[The period when the patient begins to fear death--in the medical ward].
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Studies examining fear of death and anxiety have consistently shown these constructs to be positively related. Although several measures of anxiety have been examined, fear of death has always been treated unidimensionally. The present research was an attempt to examine eight types of fear of death in relation to two types of anxiety. Questionnaire data were collected from 375 male and female undergraduates at a Mid-western university. Anxiety was measured by the State-Trait Anxiety Inventory, and fear of death by a factor analytic multidimensional scale. Significant correlations were found between seven of the eight fear of death dimensions and both measures of anxiety. Regression analysis showed fear of premature death and fear of the dead to be the most important death-related fears associated with anxiety.
Fear of death appears to be universal in the psychopathology of aging, although it is frequently repressed. Judicious pharmacotherapy and insightful psychotherapy are effective in treating the elderly. Two case histories are given in illustration. Despite the difficulties of the problem, it is possible to remove this fear of death-that causes one to waste one's later years-to make of old age a useful and contributory period of life.
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An increase in interest in death education among helping professionals and a concern for a lack of reliability and validity data on some instruments measuring attitudes about death is reviewed. The Collett-Lester Fear of Death Scale and the Lester Attitude Toward Death Scale were administered twice to 20 graduate level male and female counselor trainees over a six-week interval. Test-retest reliability coefficients on all scales and subscales were significant but low to moderate only.
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The present research was an attempt to test two hypotheses derived from a recently proposed social psychological model of suicide: The acceptability of suicide is a decreasing function of religiosity and fear of death. Questionnaire data were collected for 205 undergraduates at a midwestern university in 1978. The questionnaire included several measures of religiosity, a factor analysis multidimensional fear of death scale, and a suicide acceptability scale. Results, showing that all of the religiosity measures and certain types of fear of death were significantly related to the acceptability of suicide, supported to the hypotheses under examination.
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A total of 64 male undergraduates were administered a multistage interview which was structured to assess (a) their level of overtly expressed death anxiety, (b) covert (GSR) arousal to death stimuli (c) self-perceived competence, and (d) agreement with or dissent from life threatening national policies. The analyses that followed were concerned with examining the relationships among these variables. In previous studies of this kind it had been typically found that (1) self-perceived competence and magnitude of expressed death concern are inversely related and (2) overt expressions of death concern and covert physiological arousal to death cues are inversely related. Psychodynamic formulations centering on the ego-defensive nature of inhibited expressions of death anxiety have been cited to explain these past data. The current investigation proposed that the magnitude of expressed death concern would bear an inverse relationship to both felt competence and covert death arousal only when the level of overt concern was not contingent upon the individual's attitudes concerning the imminence of real life threatening circumstances in the environment. The rationale behind these predictions inheres in the notion that the neurotic components of strongly expressed death anxiety derive from its lack of anchoring in "real" external threats. Conversely, the expression of low death fear can only be regarded as "defensive" when real threats are perceived and acknowledged. The obtained results strongly support this rationale and the discussion centers on the impact of social conditions on psychodynamic processes.
A double-blind comparative study of clomipramine and diazepam was carried out in patients suffering from phobic and obsessional disorders. Nineteen doctors submitted 58 patients. Seventeen patients withdrew from the trial, twelve because of side-effects. Forty-one patients completed the trial and of these 14 were on clomipramine and 27 were taking diazepam. Patients were assessed for phobias, obsessions, general psychiatric symptoms and side-effects and each was rated on a special symptom inventory at 0, 2, 4 and 6 weeks of treatment. A General Health Questionnaire and Burns Questionnaire was completed for each patient at the beginning and end of the study. General level of anxiety for diffuse phobic anxiety and situational anxiety for illness and death fears responded better to clomipramine than to diazepam. Global assessment showed significantly more progress on clomipramine than diazepam between weeks 4 and 6.
Both overuse and underuse of the healthcare system have been recognised as significant problems. Relatedly, growing research has recognised the key role of death anxiety in driving various health-relevant behaviours. However, the relationship between death anxiety and healthcare utilisation has not yet been systematically explored. The current systematic review and meta-analysis addressed this gap. In total, 987 papers were screened for inclusion, of which 63 were included in the final review (Ntotal = 21,271). This included 33 quantitative studies, 27 qualitative studies and 3 mixed-methods designs. In total, 17 studies contained sufficient data to be meta-analysed. Overall, the included studies highlighted a significant relationship between death anxiety and healthcare utilisation; in particular, positive associations with desire for life-prolonging treatments and contact with hospitals and medical professionals. By contrast, a negative association was found with other aspects of healthcare utilisation, including hospice use and end-of-life communication. The sample type emerged as a significant moderator, suggesting that the relationship between death anxiety and healthcare usage was strongest in non-medical samples. The current findings suggest that death anxiety plays a key role in utilisation of the healthcare system. The fear of death may need to be targeted in psychological interventions, in order to ensure maximal effectiveness of health services, and improve outcomes for healthcare users.
Doctors have the privilege of looking after patients from the moment of birth to the moment of death. Yet, the holistic approach to patients is interfered with by the doctor's role as a warrior against death, where death's everpresent claim on our lives, and its final victory, are ignored. This paper attempts to explore why doctors are in their current position, the mechanisms for ignoring death which are shared by doctors and patients, the nature of the fear of death, and practical implications for the treatment of dying patients. More and more patients die now in medical settings. It is incumbent on doctors to understand the dying process, if much unnecessary suffering is to be prevented.