RESULTS

The main aim of the present investigation was to study the relationship

between fear of death and its cognitive, emotional and behavioural correlates

in females. Accordingly 200 females as study subjects completed background

questionnaire, Collett-Lester’s fear of death scale, Hope scale, Alienation

scale, Meaningfulness in life scale, Intrinsic religious motivation scale and

Health promoting lifestyle profile II.

The individual scores for all the variables were obtained. The total

sample was divided into two groups of 100 females based on exposure and

no exposure to death and dying. 100 female subjects who were professionally

exposed to death and dying were in group-I and another 100 females who had

no exposure to death and dying in last 2 years were included in group-II.

The secondary aims of the present investigation were to study the level

of fear of death among all subjects and in group-I (females exposed to death

and dying) and group-II (females not exposed to death and dying in last 2

years), to compare both the groups on all dimensions of death anxiety as well

as to compare the fear of death and dying of self with fear of death and dying

of others in the complete sample and among two groups of females i.e.

group-I (females exposed to death and dying) and group-II (females not

exposed to death and dying in last 2 years).

110
 Keeping in view the aims of study the descriptive and inferential

statistical tests were used. The required descriptive statistics i.e. range, mean,

standard deviation (SD) and skewness for all the study variables are presented

below:

Table-3
Descriptive Statistics for the Study Variables (N=200)
Range of Obtained Mean SD Skewness
Variables
Scores

Fear of death of self 8 to 40 24.01 7.98 .06

Fear of dying of self 8 to 40 27.78 6.52 -.31

Fear of death of others 9 to 40 30.10 6.41 -.52

Fear of dying of others 10 to 40 29.55 6.86 -.66

Hope 13 to 32 25.18 3.13 -.73

Alienation 9 to 54 34.06 8.11 -.15

Meaningfulness in life (presence) 12 to 35 26.15 4.33 -.36

Meaningfulness in life (search) 8 to 35 25.26 5.28 -.76

Intrinsic religious motivation 14 to 54 40.08 5.87 -.85

Health promoting behaviours 77 to 208 135.17 21.89 .55

Table–3 presents the descriptive statistics i.e. range, mean, standard

deviation and skewness for all the study variables i.e. fear of death of self,

fear of dying of self, fear of death of others, fear of dying of others, hope,

alienation, meaningfulness in life (presence), meaningfulness in life (search),

intrinsic religious motivation and health promoting behaviours. Range, mean,

111
standard deviation and skewness were worked out to know the nature of score

distribution. The skewness values for all the study variables were in

acceptable range.

Table-4
Distribution of Subjects According to Level of Death Anxiety
Level of Death Anxiety
Dimensions of Death
Subjects High Moderate Low
Anxiety
f % f % f %
Fear of death of self 46 23 85 42.5 69 34.5

Females Fear of dying of self 70 35 98 49 32 16

N=200 Fear of death of others 111 55.5 73 36.5 16 08

Fear of dying of others 100 50 77 38.5 23 11.5

Fear of death of self 28 28 42 42 30 30

Group-I (females
exposed to death and Fear of dying of self 46 46 40 40 14 14
dying)
Fear of death of others 60 60 32 32 08 08
n=100
Fear of dying of others 53 53 32 32 15 15

Fear of death of self 18 18 43 43 39 39

Group-II (females not
exposed to death and Fear of dying of self 24 24 58 58 18 18
dying in last 2 years )
Fear of death of others 51 51 41 41 08 08
n=100
Fear of dying of others 47 47 45 45 08 08

08-20 Low, 21-30 Medium, 31-40 High (Lester, 1990)

Table-4 indicates that in the sample as a whole maximum number of

females exhibited moderate level of fear of death and dying of self i.e. 85

(42.5%) and 98 (49%) respectively. On the other hand for fear of death and

dying of others maximum subjects reflected high anxiety level i.e. 111

(55.5%) and 100 (50%) respectively.

112
 While studying the levels of death anxiety in females exposed to death

and dying i.e. group-I, for fear of death of self moderate fear was shown by

42% and low by 30% subjects. 46% of the subjects in group-I expressed high

fear of dying of self and same for fear of death and dying of others 60% and

53% subjects expressed high fear respectively. In group-II (females not

exposed to death and dying in last two years) moderate level of fear of death

and dying of self was exhibited by maximum females i.e. 43% and 58%

respectively. For fear of death and dying of others maximum subjects were in

high category i.e. 51% and 47% respectively and minimum number of

subjects i.e. 8% and 8% showed low level of fear of death and dying of others

respectively.

Table-5
Difference between Group-I and Group-II on Death Anxiety
Group-II (females not
Group-I (females exposed
exposed to death &
Death Anxiety to death & dying) t
dying in last 2 years)
Dimensions N=100 value
N=100
Mean SD Mean SD
Fear of death of self 24.92 8.32 23.09 7.54 1.65*

Fear of dying of self 29 7.05 26.56 5.74 2.74**

Fear of death of others 30.60 6.48 29.59 6.33 1.14

Fear of dying of others 29.61 7.46 29.48 6.25 0.13

* p < .05
** p < .01

Table-5 The most common statistical technique used for comparing the

means of one variable for two groups is the group t-test. Here the
113
means of each death anxiety dimension i.e. fear of death of self , fear

of dying of self, fear of death of others and fear of dying of others were

compared individually in both the groups i.e. group-I (females exposed to

death and dying) and group-II (females not exposed to death and dying in last

2 years).

Out of four death anxiety dimensions; for two dimensions i.e. fear of

death of self (FDS) and fear of dying of self (FDyS) significant difference

was observed between the two groups. The mean of FDS in group-I (females

exposed to death and dying) is high in comparison to group-II (females not

exposed to death and dying in last 2 years) and females in group-I were

having significantly high fear of death of self as compared to females in

group-II (t=1.65, P<.05).

The FDyS is also significantly high in group-I in comparison to

group-II (t=2.74, P<.01). For fear of death of others (FDO) although no

significant difference was observed in both the groups but mean of FDO is

more in group-I (females exposed to death and dying) as compared to

group-II (females not exposed to death and dying in last 2 years). No

significant difference was noted between group-I and group-II for the fourth

dimension of death anxiety i.e. fear of dying of others.

114
 Table-6
Comparison of fear of death and dying of self with fear of death and dying of
others

Group-II
Group-I
(females not
(females
exposed to Total
exposed to
Dimensions death & Sample
death & t t t
of Death dying in last (N=200)
dying) value value value
Anxiety 2 years)
n=100
n=100

Mean SD Mean SD Mean SD

Fear of
24.92 8.32 23.09 7.54 24.01 7.98
death of self

6.87** 7.92** 10.47**

Fear of
death of 30.60 6.48 29.59 6.33 30.10 6.41
others

Fear of
29.00 7.05 26.56 5.74 27.78 6.52
dying of self

.863 5.23** 3.87**

Fear of
dying of 29.61 7.46 29.48 6.25 29.55 6.86
others

* p < .05
** p < .01

In table-6 paired t-test is used to compare subjects’ fear of death of self with

fear of death of others and fear of dying of self with fear of dying of others in

sample as a whole and in both groups i.e. group-I (females exposed to death

and dying) and group-II (females not exposed to death and dying in last 2

years). The mean of FDO was high as compared to mean of FDS in total

study subjects and significant difference was observed between fear of death

115
of self and of others (t=10.47, p<.01). FDO was significantly high. Significant

difference also exists in case of fear related to dying process of self and others

in total study sample (t=3.87, p<.01) and again the fear about the dying

process of others was significantly high in all the females.

In group-I (females exposed to death and dying) when the fear of death

of self and others were compared the mean score for fear of death of others

was higher as compared to fear of death of self and again a significant

difference was found i.e. the fear related to death of others was more (t=6.87,

p<.01). No significant difference was noted between fear of dying of self and

of others in this group of females but the mean score for the fear of dying of

others was more as compared to self.

Females in group-II (not exposed to death and dying in last 2

years) also showed significant difference between fear of death of self

and others (t=7.92, p<.01) as well as significant difference was observed

for fear of dying of self and of others (t=5.23, p<.01). In both cases the

fear of death and dying of others were more as compared to fear of death and

dying of self. All the subjects in group-II exhibited significantly higher fear of

death and dying of others as compared to self, same as that of total study

subjects.

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 Table – 7
Relationship of Cognitive, Emotional and Behavioural Correlates with Death Anxiety

Subject Different Dimensions of Hope Alienation Meaningfulness in Meaningfulness in Intrinsic Health Age
Death anxiety Life Life Religious Promoting
Motivation Behaviour
(Search) (Presence)
Total Fear of death of self .17* .24** .13 -.07 .11 .10 .019
Subjects
N=200 Fear of dying of self .17* . 22** .13 -.03 -.02 .17* -.073

Fear of death of others .04 .17* .09 -.08 .09 -.02 -.249**

Fear of dying of others .01 .11 .09 -.05 .06 .09 -.125

Group-I Fear of death of self .17 .27** .28** -.03 .04 .14 .08
(females
exposed to Fear of dying of self .25* .25* .26** -.03 -.06 .21* -.059
death &
dying) Fear of death of others .11 .13 .14 -.01 .01 -.02 -.245*
n=100
Fear of dying of others .03 .10 .21* -.03 .04 .03 -.124

Group-II Fear of death of self .17 .20* -.05 -.22* .16 .10 -.024
(females not
exposed to Fear of dying of self .05 .18 -.05 -.01 -.01 .15 -.064
death &
dying in last 2 Fear of death of others -.04 .21* .03 -.14 .15 -.02 -.245*
years)
n=100 Fear of dying of others -.01 .12 -.05 -.06 .09 .17 -.129

* p < .05
** p < .01

117
Correlation Analysis:

In this section bivariate correlation analysis was carried out to study

individually the relationship of cognitive, emotional and behavioural

correlates with different dimensions of death anxiety i.e. fear of death of self,
fear of dying of self, fear of death of others and fear of dying of others.

Table-7 is depicting the correlation coefficients of FDS, FDyS, FDO

and FDyO with hope, alienation, meaningfulness in life (search),
meaningfulness in life (presence), intrinsic religious motivation, health

promoting behaviours and age in complete sample as well as in group-I

(females exposed to death and dying) and group-II (females not exposed to
death and dying in last 2 years). Fear of death of self was found to be

significantly and positively correlated to hope (r=0.17, p<.05) and alienation

(r=0.24, p<.01) for all the study subjects. Fear of dying of self was also
found to be positively and significantly correlated with hope (r=.17, p<.05),

alienation (r=0.22, p<.01) and health promoting behaviours (r=0.17, p<.05).

Whereas meaningfulness in life (presence) and intrinsic religious
motivation presented a negative relationship with fear of dying of self but it

was not significant. Fear of death of others showed positive and significant
relationship with alienation (r=0.17, p<.05). Fear of death of others was
negatively and significantly correlated with age (r=-0.249, p<.01). Fear of

dying of self and others reflected a negative relationship with age but it was
not significant. Fear of dying of others was not found to be significantly
correlated with any of the study variables.

Correlation analysis of study variables in group-I (females exposed to

death and dying) indicated that fear of death of self was positively and
118
significantly correlated with alienation (r=0.27, p<.01) and meaningfulness
in life (search) (r=0.28 p<.01). Meaningfulness in life (presence) was
negatively correlated with fear of death of self but it was not significant. Fear

of dying of self found to be positively and significantly correlated with hope

(r=0.25, p<.05), alienation ( r=0.25, p<.05), meaningfulness in life (search)
(r=0.26, p<.01) and health promoting behaviours (r=0.21, p<.05). In these

study subjects (group-I) fear of death of others showed no significant

relationship with any of the study variables except age. Age showed
negative and significant relationship with fear of death of others (r=-0.245,

p<.05) but no significant relationship was there with other dimensions of

death anxiety. Fear of dying of others was positively and significantly
correlated with meaningfulness in life (search) (r=0.21, p<.05).

Findings of correlation analysis in group-II (females not exposed

to death and dying in last 2 years) reflected that fear of death of self
was significantly and positively correlated with alienation (r=0.20,
p<.05) but negative and significant relationship was shown with
meaningfulness in life (presence) (r=-0.22, p<.05). Fear of death of others
found to be positively and significantly correlated with alienation (r=0.21,
p<.05). Age showed negative relationship with all the dimensions of death

anxiety but with fear of death of others the relationship of age was negative
as well as significant (r=-0.245, p<.05). Fear of dying of self and others
showed no significant relationship with any of the study variables in this
group of females.

119
 Table-8
Multiple Regression Analysis (N=200)
Dependent Variables
Independent Variables
Fear of death of self Fear of dying of self Fear of death of others Fear of dying of others
↓
Reg. coeff. β coeff. R2 Reg. coeff. β coeff. R2 Reg. coeff. β coeff. R2 Reg. coeff. β coeff. R2
.21 .32 .15 -.11 -.06
Hope .08 .01 .01 .05 .002 -.03 .00
(.92) (1.74) (.60) (.33)

.19 .15 .09 .07

Alienation .19 .04 .18 .04 .12 .01 .09 .01
(2.54)* (2.47)* (1.63) (1.158)

-.003 -.24 -.16 -.11

Meaningfulness in life (presence) -.00 .00 -.16 .01 -.11 .01 -.07 .01
(.02) (1.93) (1.329) (.90)

.06 .06 .08 .07

Meaningfulness in life (search) .04 .005 .05 .00 .06 .004 .06 .00
(.50) (.73) (.86) (.75)

.02 -.11 .09 .06

Intrinsic religious motivation .02 .00 -.10 .01 .08 .01 .05 .00
(.19) (1.34) (1.10) (.65)

.02 .05 .003 .04

Health promoting behaviours .07 .01 .18 .04 .01 .00 .12 .01
(.84) (2.47)* (.15) (1.66)

-.01 -.13 -.36 -.21

Age -.01 .00 -.09 .01 -.27 .07 -.15 .02
(.15) (1.37) (3.90)** (2.06)*

R2 .07 .12 .11 .05

F-value 2.19* 3.72** 3.50** 1.51

* p < .05 , ** p < .01

t- values are given in parentheses

120
Regression Analysis:

In this section regression analysis has been carried out for the sample of

200 respondents. The total sample comprised of 100 females (exposed to

death and dying) and 100 females (not exposed to death & dying in last 2

years). In this multivariate regression analysis of four dimensions of fear of

death and dying i.e. fear of death of self (FDS), fear of dying of self (FDyS),

fear of death of others (FDO) and fear of dying of others (FDyO) were taken

as dependent variables and among independent variables hope, alienation,

meaningfulness in life (presence), meaningfulness in life (search), intrinsic

religious motivation, health promoting behaviours and age were incorporated.

Findings in table-8 suggest that the dependent variable, fear of death of

self has significant and positive relationship only with one variable which is

alienation. The regression coefficient 0.19 (t=2.54) is significant at 5 percent

level of significance. The variable age although not significant but had

negative relationship with FDS indicating that FDS declines with increasing

age. F-value is 2.19; which is significant at 5% level of significance. Out of

total contribution of 7% of all the variables, the alienation is contributing 4%

to FDS.

The second dependent variable FDyS is positively related with

alienation and health promoting behaviours taking the total sample in account.

Here variables alienation and health promoting behaviours are not only

significant, but their contribution towards FDyS is also maximum i.e. 4%

121
each. The regression coefficient for alienation is 0.15 (t=2.47) and for health

promoting behaviours the regression coefficient is 0.05 (t=2.47) both

significant at 5% level of significance. Hope showed positive relationship

with FDyS whereas meaningfulness in life (presence) exhibited negative

relationship with FDyS, but both are significant only at 10%. Hope as well as

meaningfulness in life (presence), both are equally contributing towards FDyS

i.e. 1% each. Overall significance of all independent variables is indicated by

F-value of 3.72 which is significant at 1 percent. The variables age and

intrinsic religious motivation although not significant at 5% level but the

negative relationship indicated that FDyS decreases with increase in age and

intrinsic religious motivation.

Thirdly on taking FDO as dependent variable for total sample then the

only variable that is highly significant is age for which the regression

coefficient is -0.36 (t=3.90), significant at 1 percent, and its individual

contribution towards FDO is 7%. This negative and significant variable shows

that with increasing age the fear of death of others decreases. The variable of

meaningfulness in life (presence) although not significant, exhibited a

negative relationship which depicts that FDO declines with increase in

meaningfulness in life (presence). Alienation is the other variable although

not significant at 5% but is positively related to FDO. The overall

contribution of all the independent variables is reflected by the F-value of

122
3.50 which is significant at 1% level of significance. The total contribution of

all the variables to fear of death of others is 11%.

Fourthly when FDyO has been taken as the dependent variable for total

sample then age as independent variable showed a significant and negative

relationship. Its regression coefficient is -0.21 (t=2.06) significant at 5% and

was contributing 2% towards FDyO. So it is indicating that with advancing

age FDyO reduces. Health promoting behaviours as another independent

variable is positively contributing towards FDyO but is significant only at

10%. Here all other variables are non-significant. Overall contribution as

shown by F-value is also insignificant.

It can be concluded from the preceding discussions that all the four

dimensions of death anxiety i.e. fear of death of self, fear of dying of self, fear

of death of others and fear of dying of others are mainly influenced by five

independent variables i.e. alienation, hope, health promoting behaviours

meaningfulness in life (presence) and age.

123
 Table-9
Multiple Regression Analysis in Group-I (females exposed to death and dying)
n=100
Dependent Variables
Fear of death of self Fear of dying of self Fear of death of others Fear of dying of others
Independent Variables
β
Reg. coeff. R2 Reg. coeff. β coeff. R2 Reg. coeff. β coeff. R2 Reg. coeff. β coeff. R2
coeff.
.21 .44 .29 -.06
Hope .08 .01 .19 .03 .14 .01 -.03 .00
(.62) (1.56) (1.08) (.20)
.21 .16 .02 .01
Alienation .20 .04 .18 .03 .03 .00 .02 .00
(1.79) (1.62) (.24) (.16)
-.21 -.29 -.07 -.05
Meaningfulness in life (presence) -.11 .01 -.18 .03 -.05 .00 -.03 .00
(1.006) (1.66) (.42) (.27)
.26 .19 .17 .30
Meaningfulness in life (search) .17 .04 .14 .02 .14 .02 .21 .04
(1.53) (1.32) (1.24) (1.90)
-.09 -.20 .02 .05
Intrinsic religious motivation -.07 .01 -.16 .03 .02 .00 .04 .00
(.63) (1.60) (.16) (.34)
.04 .06 -.02 .01
Health promoting behaviours .11 .01 .18 .03 -.07 .00 .02 .00
(.98) (1.61) (.62) (.20)
.14 -.09 -.39 -.26
Age .07 .01 -.06 .01 -.26 .07 -.15 .02
(.74) (.59) (2.58)* (1.45)
R2 .13 .18 .10 .06
F-value 2.06* 2.95** 1.54 .95

* p < .05, ** p < .01

t- values are given in parentheses

124
Regression analysis was separately carried out for both the study groups i.e.

group-I (females exposed to death and dying) and group-II (females not

exposed to death and dying in last 2 years) with 100 respondents in each

group. The regression analysis was carried out again taking FDS, FDyS,

FDO and FDyO as dependent variable and hope, alienation, meaningfulness

in life (presence) meaningfulness in life (search), intrinsic religious

motivation, health promoting behaviours and age as independent variables.

Firstly the multiple regression analysis was carried out in group-I

(females exposed to death and dying). As depicted in table-9 the first

dimension i.e. FDS in group-I has not shown any significant relationship with

any of the seven independent variables. In regression analysis of sample as a

whole the variable of alienation was positive and significant. Here this

variable is showing positive relationship but it is significant only at 10% level

(reg. coeff. 0.21, t=1.79). F-value (2.06) indicative of the overall contribution

of all the independent variables is significant at 5% level of significance and

out of the total contribution of 13%; alienation and meaningfulness in life

(search) both are contributing 4% each.

For the second dimension i.e. FDyS all the seven independent variables

are contributing significantly as indicated by F-value of 2.95, which is

significant at 1% and all the seven variables are making a contribution of

18%. Although none of the independent variables is exhibiting significant

relationship with fear of dying of self, but with meaningfulness in life

125
(presence) and the FDyS showed a negative relationship and it is significant

only at 10% level of significance.

FDO as dependent variable showed a negative and significant

relationship with age at 5% level (reg. coeff. -0.39, t=2.58). The negative

relationship indicates that with advancing age the fear of death of others

declines. The overall contribution of all the variables is 10% out of which age

is contributing the most i.e. 7%.

In group-I (females exposed to death and dying) FDyO has not shown

significant relationship with any of the variables. The only variable which is

significant at 10% is meaningfulness in life (search), (reg. coeff. 0.30, t=1.90)

and this variable’s contribution is 4% toward FDyO out of total contribution

of 6%. Significance of overall contribution of all the variables reflected by

F-value is again insignificant.

126
 Table-10
Multiple Regression Analysis in Group–II (Females not exposed to death and dying in last 2 years)
n=100
Dependent Variables
Independent Variables Fear of death of self Fear of dying of self Fear of death of others Fear of dying of others
Reg. coeff. β coeff. R2 Reg. coeff. β coeff. R2 Reg. coeff. β coeff. R2 Reg. coeff. β coeff. R2
-.04 .04 .009 .03
Hope -.01 .00 .02 .00 .005 .00 .01 .00
(.13) (.16) (.03) (.09)
.20 .14 .12 .07
Alienation .22 .04 .22 .04 .16 .01 .10 .01
(1.99)* (1.86) (1.50) (.82)
-.51 .005 -.27 -.16
Meaningfulness in life (presence) -.30 .04 .00 .00 -.18 .01 -.11 .00
(2.10)* (.03) (1.31) (.77)
-.30 -.14 .01 -.16
Meaningfulness in life (search) -.21 .04 -.13 .01 .01 .00 -.14 .01
(1.942) (1.09) (.09) (1.19)
.10 -.05 .19 .15
Intrinsic religious motivation .08 .00 -.05 .00 .18 .04 .14 .01
(.75) (.40) (1.61) (1.22)
.02 .05 .02 .07
Health promoting behaviours .06 .00 .19 .03 .06 .00 .25 .04
(.58) (1.85) (.55) (2.33)*
-.13 -.12 -.34 -.22
Age -.09 .01 -.10 .01 -.28 .09 -.18 .03
(.92) (1.032) (2.80)** (1.746)
R2 .13 .09 .15 .10
F-value 2.10* 1.21 2.40* 1.49

* p < .05, ** p < .01

t- values are given in parentheses

127
Table–10 is showing the regression analysis for group-II (females not

exposed to death and dying in last 2 years), here the FDS as dependent

variable is positively and significantly related to alienation at 5% level of

significance (reg. coeff. 0.20, t=1.99), whereas meaningfulness in life

(presence) showed a negative and significant relationship with FDS at 5%

level of significance (reg. coeff. -0.51, t=2.10). No other variable depicted a

significant relationship. Overall contribution of all the variables is 13% and

out of that alienation is contributing 4%, meaningfulness in life (presence) is

also equally responsible for 4% contribution. Meaningfulness in life (search)

which is significant only at 10% is also contributing 4% towards FDS.

F-value which is 2.10 is significant at 5% and indicates the overall

significance of all the variables.

With FDyS in group–II alienation and health promoting behaviours

have shown positive relationship but are significant only at 10%. None of the

independent variable is showing significant contribution towards FDyS.

FDO is negatively and significantly related with age in group-II (reg.

coeff. -0.34, t=2.80) at 1% level of significance. No other variable showed a

significant relationship with FDO. The overall contribution of all the variables

is 15% and is significant at 5% (F-value=2.40). Here age is contributing the

most i.e. 9%.

128
 In group–II taking FDyO as dependent variable, health promoting

behaviours has shown significant and positive relationship with FDyO, the

reg. coeff. is 0.07 (t-value=2.33) significant at 5% level of significance. Age

exhibited negative relationship with FDyO but is only significant at 10%. The

negative relationship indicates that with advancing age the FDyO decreases.

129
 DISCUSSION OF RESULTS

Keeping in view the objectives of the study and the hypotheses framed,

the results presented in the previous chapter are discussed in this chapter.

LEVELS OF DEATH ANXIETY

From the findings in table-4 it was comprehended that all the study

female subjects exhibited varying degrees of death anxiety and none of the

subject was free from fear of death and dying process. Moderate level of

anxiety was shown by maximum number of subjects for death and dying of

self in total study sample as well as in group-I and group-II. Majority of the

subjects reported high levels of death anxiety for death and dying of others in

both the groups as well as in sample as a whole.

Literature is supportive of these findings that fear of death is present in

all human beings. Becker (1973) and Kubler–Ross (1969) are also of the same

view that fear of death is, indeed the universal fear that all human beings

experience. Belsky (1999) while defining death anxiety emphasized that even

under normal conditions of life all people experience some degree of

fear/anxiety related to that final event of life. While we talk about normal

conditions of life same thing was observed among subjects in group-II

(females not exposed to death and dying in last 2 years) where most of them

reported moderate level of death anxiety and none of them was free from it.

130
Feifel and Branscomb (1973) reported that “everybody, in one way or another

is afraid of death”. Kastenbaum (2003) reported that individual differences on

self control exist when it comes to death – related anxiety, disallowing it from

disrupting their day to day lives but no one has the ability to completely quell

underlying feelings of threat. Presence of varying degrees of fear of death and

dying among study subjects is suggestive of individual differences in the

present study also. In a study exploring levels of death anxiety among adults

in United States it was concluded that majority of the subjects experienced

moderate to low levels of death related fears. It was also interpreted that

people readily hide their anxieties from those in their social and professional

groups, including themselves (Hayslip, 2003). Goodman (1981) views are

also similar to our findings that “The existential fear of death; the fear of non-

existence; is the hardest to conquer. Even the most defensive structures like

denial of reality, rationalization etc., do not lend themselves readily as

protective barriers against this existential fear of death”. From the present

study findings it can be concluded that here also all the subjects have

expressed their feelings related to fear of death and dying openly and all the

subjects have shown varying degrees of fear related to death and dying of self

as well as of others. No present study subject was free from this fear of death

and dying.

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FEAR OF DEATH/DYING AND EXPOSURE TO DEATH/DYING

Results of table-5 revealed that all the subjects in group-I (females

exposed to death and dying) were having significantly high level of fear of

death and dying of self as compared to the subjects in group-II (females not

exposed to death and dying in last 2 years). The findings of present study

indicate that exposure to traumatic events like death and dying increases the

death anxiety.

The present study findings have been supported by various researchers.

Wik (1991) and Wu (1991), Taiwanese Scholars are of the same view that

people who have experienced death have greater anxiety and fear than those

who have not had such experiences. Occupations where there is presence of

constant threat of death on job or there is probable exposure to death and

dying, the people engaged in such professions reveal more anxiety than other

occupations, which is again suggestive of the fact that exposure influences

death anxiety. Lattaner and Hayslip (1984) reported that firemen and funeral

personnel had higher fear of death of self than did secretaries, teachers and

accountants. In a study on death anxiety three groups of students i.e. 53

experienced and 49 non-experienced nursing students and a control group of

50 non-nursing students were compared. Study findings were similar to our

findings that both experienced and non-experienced nursing students reported

more fear of unknown than controls. Experienced nursing students were

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having significantly high fear of dying process than non-experienced nursing

students and controls (Chuen, Del, Berverly & Jean, 2006). Lees and Ellis

(1990) also documented that contact processes accompanying the death of

others make us conscious of our own mortality, giving rise to anxiety and

unease. Dealing with death and dying seems to be the principle cause of stress

in nursing students and professionals (Lees & Ellis, 1990).

In the present study while we compare group-I (females exposed to

death and dying) and group-II (females not exposed to death and dying in last

2 years) similar results were observed as mentioned above. The females who

were professionally exposed to death and dying situations in the current

sample reported significantly high fear of death and dying of self as compared

to those who were not exposed to such events in last two years.

Findings in table-5 also depict that for fear of death and dying of

others, no significant difference exists on the basis of exposure to death and

dying in both the groups but still the mean for both the dimensions i.e. fear of

death and dying of others is more in group-I (exposed to death and dying) as

compared to group-II (not exposed to death and dying in last 2 years). This

shows that exposure to death and dying also influences the death anxiety

related to others. Similar findings were reported by Fang and Howell (1976)

in a study on death anxiety, where they compared medical and law students

and it was found that medical students had a higher fear of dying of others

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than the law students. The repeated exposure gets us out of denial of death.

Force us to bring death in focus. Cues may present to some aspects related to

us e.g. age, resemblance. Nurses while providing care to the terminally ill

patients are in continuous contact with them. Neither patients nor the nurses

are machines, so some kind of bonding will be present. Thus this professional

exposure stimulates interpersonal and intrapersonal dimensions of death.

Cognitive component is present in all but close and repeated contacts with

near death aspects of patients stimulate the affective component too.

COMPARISON OF FEAR OF DEATH AND DYING OF SELF

WITH FEAR OF DEATH AND DYING OF OTHERS

In table-6 while comparing the fear of death and dying of self with fear

of death and dying of others in total sample as well as in group-I (females

exposed to death and dying) and group-II (females not exposed to death and

dying in last 2 years) the findings concluded that all the study subjects in the

sample as a whole and in both the groups were more open in exhibiting fear

related to death and dying of others as compared to self. While comparing

fear of dying of self with fear of dying of others in group-I (exposed to death

and dying) no significant difference was observed but still the mean score for

fear of dying of others was more as compared to self. But significant

difference was observed for fear of death of self as compared to fear of death

of others in the same group and fear of death of others was significantly

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higher. While comparing fear of death and dying of self with fear of death and

dying of others significant difference was observed in the sample as a whole

as well as in group-II; and here the fear exhibited related to death and dying

of others was significantly high.

Becker’s (1973) existential view supports the current findings that

much of our daily behaviour consists of attempts to deny death and there by

keep death anxiety under control. Here in the present study the results are

suggestive of denial for accepting and exhibiting death related fears for self.

Present results are also supported by terror management theory (1997) where

it is stated that people use distinct modes of defense to deal with the problems

of death. The direct rational, threat focused defenses reduces the individual

perception of his or her vulnerability to life threatening conditions, thus push

the problem of death in to vague and distant future. Here in the present study

it is the denial which has been used by the subjects as defense mechanism in

managing self-related fear of death and dying. Kubler–Ross (1969) in stages

of death and dying also stated denial as the first reaction of all human beings

and in this study also all the subjects are more open in showing their concern

for death and dying of others but in relation to self, non-acceptance or denial

was exhibited. The impersonal dimension is easier to manage. Efforts to keep

cognitive involvement only is possible if emotional distancing is kept by

feeling that it is not related to self. Since it is “mysterious” and “unknown”

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(Dumont & Foss, 1972); and the fears of hell and heaven are prevalent, so it is

best to avoid thoughts related to self. It is less threatening when it is seen in

context for others. Goldings et al. (1966) and Jeffres et al. (1961) assume that

death universally elicits anxiety. Where presence of fear can not be observed,

defensive denial is often inferred. Similar findings have been reported by the

present study.

RELATIONSHIP OF COGNITIVE, EMOTIONAL AND

BEHAVIOURAL CORRELATES WITH FEAR OF DEATH AND
DYING

In table–7 correlational study findings of fear of death and dying with

all the study variables in the sample as a whole as well as in group-I and

group-II are given. Here these findings are discussed one by one. Hope as one

of the study variables is reflecting a significant and positive relationship with

fear of death and dying of self in total study sample. Whereas females in

group-I (exposed to death and dying), fear of dying of self has shown

significant and positive relationship with hope. From the above findings it can

be concluded that as the fear of death and dying increases hope also increases.

The above findings are not in accordance with the study hypothesis,

where it was stated that with increase in death anxiety the hope will decrease.

Here in the present study with increase in fear of death and dying, hope is also

increasing. These contradictory results can be explained in the context of hope

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being related to our expectations for eternal life. Theorists and theologians

who talk about the hope for eternal life documented that this hope for a life

after death is the only thing that makes the fear of death manageable (Leming,

1979; Malinowski, 1948). Hope of eternal life for people is offered by

religious beliefs and according to Malinowski (1948) it is this hope that

makes life worth living. The present study subjects may have also exhibited

same kind of hope for eternal life.

Keller, Sherry and Piotrowski (1984) documented that while comparing

the males and females on belief in the life hereafter, the women expressed a

significantly greater belief in the life hereafter than men that can also be one

of the reasons for this hope shown by present female study subjects. Thorson

and Powell (1990) posited that people gain a sense of well-being/hope

knowing that after this life they are still part of another entity greater than

themselves. Belief in an afterlife or hope of life after death merely “serves to

protect the human psyche from the terror of confronting a meaningless reality

ending in death” (Rose & O’ Sullivan, 2002).

Another reason for this hope which can be cited here is the religious

background of the female study subjects, most of them are Hindus and Sikhs.

The philosophies of both these religions support the beliefs of life after death.

Alienation in the same table is the only study variable which reflected a

positive relationship with all the death anxiety dimensions i.e. FDS, FDyS,

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FDO and FDyO in all the study subjects as well as in group-I (exposed to

death and dying) and group-II (not exposed to death and dying in last 2

years). In all study subjects, alienation was found to be significantly and

positively correlated with FDS, FDyS and FDO and in group-I with two death

anxiety dimensions i.e. FDS and FDYS the relationship was significant and

positive. Whereas in group-II, FDS and FDO were significantly and positively

correlated with alienation.

These findings are suggestive of the fact that as feelings, emotions and

thoughts related to fear of death and dying increases, the feelings of isolation

and loneliness among people also increase or vice-versa. There is hardly any

study in the literature exploring the relationship between alienation and fear

of death among healthy individuals. Rokach, Matalon, Safarov and

Bercovitch (2007) while describing the experiences of dying patients and their

caregivers concluded that dying patients as well as their caregivers both

recorded higher on the self-alienation sub-scales. Eid (2001) also documented

that the loneliness/alienation and fear of death become equivalent in a highly

advanced capitalist society, where people die in the alien world of modern

hospitals. As the Indian society is in the transitional phase where we are

adopting the western culture and the sense of belongingness and social values

are disappearing, ultimately the feelings of isolation and loneliness among

people are bound to increase. This implies that fear of death too would be

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expected to be on the rise in the coming times. In this societal context it can

be said that present female study subjects are also the part of same society

where we do not have time for each other and if someone is sick then all the

modern facilities are available in hospitals but the human touch is missing.

Leaving you in the alien world where you do not find anybody to discuss your

concerns/fears, resulting in feelings of loneliness and isolation.

Meier, Back and Morrison (2001) documented that while caring for

seriously ill patients the unexamined feelings of physicians have impact on

their life as they start having feelings of professional loneliness, helplessness,

hopelessness, frustration, depression, loss of professional sense of meaning

and mission. In the present study the cumulative effect of exposure to death

and dying for subjects in group-I may have led to their feelings of alienation

and its relationship with fear of death and dying. When feeling alienated i.e.

increased sense of powerlessness, meaninglessness, normlessness, isolation

and self-estrangement; it extends to fears of complete loss of life and engulfed

in the unknown sphere of death. As the fear of death increases, the contact

with others and involvement with others around is replaced with concerns,

with the abstract and the unknown called ‘death’. Thus increased fear of death

cannot coexist with belongingness and concerns over other human beings.

Fear of death and fear of dying increases when emotional support is perceived

as absent or when one feels alienated. So here the relationship with significant

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others and their support could have proved as buffer for irrationally increased

fear of death and fear of dying. In the absence of this support to cope with

these fears is difficult rather they increase.

Meaningfulness in life has two dimensions i.e. meaningfulness in life

(search) and meaningfulness in life (presence). In table-7 for complete study

sample the search for meaning in life was found to be positively associated

with all the dimensions of death anxiety although the relationship was not

significant. Whereas in group-I search for meaning in life showed a positive

and significant relationship with three dimensions of death anxiety i.e. FDS,

FDyS and FDyO. These results indicate that life without meaning provokes

death related fears. The other dimension where the meaningfulness in life is

present depicted a negative relationship with all the dimensions of death

anxiety (FDS, FDyS, FDO, FDyO) in total study sample as well as in both the

study groups i.e. group-I (exposed to death and dying) and group-II (not

exposed to death and dying). In group-II subjects with presence of meaning in

life depicted a significant and negative relationship with fear of death of self.

It is concluded that individuals who have purpose in life have less death

anxiety. The above findings are supported by the literature both in case of

meaning in life search and in presence.

The trend of present findings is supported by the search for meaning

theories which focus on the meaningfulness of one’s existence following

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death and of the opinion that the more content or satisfied a person feels about

his or her existence, the lower the death anxiety level or vice-versa (Beshai &

Naboulsi, 2004).

Durlack (1972) reported that subjects who had a purpose and meaning

in their lives tended to have less fear of death and more positive and accepting

attitude towards death. Simpson (1980) suggested that death acceptance is not

necessarily the opposite of death anxiety; these two can correlate positively

and be distinguished from death denial. Personal meaning that people pursue

in their lives is important. The above findings are in conformity with our

results where the subjects who lacked meaning in life scored high on fear of

death scale and those who reported presence of satisfaction or purpose in life

scored low on death anxiety scale.

Butler (1963 & 1975) also proposed that people are more afraid of

existence without any meaning than of death. Quinn and Rezinkoff (1985)

found that subjects who lacked a sense of purpose and direction in their lives

reported high levels of death anxiety. Above studies also support the

existential view that whether one fears or accepts death depends on whether

one has found meaning in life and achieved integrity or not. Our findings are

in accordance to literature that the subjects with meaning or goals in life were

less afraid of death and dying as compared to those having no purpose in life.

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 Intrinsic religious motivation reflected a negative association with fear

of dying of self in study sample as a whole as well as in both study groups i.e.

group-I (exposed to death and dying) and group-II (not exposed to death and

dying) but the association was statistically insignificant whereas with other

dimensions of death anxiety i.e. FDS, FDO, FDyO a positive but insignificant

relationship was shown. So from the present study findings it seems difficult

to make a conclusive statement about the nature of relationship between

intrinsic religiosity and death anxiety. Although it is written in the literature

that the relationship between intrinsic religious motivation and fear of death is

quiet complex and it is hard to draw a simple pattern of findings. But still

there are studies in the literature which have tried to explore the type of

association between these two variables. Intrinsic religiosity had strong

positive effect on approach acceptance of death whereas extrinsic religiosity

was positively related to death anxiety (Ardelt & Koenig, 2006). This implies

that the ritualistic aspect of religion tends to increase fear of death while the

spiritual aspect of religion decreases fear of death. Duff and Hong (1995)

documented that simply attending religious services was more predictive of

death anxiety than importance of religion to the individual. Shadingar,

Hinninger, and Lester (1999) and Leming (1979) documented no relationship

between religion and death anxiety. Chuin (2010) also reported no significant

relationships between intrinsic religious orientation and death anxiety as well

as between extrinsic religious orientation and death anxiety. Results of

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various studies on religiosity and death anxiety reflect positive, negative or no

relationship among these two variables.

The scale that was used to assess the intrinsic religiosity in the present

study could be one of the factors for not catching the real feelings of people in

Indian settings where religiosity even at the intrinsic level may have not been

tapped by it. On the other hand it is possible that no single direct significant

relationship existed between death anxiety and intrinsic religious motivation

in the present study sample. Heterogeneous religion of the sample and the

possible impact of religion type might be responsible for the current results.

Religion is very individualistic in its interpretation and generalization ability

of relationship may be limited because of too many individual variations.

The fear of dying of self in total study subjects as well as in group-I

(females exposed to death and dying) exhibited a significant positive

relationship with health promoting behaviours. So it can be said that human

health behaviors are related to our death related fears. The terror management

theory supports the above findings, which posits that primary function

underlying human behavior is self preservation. Human beings are uniquely

conscious of the fact that they will inevitably die, and death related thoughts

regulate their behaviors. Thoughts of death remove an individual “perception”

of immortality and make them seek ways to “save themselves” (Greenberg,

Solomon & Pyszczynski, 1997).

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 Recent studies are also supportive of the present findings, where it is

documented that health related slogans create emotions such as provoking

anxiety, aggression and avoidance that are highly effective in promoting

socially desirable behaviors (Millar and Millar, 1996; Ohbuchi, Ohno and

Mukai, 2001; Shehryar & Hunt, 2005). Thus, as in our sample as the fear of

death becomes focused (when exposed to death) or increases due to any

reasons the individual makes good efforts towards behaviours which are

perceived to enhance life longevity.

Henley (2002) documented that on exposure to many reminders of our

finite existence, the existentialists’ response would be to embrace these

reminders and use them to sustain mindfulness. It is this state of mindfulness,

through which comes a heightened sense of responsibility for one’s own

being and in this ontological mode we are more likely to adopt the healthy

behaviours recommended in health promotion messages. The present study

subjects were found to be more influenced by the fear of dying process when

it comes to adoption and practice of healthy behaviours which can be

supported by the fact that no one wants to experience the pain and sufferings

associated with the dying process, as evident from moderate to high levels of

fear of dying of self, exhibited by majority of the subjects in the present study

sample. Another study conducted by Henley and Donovan (2003) is also

supportive of our findings where the researcher examined the effect of threat

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appeals on health promotion of the people. Threat appeals are used frequently

in health promotion, with threats of (premature) death. There is a common

notion that young people feel that they are immortal. A study which tried to

explore this concept studied smokers in two age groups i.e. 16-25 and 40-45

years. Each respondent was exposed to one message about the threat of

emphysema, either a death or non- death message. Younger smokers did not

respond more to non-death threats than death threats and expressed a higher

level of response to all threats than older smokers. It appears from this study

that death threats are more effective with young people and notion related to

immortality proved wrong here.

Age has shown significant and negative relationship with fear of death

of others in total sample as well as in group-I (exposed to death and dying)

and group-II (not exposed to death and dying in last 2 years). With all other

dimensions of death anxiety again age showed a negative relationship

although not significant except for fear of death of self in group-I as well as in

sample as a whole.

Findings suggest that death anxiety decreases with advancing age. A

plethora of results has been produced by various studies conducted in this

field. But still there are no conclusive findings on the nature of relationship

between age and death anxiety. Study hypothesis is not supported by the

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present study findings where it had been stated that with advancing age the

fear of death will also increase.

Tang (2002) while comparing younger with older students and women

with men it was concluded that younger and women subjects were more

anxious about death. Rasmussen and Brems (1996) are of the view that

instead of age, psychosocial maturity and life satisfaction are better predictors

of death anxiety. According to these authors as the psychosocial maturity and

age increases the death anxiety decreases. Most of the subjects recruited for

the current study were healthy, economically independent women, residing

with their families. The above mentioned characteristics of the sample

subjects might be acting as a source for feelings of love and belongingness,

improved self-esteem and life satisfaction which in return might be buffering

the death anxiety. Thus it can be said that for decrease in fear of death with

advancing age, age does not seem to be the only factor responsible for

negative relationship in the present study but the above written characteristics

of study sample have definitely contributed for reducing the death anxiety.

The range of the age studied was relatively small and with that range the

reason for present findings can be that all the subjects in this age group by

starting their careers try to reach the stage of maximum productivity and work

for enhancement of status. Same is true for family life and relationships. So

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here one experiences stability and comfort in life as the crisis of that age are

over and developmental excellence gained after resolving the crisis.

Findings of regression analysis depict that for FDS, FDyS and FDO the

overall contribution of all the variables was significant in total study group of

females and among all the variables hope, alienation, health promoting

behaviours and age were most influencing variables. In group-I fear of death

of self and fear of dying of self was having an overall contribution of all the

variables, reaching up to the level of significance and in group-II the overall

contribution of all the variables was significant for fear of death of self as well

as for fear of death of others. The most contributing variables were hope,

alienation, meaningfulness in life (presence), health promoting behaviours

and age.

Further, till we are exposed to death there is a marked tendency to view

death only in the context of others. Even if our hopes, alienation,

meaningfulness in life, intrinsic religious motivation and health promoting

behaviours have an effect on the perceptions of death and fears related to it; it

is not personalized. We prefer to distance ourselves from this reality even

when we know of its existence.

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 CONCLUSIONS AND IMPLICATIONS

The results of the present study support the fact that fear of death and

dying is universal as no study subject was found to be free from it. Degrees of

death anxiety vary from individual to individual and from situation to

situation. Levels of death anxiety from mild to severe are influenced by

various factors but from the present findings it can be concluded that exposure

to events like death/dying and occupation definitely influence our death

related fears. As yielded from the results of this study the females who were

professionally exposed to death/dying were significantly high on fear of death

and dying of self. These high levels of death anxiety may function as a

significant antecedent to maladaptive coping with trauma. Recurrent exposure

to death/dying leads to cumulative trauma and the delayed post-traumatic

stress symptoms are reflected in the form of re-experiencing traumatic events,

reduced emotional involvement and a variety of autonomic or cognitive

symptoms (increased startle responses, survivor guilt) (Boman, 1982). To

prevent the serious psychological breakdown of the individuals associated

with recurrent exposure to death/dying, free and confidential,

guidance/counseling services are required for these professional groups.

Through guidance and counseling sessions coping strategies can be suggested

and the defense mechanisms used by them can be strengthened. To minimize

the mental effects of such events, mutually supportive organizational

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environment is important, as well as the self help groups or peer reviews can

be encouraged. At institutional level the staff deployment policies need to be

modified keeping in view the death rates in different areas of hospital to limit

the time of recurrent exposure to death/dying for a particular individual.

When it comes to express fear related to death/dying of self vs. others,

an interesting pattern of findings was noted, that all the subjects were quite

open in expressing their death/dying related fear for others as compared to

self. This clearly indicates that while sharing ones feelings about death and

dying of self no one is comfortable and denial is present, the acceptance does

not come easily. Here the existential psychotherapy can be of great help as it

enables the individual to live authentically: actively observed and involved

with other people and things, while appreciating and accepting his nature as

being the world (Yalom, 1980).

These services can be helpful in removing the negativism associated

with death because the existentialists believe that it is important to think about

death if we want to think significantly about life. If we defend ourselves

against this ultimate reality of eventual death, life becomes purposeless/

meaningless. By realizing that we are mortal beings every moment in life

becomes important and crucial. Thus the self awareness of death is important

to make life a source of zest for life and creativity.

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 As the fear of death and dying increases the hope also increases. Here

the hope expressed by the subjects in context to death anxiety needs further

investigation. In Indian context this hope in relation to fear of death might be

influenced by the philosophies of Hindu and Sikh religions and the hope

expressed here can be a hope for life after death or the hope for eternal life.

The feelings of alienation increase with increase in the level of fear of

death and dying. So it can be said the death related fears produce the feelings

of emptiness, loneliness and depression among the individuals. Keeping in

view the above findings reintegration of society is required. In childhood

parent-child relationship needs to be strengthened. With adoption of western

culture we are becoming more self centered, hardly have time to care and

think about others, it is ultimately bringing feelings of dehumanization among

us. Equilibrium needs to be maintained between modernization and our age

old Indian traditions. Education and the reinforcement about the importance

of Indian family values, social values and social system is required. So that

people can have feelings of love, affection, belongingness and relatedness.

Results of present study conclude that subjects who have some

purpose/meaning in their life will have less death anxiety as compared to

those who are searching for the meaningfulness in life. In light of these

findings it can be suggested that instead of focusing on failures or missed

opportunities in life one needs to be focused on the positive happenings or

150
things in their life. The thoughts of mortality should be taken as challenge in

life and each and every moment of the life should be enjoyed. Concentrate

and work for the projects to be completed in life whole heartedly. Existential

psychotherapy can also be of great help in discovering as well as on

rediscovering the meaningfulness in life.

No conclusive statement can be made about the relationship of fear of

death/dying and intrinsic religious motivation. It is important to further

investigate this concept of intrinsic religiosity in relation to fear of death.

Although we say that we are intrinsically religious but still in Indian society

the ritualistic behaviours persist. The western scale used for measuring

intrinsic religious motivation among the present study subjects failed to catch

the real feelings of people about intrinsic religiosity in Indian set up. Indian

scales can be tried for further exploration.

While studying the relationship of fear of death and dying with health

promoting behaviours it was found that it is not the fear of death but the fear

of dying process which influences the adoption of health promoting

behaviours. That means people are more fearful of the sufferings/pain

associated with dying process than death itself. It can be mentioned here that

people will be more willing to practice healthy behaviours when the dying

process is under focus. One important suggestion which can be made is about

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the incorporation of elements of dying process in health messages given either

by governmental or nongovernmental health promoting agencies.

Age has shown negative relationship with fear of death/dying in the

present study. The present subjects were not in the age group where we can

talk about the integrity vs. despair but the other factors which might have

played the role in this negative relationship can be health, economic security

and the feelings of social security in these subjects. Because all these things

bring some kind of life satisfaction, which is inversely proportional to death

anxiety.

LIMITATIONS

Some of the limitations in the present study are presented below:

1. The present study was confined only to the female subjects.

2. Occupation specificity on the basis of exposure to death and dying

was another limitation.

3. The present investigation focused on the adult population.

4. Intrinsic religious motivation and hope need further exploration

using tools which emphasize the Indian conceptualization of these

constructs.

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RECOMMENDATIONS

On the basis of the findings of present investigation, the following

suggestions can be made for future research.

1. Impact of exposure to death and dying of significant others in general

population can be explored.

2. Comparative study on the levels of death anxiety among males and

females can be done.

3. Gender wise comparison of death anxiety among different professionals

on the basis of exposure can be made.

4. Replication of the present study findings need to be done in

different age groups i.e. young and old populations.

5. Concepts of hope and intrinsic religious motivation are constructs which

need to be redefined in the Indian context.

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