cancer. OMEGA-Journal of Death and Dying. https://doi.org/10.1177/00302228211070400
Sharif Nia, H., Pahlevan Sharif, S., Koocher, G. P., Yaghoobzadeh, A., Haghdoost, A. A., Mar Win, M. T., & Soleimani, M. A. (2020). Psychometric properties of the death anxiety scale-extended among patients with end-stage renal disease. OMEGA-Journal of Death and Dying, 80(3), 380–396. https://doi.org/10.1177/0030222817733220
Sharpe, L., Curran, L., Butow, P., & Thewes, B. (2018). Fear of cancer recurrence and death anxiety. Psycho-Oncology, 27(11), 2559–2565. https://doi.org/10.1002/pon.4783
Shirkavand, L., Abbaszadeh, A., Borhani, F., & Momenyan, S. (2018). Correlation between spiritual well-being with satisfaction with life and death anxiety among elderlies suffering from cancer. Journal of General Medicine, 15(3), 1–7. https://doi.org/10.29333/ejgm/85501
Shukla, P., & Rishi, P. (2014). A corelational study of psychosocial & spiritual well being and death anxiety among advanced stage cancer patients. American Journal of Applied Psychology, 2(3), 59–65. https://doi.org/10.12691/ajap-2-3-1
Soleimani, M. A., Bahrami, N., Allen, K.-A., & Alimoradi, Z. (2020). Death anxiety in patients with cancer: A systematic review and meta-analysis. European Journal of Oncology Nursing, 48, 101803. https://doi.org/10.1016/j.ejon.2020.101803
Soleimani, M. A., Lehto, R. H., Negarandeh, R., Bahrami, N., & Nia, H. S. (2016). Relationships between death anxiety and quality of life in Iranian patients with cancer. Asia-Pacific Journal of Oncology Nursing, 3(2), 183–191. https://doi.org/10.4103/2347-5625.182935
Soriano, G. P., Calong Calong, K. A., Martinez, R. C. K. P., & Locsin, R. C. (2022). Religiosity, spirituality and death anxiety among older adults living at home and in institutional facilities: A comparative study. Journal of Religion, Spirituality & Aging, 34(3), 284–296. https://doi.org/10.1080/15528030.2021.1948948
Üstükuş, A., & Eskimez, Z. (2021). The effect of death anxiety in nurses on their approach to dying patients: A cross-sectional study. Perspectives in Psychiatric Care, 57(4), 1929–1936. https://doi.org/10.1111/ppc.12768
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Heidari Gorji, M.A., Ghorbani Vajargah, P., Salami Kohan, K. et al. The Relationship Between Spirituality and Religiosity with Death Anxiety Among Cancer Patients: A Systematic Review. J Relig Health (2024). https://doi.org/10.1007/s10943-024-02016-5
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DOI: https://doi.org/10.1007/s10943-024-02016-5