Death anxiety measurement using Templer Death Anxiety Scale: a systematic review and validation study

Area of Science:

• Psychology
• Healthcare Research
• Psychometrics

Background:

• Death anxiety is a significant concern for healthcare professionals, especially nurses, due to frequent end-of-life encounters.
• Cultural and religious factors in India, alongside high patient loads and limited validation studies, necessitate context-specific research on death anxiety.

Purpose of the Study:

• To systematically review existing validation studies of Templer's Death Anxiety Scale (TDAS).
• To empirically assess the psychometric properties of the TDAS among Indian nurses.

Main Methods:

• A systematic review (1970-2024) following PRISMA guidelines identified 19 studies.
• A cross-sectional study collected data from 1360 nurses in India using the 15-item TDAS.
• Exploratory and confirmatory factor analyses were employed.

Main Results:

• Existing TDAS validation studies reported varied structures and limitations like small sample sizes and cultural bias.
• Factor analyses confirmed a three-factor structure for the TDAS: Fear of Personal Mortality, Philosophical and Temporal Fear/Anxiety, and Fear of Societal Violence and Uncertainty.
• The 9-item model showed acceptable reliability (Cronbach's α=0.71) and good model fit.

Conclusions:

• The study provides a psychometrically validated TDAS for Indian healthcare settings.
• Culturally relevant validation is crucial for improving clinical and research applications of death anxiety assessments.