The mediating role of meaning in life between experiential avoidance and death anxiety among cancer patients: a cross-sectional study

• Published in: BMC cancer Vol. 24; no. 1; pp. 663 - 9
• Main Authors: Yan, Yixia, Chen, Yongyi, Ou, Meijun, Gong, Youwen, Yang, Renting, Liu, Xiangyu, Xia, Wanting, Chen, Furong, Zheng, Hongling, Xu, Xianghua
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 31.05.2024; BioMed Central; BMC
• Subjects: Adult; Aged; Analysis; Anxiety; Anxiety - psychology; Attitude to Death; Avoidance Learning; Cancer; Cancer patients; Care and treatment; China - epidemiology; Cooperation; Coping; Correlation analysis; Cross-Sectional Studies; Death; Death anxiety; Diagnosis; Experiential avoidance; Fear & phobias; Female; Flexibility; Humans; Hypotheses; Male; Management theory; Meaning in life; Mediation effect; Mental disorders; Mental health; Middle Aged; Neoplasms - mortality; Neoplasms - psychology; Patients; Quality of life; Quality of Life - psychology; Questionnaires; Regression analysis; Surveys and Questionnaires; China; Meaning in life; Cancer patients; Death anxiety; Mediation effect; Experiential avoidance
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-024-12433-0

Death anxiety is thought to cause a range of mental disorders among cancer patients, which may affect their mental health and even quality of life. This study sought to investigate experiential avoidance, meaning in life, and death anxiety among Chinese cancer patients and then explore the relationship between these 3 variables. A total of 300 cancer patients recruited from a tertiary cancer hospital participated in this study from October to December 2021. A cross-sectional survey was conducted using a demographic and clinical characteristics questionnaire, the Acceptance and Action Questionnaire II, the Meaning in Life Questionnaire, and Templer's Death Anxiety Scale. Correlation analysis, hierarchical regression analysis, and mediating effect analysis were used to analyze the relationship among experiential avoidance, meaning in life (including 2 dimensions: presence of meaning and search for meaning), and death anxiety. A total of 315 questionnaires were distributed, and 300 valid questionnaires were returned, resulting in a valid response rate of 95.2%. Experiential avoidance (r = 0.552, p < 0.01) was moderately positively correlated with death anxiety. Presence of meaning (r = - 0.400, p < 0.01) was moderately negatively correlated with death anxiety, while search for meaning (r = - 0.151, p < 0.01) was weakly negatively correlated with death anxiety. Regression analysis showed that experiential avoidance (β = 0.464) and presence of meaning (β = -0.228) were predictors of death anxiety. Mediating effect analysis revealed that presence of meaning either completely or partially mediated the effect of experiential avoidance and death anxiety, and the indirect effect accounted for 14.52% of the total effect. Overall, experiential avoidance predicts death anxiety in cancer patients, and meaning in life can mediate this effect. The results of this study provide a new path for studying the mechanism of death anxiety and suggest a more positive and promising strategy for its management.