Impact of Death Anxiety and Psychological Distress on the Quality of Life of Thalassemia Patients
DOI:
https://doi.org/10.52053/jpap.v6i4.467Keywords:
Death Anxiety, Psychological Distress, Quality of Life, Thalassemia PatientsAbstract
The purpose of this study was to explore the relationship between death Anxiety, psychological distress and quality of life among thalassemic patients. The quantitative research design was used, utilizing non probability purposive sampling to draw sample size of (N=103) adult thalassemic patients of aged 18 to 40 years. Consent form and demographic sheet was provided to each participant. Urdu versions of Death Anxiety Scale, Depression, Anxiety, Stress Scale (DASS-21), and EUROHIS-QOL-8 items Scale were administered to each participant. Data was analyzed by using regression analysis, Pearson correlation and independent t test. The regression analysis shows that death anxiety negatively impacts the quality of life of thalassemia patients (? = -.62, p < .001). The correlation analysis finds out that psychological distress is negatively correlated (r= -.58**) with the quality of life. Further correlation analysis shows that psychological distress has stronger positive association (r= .88**) with the death anxiety. The independent t test showed statistically significant gender difference in the psychological distress. The findings of this study will help nurses, health care professionals and thalassemic centers to improve the thalassemic patient’s quality of life by applying interventions and appropriate therapies.
References
Afifi, T., Elessi, K., Baraka, O., Omar, M., Ahmad, I., Al-Attar, H., Qudaih, A., Alsultan, K., Abdelati, M., Astal, A., Shammala, S.A., Obaid, M.A., Abu-Rous, M.R., Samaan, M., Albatsh, K., & Almoqaid, A. (2022). Assessment of Quality of life Among Children with Cancer, Children Undergoing Hemodialysis and Children with Thalassemia: A Comparative Study. International Journal of Clinical and Medical Education Research, 1-16. https://doi.org/10.21203/rs.2.23686/v1
Ahmadi, M., Gheibizadeh, M., Rassouli, M., Ebadi, A., Asadizaker, M., & Jahanifar, M. (2020). Experience of uncertainty in patients with thalassemia major: a qualitative study. International Journal of Hematology-oncology and Stem Cell Research, 14(4), 237. . doi: 10.18502/ijhoscr.v14i4.4479
Alkhaqani, A. (2022). Psychological impact of chronic kidney disease and Hemodialysis: Narrative review. Psychosomatic Medicine Research, 4(2), 1-5. https://doi.org/10.53388/202209
Ansari, A. H., Ansari, S. H., Salman, M. J., Ansari, M. U. H., & Jabeen, R. (2024). A scoping review on the obstacles faced by beta thalassemia major patients in Pakistan-Matter of policy investment. AIMS Public Health, 11(4), 1105. doi: 10.3934/publichealth.2024057
Ansari, S. H., Shamsi, T. S., Khan, M. T., Perveen, K., Farzana, T., Erum, S., & Ansari, I. (2012). Seropositivity of Hepatitis C, Hepatitis B and HIV in chronically transfused ??-thalassaemia major patients. Journal of College of Physicians & Surgeons of Pakistan, 22(9), 610-611.
Aqeel, M., Abbas, J., Shuja, K. H., Rehna, T., Ziapour, A., Yousaf, I., & Karamat, T. (2022). The influence of illness perception, anxiety and depression disorders on students mental health during COVID-19 outbreak in Pakistan: a web-based cross-sectional survey. International Journal of Human Rights in Healthcare, 15(1), 17-30. doi: https://doi.org/10.1108/IJHRH-10-2020-0095
Anum, J., & Dasti, R. (2016). Caregiver burden, spirituality, and psychological well-being of parents having children with thalassemia. Journal of Religion and Health, 55, 941-955. doi:10.3998/jmmh.10381607.0008.204)
Azarkeivan, A., Hajibeigi, B., Alavian, S. M., Lankarani, M. M., & Assari, S. (2014). Associates of poor physical and mental health-related quality of life in beta thalassemia-major/intermedia. Journal of Research in Medical Sciences: The Official Journal of Isfahan University of Medical Sciences, 14(6), 349.
Aziz, E., El Mliegy, O. I., Esmail, A., & Mohammed, A. (2022). Effect of Health Education about Care of Stroke Patients on the Burden of Care Providers and their Quality of Life. https://doi.org/10.21203/rs.3.rs-2320142/v1
Bibi, A., Hassan, M., Khan, S. U., Naeem, M. O., & Asnath, L. (2021). Assessment of the quality of life of children with beta thalassemia in Peshawar district: A cross sectional study. Pakistan Journal of Medical Research, 60(3), 121-125.
Colah, R., Gorakshakar, A., & Nadkarni, A. (2010). Global burden, distribution and prevention of ?-thalassemias and hemoglobin E disorders. Expert Review of Hematology, 3(1), 103-117. https://doi.org/10.1586/ehm.09.74
Eren, M. G., Üçgül, K., & Sert, H. (2023). Effectiveness of interventions on death anxiety and fear in adults with chronic disease: A systematic review and meta-analysis of randomized controlled trials. OMEGA-Journal of Death and Dying, 00302228231167725. https://doi.org/10.1177/00302228231167725
Etemad, K., Mohseni, P., Aghighi, M., Bahadorimonfared, A., Hantooshzadeh, R., Taherpour, N., Piri, N., Sotoodeh Ghorbani, S., Malek, F., Kheiry, F., Khodami, A., Valadbeigi, T., & Hajipour, M. (2021). Quality of Life and Related Factors in ?-Thalassemia Patients. Hemoglobin, 45(4), 245–249. https://doi.org/10.1080/03630269.2021.1965617
Eyetsemitan, F. E. (2021). Death, dying, and bereavement around the world: Theories, varied views and customs. Charles C Thomas Publisher.
Ghanizadeh, A., Khajavian, S., & Ashkani, H. (2006). Prevalence of psychiatric disorders, depression, and suicidal behavior in child and adolescent with thalassemia major. Journal of Pediatric Hematology Oncology, 28(12), 781-784. https://doi.org/10.1097/01.mph.0000243665.79303.9e
Ishfaq, K., Diah, N. M., Ali, J., Fayyaz, B., & Batool, I. (2018). Psychosocial problems faced by thalassemia major patients of district Multan, Pakistan. Pakistan Pediatric Journal, 42(1), 22-26.
Jabeen, R., Ansari, I., Durrani, B., Salman, M. J., Mazhar, L., Ansari, M. H., Ansari, A. H., Kabani, S., Ansari, S. H. (2024). Exploring the perceptions and experiences of female’s with ß-thalassemia major in a Tertiary Care Private Hospital in Pakistan. Transfusion Clinique et Biologique, 31(4), 244-252. https://doi.org/10.1016/j.tracli.2024.06.008
Jamil, Z., Ejaz, U., Najeeb, A., & Jamil, A. (2024). Psychosocial Problems Faced by Parents of Children with Thalassemia: A Cross Sectional Study Conducted in Quetta Pakistan. Journal of Psychosocial Rehabilitation and Mental Health, 1-10. https://doi.org/10.1007/s40737-024-00400-8
Khoury, B., Lecomte, T., Fortin, G., Masse, M., Therien, P., Bouchard, V., Chapleau, M. A., Paquin, K., & Hofmann, S. G. (2013). Mindfulness-based therapy: a comprehensive meta-analysis. Clinical Psychology Review, 33(6), 763-771. https://doi.org/10.1016/j.cpr.2013.05.005
Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33(3), 335–343. https://doi.org/10.1016/0005-7967(94)00075-u
Mediani, H. S., & Fuadah, N. T. (2025). Factors contributing to anxiety in adolescents surviving thalassemia major in Indonesia. BMC Pediatrics, 25(1), 86. https://doi.org/10.1186/s12887-025-05403-3
Mostafa, H. A., Zeid, E. N. A., & Mahmoud, D. A-B. (2024). Correlation between Psychological Problems, Quality of Life and Coping Strategies among Parents of Children with Thalassemia. Egyptian Journal of Health Care, 15(4), 1536-1555. doi: 10.21608/ejhc.2024.403567
Motiani, A., Zubair, M., & Sonagra, A. (2024). Laboratory evaluation of alpha thalassemia. StatPearls. StatPearls Publishing.
Nabi, A. T., Muttu, J., Chhaparwal, A., Mukhopadhyay, A., Pattnaik, S. J., & Choudhary, P. (2022). Implications of ?-thalassemia on oral health status in patients: A cross-sectional study. Journal of Family Medicine and Primary Care, 11(3), 1174-1178. DOI: 10.4103/jfmpc.jfmpc_1215_21
Ramzan, A., & Ahmad, S. (2024). Psychological distress, General health and Life satisfaction among children with Thalassemia and children undergoing Haemodialysis. Pakistan Journal of Medical Sciences, 40(10), 2309. doi: 10.12669/pjms.40.10.9412
Rikos, N., Giannadaki, G.-K., Spontidaki, A., Tzagkaraki, M., & Linardakis, M. (2021). Health status, anxiety, depression, and quality of life of patients with thalassemia. Journal of Public Health, 29, 1313-1320. https://doi.org/10.1007/s10389-020-01241-y
Saeed, W. (2025). The relationship of depression and quality of life with mediating role of death anxiety, silver lining and religious coping among women cancer patients in Pakistan. Frontiers in Oncology, 15, 1489169. doi: 10.3389/fonc.2025.1489169
Sarhan, A. L., Modallal, S., Mahamid, F. A., & Berte, D. Z. (2022). Depression symptoms and associated factors among thalassemia patients in the Palestinian Territories: a cross-sectional study. Middle East Current Psychiatry, 29, 1-8. https://doi.org/10.1186/s43045-021-00166-w
Sari, D. P., Wahidiyat, P. A., Setianingsih, I., Timan, I. S., Gatot, D., & Kekalih, A. (2022). Hematological parameters in individuals with beta thalassemia trait in South Sumatra, Indonesia. Anemia, 2022(1), 3572986. https://doi.org/10.1155/2022/3572986
Schmidt, S., Mühlan, H., & Power, M. (2006). The EUROHIS-QOL 8-item index: psychometric results of a cross-cultural field study, European Journal of Public Health, 16(4), 420–428, https://doi.org/10.1093/eurpub/cki155
Seyedifar, M., Dorkoosh, F. A., Hamidieh, A. A., Naderi, M., Karami, H., Karimi, M., Fadaiyrayeny, M., Musavi, M., Safaei, S., Ahmadian-Attari, M. M., Hadjibabaie, M., Cheraghali, A. M., & Akbari Sari, A. (2016). Health-related quality of life and health utility values in beta thalassemia major patients receiving different types of iron chelators in Iran. International Journal of Hematology-oncology and Stem Cell Research, 10(4), 224.
Shuja, K. H., Aqeel, M., & Sarfaraz, R. (2021). Chronic pain management a fundamental human right: adaptation and examination of psychometric properties of pain anxiety symptoms scale among osteoporosis sample from Pakistan. International Journal of Human Rights in Healthcare, 14(1), 42-57. https://doi.org/10.1108/IJHRH-07-2020-0057
Suryawan, A., Ningtiar, H. W., Irwanto, I., & Ugrasena, I. D. G. (2021). Determinant factors of depression in beta major thalassemia children. Folia Medica Indonesiana, 57(1), 46-52. https://doi.org/10.20473/fmi.v57i1.13664
Taher, A. T., Bou-Fakhredin, R., Kattamis, A., Viprakasit, V., & Cappellini, M. D. (2021). Improving outcomes and quality of life for patients with transfusion-dependent ?-thalassemia: recommendations for best clinical practice and the use of novel treatment strategies. Expert Review of Hematology, 14(10), 897-909. https://doi.org/10.1080/17474086.2021.1977116
Tar?m, H. ?., & Öz, F. (2022). Thalassemia major and associated psychosocial problems: a narrative review. Iranian Journal of Public Health, 51(1), 12. doi: 10.18502/ijph.v51i1.8287
Templer, D. I. (1970). The construction and validation of adeath anxiety scale. Journal of General Psychology, 82,165–177.
The World Health Organization Quality of Life assessment (WHOQOL): position paper from the World Health Organization. (1995). Social Science & Medicine (1982), 41(10), 1403–1409. https://doi.org/10.1016/0277-9536(95)00112-k
Vitrano, A., Calvaruso, G., Lai, E., Colletta, G., Quota, A., Gerardi, C., Concetta Rigoli, L., Pitrolo, L., Cuccia, L., Gagliardotto, F., Filosa, A., Caruso, V., Argento, C., Campisi, S., Rizzo, M., Prossomariti, L., Fidone, C., Fustaneo, M., Di Maggio, R., & Maggio, A. (2017). The era of comparable life expectancy between thalassaemia major and intermedia: Is it time to revisit the major?intermedia dichotomy? British Journal of Haematology, 176(1), 124-130. https://doi.org/10.1111/bjh.14381
Waite-Jones, J. M., & Rodriguez, A. M. (2022). The Impact of Long-Term Conditions During Childhood and Adolescence. In Psychosocial Approaches to Child and Adolescent Health and Wellbeing (pp. 195-225). Springer. https://doi.org/10.1007/978-3-030-99354-2_10
Zaheer, H. A., Waheed, U., Abdella, Y. E., & Konings, F. (2020). Thalassemia in Pakistan: A forward-looking solution to a serious health issue. Global Journal of Transfusion Medicine, 5(1), 108-110. DOI: 10.4103/GJTM.GJTM_72_19
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