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Death anxiety in patients with heart failure: an updated integrative review Cover

Death anxiety in patients with heart failure: an updated integrative review

By:   
Open Access
|Mar 2026

Figures & Tables

Figure 1.

Literature search flowchart.

Table 1.

Characteristics of included studies.

Characteristics of studiesNumber of studies (n)Percentage (%)
Country
   Iran758.33
   Turkey433.34
   USA18.33
Design
   Cross-sectional975.10
   Mixed-method longitudinal18.33
   Quasi-experimental18.33
   Randomized controlled trial18.33
Sample size
   <100216.67
   101-150541.67
   150-20018.33
   >200433.33
Table 2.

Summary of included studies on death anxiety in HF.

Authors (years)PurposeDASScore rangeMean death anxiety (SD)Severity interpretationMain findings
Asgari et al. (2018)6To examine death anxiety and its relationship with demographics in patients with HFTempler DAS (15-item)15–7547.95 ± 6.91Moderate–highOver 90% of patients experienced moderate to severe death anxiety
Çamcı et al. (2024)7To explore the relationship between religious coping and death anxiety in HFTempler DAS (15-item)0–157.78 ± 3.91Moderate–highHigher death anxiety associated with longer HF duration; weak positive correlation with religious coping
Ghorbani et al. (2023)12To compare spiritual experiences and death anxiety in HF vs angina patientsTempler DAS (15-item)15–7543.15 ± 13.41Moderate–highSignificant negative correlation between spiritual experience and death anxiety
Merati et al. (2024)13To examine relationship between QoL and death anxiety in patients with HFTempler DAS (15-item)15–757.54 ± 2.35Moderate–highHigher death anxiety associated with poorer QoL (r = 0.329, P < 0.001)
Sacco et al. (2014)18To investigate psychosocial resources and well-being in HFDAS/WHOQOL0–105.58 ± 2.62ModerateReligious/spiritual support associated with lower death anxiety
Yildirim et al. (2024)17To explore associations between death anxiety, loneliness, and hopeTempler DAS (15-item)0–1510.41 ± 3.94HighDeath anxiety positively predicted by age and loneliness (R2 = 23.1%)
Sazak et al. (2025)15To examine spiritual orientation and frailty mediated by death anxietyTempler DAS (15-item)0–158.03 ± 4.45Moderate–highDeath anxiety mediated the relationship between spiritual orientation and frailty
Soleimani et al. (2020)14To identify predictors of death anxiety among cardiac patientsTempler DAS (15-item)15–7545.15 ± 8.44Moderate–highGreater economic standing, reliance on friends as a primary income source, older age, stronger religious faith, and heightened hope were linked to reduced death anxiety.
Moradi et al. (2022)4To assess cognitive-behavioral therapy’s effect on death anxiety and depression in HFTempler DAS (15-item)0–159.96 ± 1.69Moderate–highCognitive-behavioral therapy significantly reduced death anxiety in patients with HF (P < 0.001).
Aryafard et al. (2023)10To examine correlations of death anxiety with spirituality and resilienceTempler DAS (15-item)0–157.21 ± 2.22ModerateReligious attitude and resilience inversely associated with death anxiety
Batı et al. (2024)16To explore self-care agency and death anxiety among elderlyTempler DAS (15-item)0–156.76 ± 3.25ModerateVery weak positive correlation between self-care and death anxiety (r = 0.158, P = 0.004)
Babaei Vahed et al. (2022)11To evaluate illness perception training on death anxiety in HFTempler DAS (15-item)0–15NRModerateTraining on illness perception significantly reduced anxiety about death, with a pre- to post-training change that was statistically significant (P < 0.001).

1 Note: DAS, death anxiety scale; HF, heart failure; NR, not reported; QoL, quality of life; SD, standard deviation; WHOQOL, World Health Organization Quality of Life.

DOI: https://doi.org/10.2478/FON-2026-0002 | Journal eISSN: 2544-8994 | Journal ISSN: 2097-5368
Language: English
Page range: 7 - 14
Submitted on: May 19, 2025
Accepted on: May 29, 2025
Published on: Mar 24, 2026
Published by: Shanxi Medical Periodical Press
In partnership with: Paradigm Publishing Services

© 2026 Wanich Suksatan, published by Shanxi Medical Periodical Press
This work is licensed under the Creative Commons Attribution 4.0 License.