Journal of Education and Health Promotion

Abstract BACKGROUND: Existential anxiety (EA) revolves around the question of ultimate concern related
to life and death. It gets more prominent when there is an exposure to stressful experiences where
the stress is profound and resources seem insufficient. The objective was to measure the prevalence
and magnitude of EA in the study population from the Kashmir valley during the COVID‑19 pandemic.
MATERIALS AND METHODS: In this cross‑sectional study, data were collected through social media.
All the participants belonging to the Kashmir valley were included. EA questionnaire developed by
Weems et al. was used.
RESULTS: A total of 132 subjects were included. The prevalence of EA concerns was death 55%,
fate 62%, emptiness 73%, meaninglessness 32%, guilt 55%, and condemnation 64%. The mean EA
score was 5.0. EA was higher in those who had been diagnosed with mental illness ever in their life
by a psychiatrist than those who had no such history. EA score was much higher in those who had
ever felt a need to visit a psychiatrist than those who had not. There was no statistically significant
difference in the mean scores of EA for those who never felt this need and those who felt this need
since the start of the COVID‑19 pandemic.
CONCLUSION: There was a high prevalence of EA in the study population from the Kashmir valley.
Relative concerns were more prevalent than absolute concerns. EA score was higher among those
who had mental health issues compared to others.

Abstract BACKGROUND: Death anxiety is one of the most common problems among women with cancer,
which can affect the useful treatment process. With regard to the superior role of spiritual well‑being
over other aspects of health, the present study is aimed to compare the relationship between spiritual
well‑being and death anxiety among women with breast and cervical cancers and women with gastric
and colorectal cancers.
METHODOLOGY: This was a descriptive–correlational study. Research statistical population included
Iranian women with cancer at major hospitals in Isfahan, Iran. 160 research samples were selected
through convenience sampling method based on inclusion criteria using a demographic questionnaire,
spiritual well‑being scale (Paloutzian et al.) and death anxiety scale (Templer). Research data were
analyzed through SPSS 22 using independent t‑test, Pearson’s correlation, and analysis of variance
at significance level 0.05.
RESULTS: The study findings indicated a significant inverse relationship between death anxiety
and spiritual well‑being (at 0.05) in both groups. As a result, people with higher spiritual well‑being
would experience less anxiety about death. In addition, the relationship between death anxiety and
spiritual well‑being in women with gastric and colorectal cancers was stronger than those with breast
and cervical cancers.
CONCLUSION: Spiritual well‑being is of effective factors of death anxiety among women suffering
from cancer. Spirituality and meeting spiritual needs are considered as nursing care priorities for
these women. Furthermore, paying attention to the spirituality by nurses may shield against individual
difficulties.