fear of death

Background The coronavirus disease 2019 (COVID-19) pandemic and Russia’s full-scale invasion of Ukraine represent unprecedented global stressors with substantial consequences for mental health. Objective A repeated cross-sectional study was conducted in three independent Hungarian samples before COVID-19 ( N = 249), after the second wave of COVID-19 ( N = 265), and during the early phase of Russia’s full-scale invasion of Ukraine ( N = 148) to examine differences in meaning in life, coping competencies, and fear of death, as well as in the relationships among these constructs. The outbreak of the invasion during data collection provided a unique opportunity to examine these constructs during its early phase. Results Compared with the post-COVID sample, lower descriptive levels of fear of death were observed following the outbreak of Russia’s full-scale invasion of Ukraine. Lower levels of several coping resources, particularly sense of coherence and social competencies, together with the greater relevance of search for meaning, were among the key findings associated with these unforeseen stressors. Stronger associations between coping and meaning in life were identified, while the association between presence of meaning and search for meaning became stronger following the outbreak of the invasion. Network analyses further suggested a closer integration of meaning-related processes with fear of death and coping resources, although these patterns should be interpreted cautiously given the limited stability of the network estimates. Conclusion The findings suggest that exposure to successive unforeseen large-scale stressors may be associated with the reorganization of meaning-related processes and coping resources. The patterns observed following the outbreak of the war may be interpreted within the framework of distal defense processes described by the terror management theory, although these mechanisms were not directly assessed in the present study. The results suggest that longer-term existential anxiety processes and their delayed psychological and social consequences should be considered when developing mental health interventions. These findings may contribute to the refinement of healthcare interventions across multiple levels and cultural contexts in preparation for current and future crises.

This qualitative descriptive study aimed to identify the stressors encountered by surgical patients in the operating room through their own expressions and subjective experiences. The study was conducted withinvolved 14 surgical patients who were admitted to the surgical wards of a training and research hospital after surgery. Participants were selected using maximum variation sampling. Data were collected through face-to-face, semi-structured, in-depth interviews conducted 48–72 hours after surgery, when patients were clinically stable and able to express their experiences. Interviews lasted 41–64 minutes, were audio-recorded with consent, and were supported by field notes. Data were analysed by three researchers using inductive content analysis with MAXQDA software by three researchers. Trustworthiness was ensured according to Lincoln and Guba’s criteria. Four main themes were identified: psychological and emotional stressors, physical and environmental stressors, social and communication-related stressors, and waiting related stressors. Patients reported uncertainty about the course of surgery, fear of death or complications, loss of control under anaesthesiaduring anaesthesia, cold temperaturecold temperatures, bright lights, unfamiliar environmental stimuli, insufficient information, emotionally distant communication, loneliness, and prolonged waiting. Coldness was experienced both as physical discomfort and as a symbolic reminder of death. Postoperative pain, perceived deficiencies in care, and mobilisation-related concerns were presentedidentified as contextual findings. The findings indicate that operating room stressors are multidimensional and extend beyond technical surgical preparation. Patient-centred operating room nursing should include clear information, emotional reassurance, environmental comfort, protection of the patient’s dignity, and support during waiting and transfer processes.

این مطالعه توصیفی کیفی با هدف شناسایی عوامل استرس‌زا که بیماران جراحی‌شده در اتاق عمل با آن مواجه می‌شوند، بر اساس بیان‌ها و تجارب ذهنی خود بیماران انجام شد. این پژوهش شامل ۱۴ بیمار جراحی‌شده بود که پس از عمل جراحی در بخش‌های جراحی یک بیمارستان آموزشی و پژوهشی بستری شده بودند. شرکت‌کنندگان با استفاده از نمونه‌گیری حداکثر تنوع انتخاب شدند. داده‌ها از طریق مصاحبه‌های عمیق نیمه‌ساختاریافته و رو‌در‌رو که ۴۸ تا ۷۲ ساعت پس از جراحی و زمانی که بیماران از نظر بالینی پایدار و قادر به بیان تجارب خود بودند، جمع‌آوری شد. مدت زمان مصاحبه‌ها بین ۴۱ تا ۶۴ دقیقه بود، با رضایت بیماران ضبط صوتی شد و با یادداشت‌های میدانی تکمیل گردید. داده‌ها توسط سه پژوهشگر با استفاده از تحلیل محتوای استقرایی و نرم‌افزار MAXQDA تحلیل شدند. اعتبار پژوهش بر اساس معیارهای Lincoln و Guba تضمین شد. چهار مضمون اصلی شناسایی گردید: عوامل استرس‌زای روان‌شناختی و هیجانی، عوامل استرس‌زای جسمی و محیطی، عوامل استرس‌زای اجتماعی و مرتبط با ارتباطات، و عوامل استرس‌زای مرتبط با انتظار. بیماران به مواردی چون عدم قطعیت نسبت به روند جراحی، ترس از مرگ یا عوارض، از دست دادن کنترل در حین بیهوشی، دمای سرد، نورهای شدید، محرک‌های محیطی ناآشنا، اطلاعات ناکافی، ارتباط عاطفی سرد، احساس تنهایی و انتظار طولانی اشاره کردند. سرما هم به عنوان ناراحتی جسمی و هم به عنوان یادآور نمادین مرگ تجربه شد. درد پس از عمل، برداشت از کمبود مراقبت و نگرانی‌های مرتبط با تحرک به عنوان یافته‌های زمینه‌ای مطرح شدند. یافته‌ها نشان می‌دهد که عوامل استرس‌زای اتاق عمل چندبعدی بوده و فراتر از آمادگی فنی جراحی هستند. پرستاری مبتنی بر بیمار در اتاق عمل باید شامل ارائه اطلاعات شفاف، اطمینان‌بخشی عاطفی، راحتی محیطی، حفظ کرامت بیمار و حمایت در فرآیندهای انتظار و انتقال باشد.