The Effect of Pain on Intolerance of Uncertainty and Death Anxiety in Individuals Developing Vertebral Fractures...

Objective: The aim of this study is to compare the levels of intolerance of uncertainty and death anxiety between individuals who developed vertebral fractures after liver transplantation and those who did not and to examine the effect of pain on these two variables. Materials and Methods: This study was designed as an observational cross-sectional study. Clinical and demographic data were retrospectively obtained from electronic medical records, while missing information and patient-reported outcomes (pain, intolerance of uncertainty, and death anxiety) were collected during a single structured telephone interview. The retrospective investigation was carried out among liver transplant recipients at İnönü University Turgut Özal Medical Center, comparing patients who developed vertebral fractures post-transplant with those who did not. Data were collected from the electronic medical records system of the hospital. Based on the evaluations obtained from the registration system, individuals diagnosed with vertebral fractures and individuals without vertebral fractures but with similar demographic characteristics (such as age, gender, duration of transplantation, and etiological factors) were included in the study. The data collection tools used were the "Patient Information Form," "Visual Analog Scale (VAS)," "Intolerance of Uncertainty Scale," and "Death Anxiety Scale." The study employed Mann-Whitney U analysis, Spearman correlation analysis, and Fisher's exact chi-square analysis. Results: Comparative analysis revealed statistically significant differences (p < 0.001) between post-liver transplant patients with vertebral fractures versus those without fractures across three key measures: pain intensity (VAS scores), intolerance of uncertainty, and death anxiety levels. A strong positive correlation was found between the patients' pain levels and their level of intolerance of uncertainty (r = 0.823), as well as between pain levels and death anxiety (r = 0.840) (p < 0.001). Additionally, a strong positive correlation was identified between intolerance of uncertainty and death anxiety (r = 0.883) (p < 0.001). Conclusions: It was found that individuals with vertebral fractures had higher levels of pain, intolerance of uncertainty, and death anxiety compared to the group without vertebral fractures. As patients' pain levels increased, their levels of intolerance of uncertainty and death anxiety also increased. Additionally, it can be stated that as patients' intolerance of uncertainty increased, their death anxiety also increased.