Correlates of death anxiety for patients with cancer: A systematic review and meta‐analysis

OBJECTIVE: A systematic review and meta-analysis was performed to identify the factors related to cancer death anxiety based on available evidence. DESIGN: This systematic review and meta-analysis followed the PRISMA 2020 guidelines. METHODS: Seven databases were searched to identify studies on the relationships of cancer death anxiety with demographic characteristics, disease factors and psychosocial factors from inception to May 2023. The Agency for Medical Research and Quality (AHRQ) scale was used to evaluate the quality of the included studies. After two researchers independently completed the literature search, data extraction and quality evaluation, meta-analysis was conducted by using RevMan5.3 and Stata 17.0 software. RESULTS: In total, 52 studies were included in this review. The results revealed that there were positive correlations of death anxiety with female sex, the symptom burden, anxiety levels, depression levels, fear of recurrence, attachment avoidance, psychological distress, resignation and confrontation coping. Death anxiety was negatively correlated with age, education level, ability to perform daily activities, self-esteem, spiritual well-being, sense of meaning in life, resilience, quality of life, social support and religious beliefs. CONCLUSIONS: Our results can inform the design of interventions to address death anxiety and improve the overall quality of life of cancer patients. Healthcare professionals should promptly identify and focus on death anxiety in high-risk populations of cancer patients. RELEVANCE TO CLINICAL PRACTICE: Cancer patients commonly experience death anxiety, and this anxiety has a nonnegligible impact on patients' mental health and overall quality of life. This study can inform the development of interventions by clinical healthcare professionals. NO PATIENT OR PUBLIC CONTRIBUTION: This was a meta-analysis based on data from previous studies.