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Updated: Jun 5, 2026

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Psychological interventions to alleviate death anxiety among patients with cancer: a systematic review and
Guiyun Wang1, Jiaojiao Li1, Jinnan Xiao2
1School of Nursing, Shandong Xiehe University, No; 6277 Jiqing Road, Licheng District, Jinan City, Shandong Province, China.
Objective:
Death anxiety is a common psychological distress in cancer patients and is associated with reduced quality of life. However, the efficacy of current psychological interventions for relieving this symptom remains unclear. This study aims to assess the effectiveness of psychological interventions in alleviating death anxiety among cancer patients and explore key effective intervention components.
Methods:
A systematic review of randomized controlledstudies.
Data Sources:
Eight databases (PubMed, Embase, Cochrane Library, Web of Science, PsycINFO, CNKI, Wanfang, and VIP) were searched from inception to February 28, 2025. The Cochrane Risk of Bias 2 (RoB 2.0) tool was used to assess the risk of bias in the included studies.
Results:
Nine papers involving 1,024 cancer patients were included. According to intervention components, the studies were divided into two categories: (1) Exploration of Life Meaning Interventions (ELMI) and (2) Cognitive Restructuring Interventions (CRI). Meta-analysis showed ELMI had a statistically significant but modest effects on death anxiety (SMD: - 0.17, 95% CI: (-0.32, - 0.01), P = 0.03). Narrative synthesis suggested that CRI may alleviate death anxiety among cancer patients. GRADE assessment rated the evidence for death anxiety as very low.
Conclusions:
The effect of psychological interventions on alleviating death anxiety in cancer patients remains inconclusive. ELMI showed a statistically significant but modest effect, while evidence for CRI was inconsistent. Further high-quality studies with larger samples, standardized protocols, and longer follow-up are needed to explore combined or personalized intervention strategies.
Trial Registration:
The study protocol for this systematic review has been registered in PROSPERO(CRD420251169425).
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