Volume 37, Issue 150 (November 2024)                   IJN 2024, 37(150): 306-321 | Back to browse issues page

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Hajian S, Tamannaeifar M. The Mediating Role of Perceived Stress in the Relationship Between the Meaning of Life and Death Anxiety in Iranian Nurses. IJN 2024; 37 (150) :306-321
URL: http://ijn.iums.ac.ir/article-1-3810-en.html
The Mediating Role of Perceived Stress in the Relationship Between the Meaning of Life and Death Anxiety in Iranian Nurses
Safiye Hajian1 , Mohammadreza Tamannaeifar 2
1- Department of Psychology, Faculty of Humanities, University of Kashan, Kashan, Iran.
2- Department of Psychology, Faculty of Humanities, University of Kashan, Kashan, Iran. , tamannai@kashanu.ac.ir
Keywords: Perceived stress, Meaning of life, Death anxiety, Nurses
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Introduction
Death anxiety is a multifaceted concept that encompasses a wide range of emotions. Nurses are at higher risk of developing death anxiety compared to other healthcare professionals due to direct contact with critically ill or incurable patients. In the long term, death anxiety can cause job burnout, reduced efficiency in the workplace, high absenteeism, lack of proper relationships with colleagues, depression, anxiety, and even suicide in nurses. Death anxiety is associated with exposure to life-threatening events, reduced physical functions, psychological stress, and life dissatisfaction. Meanwhile, some factors can predict death anxiety among nurses, one of which is the meaning of life. In general, the meaning of life is defined as a person's subjective feelings of purpose or direction in life and an ability to understand life circumstances.  Some factors can strengthen or weaken the relationship between death anxiety and the meaning of life in nurses, one of which is perceived stress. This study aims to assess the mediating role of perceived stress in the relationship between the meaning of life and death anxiety in nurses. 

Methods 
This is a correlational study using structural equation modeling (SEM). The study population consists of all nurses working in public hospitals in Isfahan, Iran, in 2023. Using a convenience sampling method, 240 eligible nurses were selected from two public hospitals. The data collection tools included a demographic form (surveying age, gender, marital status, educational level), the Meaning in Life Questionnaire (MLQ), the Death Anxiety Scale (DAS), and the Perceived Stress Scale (PSS). The MLQ is a 10-item tool with two components of “presence” and “search”, developed by Steger et al. [22] The DAS is a 15-item tool developed by Templer et al. [24] The PSS is a 14-item instrument developed by Cohen et al. To analyze the collected data, descriptive statistics (such as mean and standard deviation) and inferential statistics, including Pearson’s correlation test and SEM, were used in SPSS software, version 23 and Amos.

Results 
Out of 240 participants, 230 answered the questionnaires completely. Most of them were female (71%) and married (70%). According to the results, the mean MLQ score was 50.14, the mean PSS was 28.21, and the mean DAS score was 7.67. In the SEM model, the relationship between the meaning of life and death anxiety was negative and significant (β=-0.160, P=0.009). The relationship between perceived stress and death anxiety was positive and significant (β=0.216, P=0.002). Also, the indirect relationship between the meaning of life and death anxiety through perceived stress was negative and significant (β=-0.702, P=0.006). Therefore, the mediating role of perceived stress in the relationship between the meaning of life and death anxiety was confirmed.

Conclusion 
The meaning of life has a negative relationship with death anxiety in Iranian nurses, indicating that the increase in the meaning of life can reduce the death anxiety in nurses. Perceived stress has a positive relationship with death anxiety in Iranian nurses, indicating that nurses’ higher perception of stress can increase their death anxiety. Furthermore, perceived stress has a mediating role in the relationship between the meaning of life and death anxiety in Iranian nurses.

Ethical Considerations

Compliance with ethical guidelines
All ethical principles were considered. The study was approved by the Ethics Committee of Kashan University (Code: IR.KASHANU.REC.1402.009).

Funding
This article was extracted from the Master's thesis of Safiye Hajian, at the Department of General Psychology, Faculty of Humanities, Kashan University. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Authors' contributions
Data collection, writing, and statistical analysis: Safiye Hajian; supervision and project management: Mohammadreza Tamanaifar; review and final approval: All authors.

Conflict of interest
The authors declared no conflict of interest.

Acknowledgments
The authors would like to thank all the nurses who participated in this research for their cooperation.



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Type of Study: Research | Subject: nursing
Received: 2024/05/10 | Accepted: 2024/09/25 | Published: 2024/10/31
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