A Meta Analysis on Variables related to Death Anxiety of Elderly in Korea

Sinhyang Kim; Kyung Sook Park

doi:10.7469/kjan.2016.28.2.156

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A Meta Analysis on Variables related to Death Anxiety of Elderly in Korea

Sinhyang Kim¹, Kyung Sook Park²

Korean Journal of Adult Nursing 2016;28(2):156-168.
Published online: April 30, 2016

DOI: https://doi.org/10.7469/kjan.2016.28.2.156

¹Graduate School of Nursing, Chung-Ang University, Seoul

²Red-Cross College of Nursing, Chung-Ang University, Seoul, Korea

Corresponding author: Park, Kyung Sook Red-Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, Korea. Tel: +82-2-820-5676, Fax: +82-2-824-7961, E-mail: kspark@cau.ac.kr

• Received: January 29, 2016 • Accepted: April 15, 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abstract
REFERENCES

Abstract

Purpose
The purpose of this study was to provide basic data by surveying the literature for the past fifteen years (2001-2015). The focus of the search was death anxiety among the elderly.
Methods
Sixty-two published works including graduate theses were selected for the Meta-analysis.
Results
Study results showed that variables related to familial factors were the most often cited in the review of the manuscripts as relevant to death anxiety among the elderly. Specifically family support was most important. The other variables reported in the literature review were classified into four other groupings: social, physical, psychological, and demographics. The significant variable in the social grouping was religious activities, health promotion in the physical grouping and ego integrity in the psychological group.
Conclusion
This study could provide effect sizes of variables based on materials, which are needed to make an intervention program that is related to death anxiety of the elderly. Since this study identified major variables as significant to death anxiety, several distinctions within these variables can be further studied as these relate to death anxiety.
Key Words: Elderly; Death anxiety; Meta analysis

Figure 1.

Inclusion flow of studies from database search.

Table 1.

Quality Evaluation of the Study

Variables	Yes	No
Variables	n (%)	n (%)
Did you clearly present the study?	62 (100.0)	0 (0.0)
Did you talk about sampling?	42 (68.0)	20 (32.0)
Did you gain a measure of science and technology (reliability, validity)?	62 (100.0)	0 (0.0)
Did you clearly present the analytical method?	62 (100.0)	0 (0.0)
Has presented the sample size can be calculated based?	12 (19.0)	50 (81.0)

Table 2.

Effect Size of Variables related to Death Anxiety

Variables	Categories	K	ES	95%	% CI	I² (%)	N	Q (p)	ERI (p)	Fisher's Z and 95% CI
Demographic	Age	8	-0.18	-0.26	-0.10	85.4	2,176	4.03 (.400)	-2.74
	Education	10	-0.16	-0.23	-0.09	53.8	2,270		(.12)
	Economic conditions	9	-0.14	-0.21	-0.06	68.3	2,280
	Religious status	6	-0.13	-0.22	-0.04	24.0	1,514
	Marital status	5	-0.11	-0.21	-0.01	0.0	1,185
	Sub total	38	-0.15	-0.20	-0.10	65.4	9,425	107.01 (＜.001)
Familial	Family support	5	-0.42	-0.72	-0.13	96.7	778	18.22 (＜.001)	2.40
	Family cohesion	7	-0.30	-0.55	-0.06	94.1	1,721		(.76)
	Sub total	12	-0.35	-0.45	-0.26	95.4	2,499	239.46 (＜.001)
Physical	HPB	2	-0.23	-0.39	-0.07	0.0	487	5.04 (.080)	0.97
	Objective health status	6	-0.21	-0.30	-0.11	85.1	1,155		(.63)
	Subjective health status	13	-0.16	-0.22	-0.10	44.1	3,457
	Sub total	21	-0.18	-0.25	-0.11	66.7	5,099	60.04 (＜.001)
Social	Religious activities	6	-0.25	-0.36	-0.13	87.3	1,551	6.72 (.030)	-4.59
	Social support	12	-0.22	-0.30	-0.14	84.9	2,978		(.11)
	Social activities	8	-0.17	-0.27	-0.07	75.0	3,527
	Sub total	26	-0.21	-0.27	-0.15	83.1	8,056	147.43 (＜.001)
Psychological	Ego integrity	21	-0.35	-0.42	-0.29	85.4	6,347	98.71 (＜.001)	-1.40
	Depression^†	24	-0.28	-0.34	-0.21	84.6	6,420		(.72)
	Spiritual well-being	9	-0.26	-0.36	-0.16	94.5	2,838
	Life satisfaction	16	-0.26	-0.34	-0.17	80.5	3,431
	Self-esteem	4	-0.24	-0.41	-0.08	0.0	716
	Death readiness	7	-0.18	-0.29	-0.06	71.3	2,117
	Mental health	2	-0.17	-0.40	0.06	0.0	371
	Meaning of life	3	-0.17	-0.35	0.02	0.0	702
	Afterlife view	5	-0.16	-0.30	-0.02	58.0	1,670
	Sub total	91	-0.27	-0.30	-0.23	86.1	24,612	640.53 (＜.001)
Whole variable effect size of death anxiety		188	-0.23	-0.26	-0.21	86.2	49,691 1	,359.14 (＜.001)	-0.70
									(.43)	-0.8 -0.6 -0.4 -0.2 0

K=number of studies; ES=effect size; CI=confidence interval, Q=Q-value between subgroups; I

²=the proportion of true variance; N=sample size; ERI=Egger's regression intercept; HPB=health promoting behaviors;

^†Coding reverse.

Table 3.

Effect Size of the Adjustment Factors

Variables	Categories	K	ES	95% CI	I² (%)	Q	p
Type of residence	Facility	26	-0.26	-0.33 -0.20	82.3	1.79	.410
	Home	158	-0.23	-0.25 -0.20	86.9
	Facility· Home	4	-0.15	-0.32 0.02	0.0
Source	PhD. dissertation	15	-0.23	-0.31 -0.14	84.2	4.04	.130
	Master's thesis	82	-0.20	-0.24 -0.17	77.4
	Journal	91	-0.26	-0.29 -0.22	89.8
Measurement of death anxiety	FODS	94	-0.22	-0.25 -0.18	86.6	3.76	.290
	PDAS	26	-0.27	-0.34 -0.20	89.4
	RDAS	12	-0.29	-0.38 -0.20	91.6
	TDAS	56	-0.22	-0.27 -0.18	78.9

K=Number of studies; ES=Effect Size; CI=Confidence interval; I

²=the proportion of true variance; Q=Q-value between subgroups; FODS=Fear of Death Scale; TDAS=Templer Death Anxiety Scale; RDAS=Revised Death Anxiety Scale.

Appen dix: Summary of Characteristic cs of f Studi ies included for Meta- -Analy sis

Researchers	Title	SS	Source	Related variables	TR	DM
Yim (2001)	A study on the social support, self-esteem and death anxiety of the elderly	311	Thesis	Social support, self-esteem	Home	PDAS
Sim (2001)	The relationships between death anxiety and social support in the elderly people	263	Thesis	Social support	Home	FODS
Bae (2002)	The relationships between death anxiety and family support in the elderly people	70	Thesis	Family support	Home	FODS
Kwon et al. (2003)	A correlation study on spiritual well-being and death anxiety of the elderly	358	Journal	Spiritual well-being	Home	PDAS
Yim (2003)	A study on death-fear, health improvement activity and life satisfaction of old people	130	Thesis	Health improvement activity, life satisfaction	Home	FODS
Yeo et al. (2005)	The impact of the death anxiety and social activity on the depression in the elderly	517	Journal	Social activity, depression	Home	RDAS
Lee (2005)	A study of factors influencing the death anxiety of the aged in nursing home for the patients with the mental disorders	151	Thesis	Family relation ship, family support, education, age, ego integrity, religious activities, sense of alienation, personality change	Facility	TDAS
Yeo et al. (2006)	Effects of reminiscence function, depression, death-anxiety and social activity on the ego-integrity in the elderly	517	Journal	Social activity, ego integrity	Home Facility	TDAS
Kim (2006)	Meaning in life and death anxiety in the elderly	285	Thesis	Meaning in life	Home	FODS
Jang et al. (2007)	The effect of family factors on death anxiety of the aged	238	Journal	Family cohesion, family support	Home	FODS
Kim et al. (2007)	A study of quality of life, death anxiety and spiritual well being in elders	76	Journal	Quality of life, spiritual well-being	Facility	PDAS
Kim (2007)	Relationship between spiritual well-being and anxiety toward death of the elderly	156	Thesis	Spiritual well-being	Facility	PDAS
Kim (2007)	Death anxiety of hospitalized elderly patients	104	Thesis	Health status	Facility	FODS
Lee (2008)	Impact of religious activities on life satisfaction and death anxiety in the elderly	137	Thesis	Life satisfaction, religious activities	Home	FODS
Moon et al. (2008)	The relaeionship between the death preparation of the aged and successful aging: focusing depression and death anxiety as mediators	283	Journal	Depression, ego integrity	Home	RDAS
Park (2008)	Elderly preparation for death and anxiety of death	200	Thesis	Preparation for death	Home	PDAS
Oh (2008)	Study of senior housing residents’ fear of death	140	Thesis	Self-esteem	Facility	FODS
Kwon (2008)	A survey on the determinants of death anxiety in nursing-home residents	280	Journal	Depression, ADL, ego integrity, self-esteem, mental health, social support, health status	Facility	TDAS
Suh et al. (2008)	A study on death anxiety of older adults focusing on gender and spouse -on the basis of the four dimensions of death anxiety-	296	Journal	Preparation for death, afterlife view, education	Home	FODS
Kim (2009)	Effects of spirituality in old age on death anxiety	247	Thesis	Family function, living together family, age, spirituality, ego integrity, chronic disease, subjective health status, subjective economy status,	Home	TDAS
Kim et al. (2009)	Death anxiety and quality of life among the elderly	156	Journal	Life satisfaction	Home	PDAS
Kim et al. (2009)	The relationship between sociodemographic variables and death anxiety among the elderly	156	Journal	Family relation ship, education, gender, age, living together family, past occupation, subjective economy status, religious activities, subjective health status	Home	PDAS
Choi (2009)	The effect of the spiritual well-being of the aged on ego integrity and death anxiety	405	Thesis	Spiritual well-being, ego integrity	Home	TDAS
Seo (2009)	The effect of anxiety of death of the elderly on mental health: focused on the mediating effect verification of preparation of death	231	Thesis	Preparation for death, mental health	Home	FODS
Moon (2009)	The influence of death preparation and forgiveness of the elderly on successful aging: focused on the mediating effects of depression and death anxiety	498	Thesis	Depression, ego integrity, preparation for death, forgiveness, psychological well-being, afterlife view	Home	RDAS
Jung (2009)	Social support of the elderly are factors impact on death anxiety	157	Thesis	Social support	Home	FODS
Park (2009)	Structural model for the death anxiety factors of home-staying elderly people	494	Thesis	Social support, social activities, age, spiritual well-being, ego integrity, religious activities, death readiness, preparation for death,	Home	FODS
Lee et al. (2010)	A study on the factors influencing death anxiety: examintion of impact of family function. Spirtual well-being and ego-integrity	247	Journal	Family function, life satisfaction	Home	TDAS
Hwang (2005	) The effect that self-esteem, level of preparation for death and view of life after death influence on the death anxiety in the elderly	150	Thesis	Afterlife view, self-esteem, preparation for death	Home	FODS
Yoon (2010)	The impact on the participation of the elderly religious life satisfaction: mediated death anxiety and depression	154	Thesis	Life satisfaction, depression, religious activities	Home	FODS
Jang (2010)	Study on the ecological factors affecting the death anxiety among the elderly	236	Journal	Education, afterlife view, religious activities, the presence of a spouse, social support, age, social activity, gender, subjective health status, ego integrity, subjective economy status	Home	PDAS
Nam et al. (2010)	The influence of participation in religious and social activities of the elderly on their life satisfaction -focusing on depression and death anxiety-	320	Journal	Life satisfaction, depression, religious activities, social activity	Home	TDAS
Kim (2010)	A study on the influence of ego integrity on death anxiety for elderly people and the moderating effect of death preparation: mainly focus on users of senior leasure welfare facilities	200	Thesis	Education, social support, gender, ego integrity, Leisure activity, religious activities, subjective health status, subjective economy status, preparation for death, marital state, economic activity, age,	Home	FODS
Kim et al. (2010)	Psychological and spiritual factors associated with death anxiety of elderly people living at home	494	Journal	Ego integrity, psychological well-being, depression, afterlife view, preparation for death	Home	FODS
Lee (2010)	A study on the effects of depression on death anxiety and the moderating effect of life satisfaction of elders	81	Journal	Life satisfaction, depression	Home	TDAS
Ju (2011)	The influence of spirituality, ego integrity, and death anxiety on life satisfaction among Korean elderly	194	Thesis	Education, the presence of a spouse, gender, life satisfaction, subjective economy status, ego integrity, religious activities, spirituality, subjective health status, age,	Home	TDAS
Jang (2000)	The effects of ego integrity on death anxiety of the elderly: focusing on the mediating effect of depression	313	Journal	Depression, ego integrity	Home	TDAS
Lim et al. (2011)	A study about the model of subjective quality of life for the elderly: focused on the mediating effects of death anxiety	330	Journal	Depression, monthly income, subjective health status, subjective economy status	Home	RDAS
Lee et al. (2011)	Factors influencing death anxiety in the aged.	357	Journal	Family function, health promotion behaviors, ego integrity, morale	Home	FODS
Nam et al. (2011)	The influence of social activity and social support perceived by elderly women living alone on their quality of life: focusing on the mediating effect of depression and death-anxiety	353	Journal	Education, social support, quality of life, age, social activity, depression, religious activities	Home	FODS
Nam et al. (2011)	The effects of group reminiscence counseling on ego integrity, depression, death anxiety of the elderly	27	Journal	Depression, ego integrity	Facility	TDAS
Jo et al. (2012)	Effect of family cohesion, subjective happiness and other factors on death anxiety in Korean elders	280	Journal	Family cohesion, subjective happiness	Home	FODS
Lee (2012)	Relationship between senior citizens' social support and anxiety over death: by comparing senior citizens participating' elderly care by elderly' project with non-participating ones	203	Thesis	Education, the presence of a spouse, social support, gender, age, monthly income, religious activities, subjective health status	Home	FODS
Oh et al. (2012)	Influence of depression on psychological death anxiety of the elderly: moderate effect of self-esteem.	146	Journal	Education, gender, age, depression, self-esteem	Home	FODS
Song (2012)	Relationships among religious activity, life satisfaction and death anxiety in elders	199	Thesis	Life satisfaction, religious activities	Home	FODS
Park et al. (2012)	Determinants of the death anxiety among the elderly	250	Journal	Education, the presence of a spouse, gender, age, subjective health status, social support, leisure activity, depression, monthly income, ego integrity, religious activities	, Home	FODS
Lee (2013)	A study institutionalized elderly depression, death anxiety and end-of-life medical care. Treatment preference	189	Thesis	Depression	Facility	TDAS
Park et al. (2013)	Correlation among depression, death anxiety, and quality of life of aged women	115	Journal	Quality of life, depression	Home	PDAS
Kim et al. (2013)	Self-transcendence, spiritual well-being, and death anxiety of the elderly.	243	Journal	Spiritual well-being, self-transcendence	Home	TDAS
Lee (2013)	A study on the effects of the social activity of the elderly to death anxiety	238	Journal	Education, the presence of a spouse, gender, age, subjective health status, social activity, subjective economy status, religious	Home	FODS
Jung (2013)	The effect of a well-dying program on death anxiety and successful aging of elderly	60	Thesis	Self efficiency, life satisfaction	Facility	FODS
Park (2013)	The impact of depression and death anxiety in the elderly life satisfaction	303	Thesis	Education, the presence of a spouse, age, social activity, depression, religious activities, subjective health status, subjective economy status, life satisfaction	Home	FODS
Choi (2014)	The effects of availability of social support, meaning of life and the sense of loss on death anxiety in elderly	325	Thesis	Social support, meaning in life, sense of loss	Home	PDAS
Kim (2014)	The relationship between illness perception, death anxiety, family support and life satisfaction in elderly inpatients	147	Thesis	Family support, life satisfaction, illness perception	Facility	PDAS
Kim et al. (2014)	Relationships among family support, ageism experience, loneliness, helplessness and death anxiety in elders	155	Journal	Family support, feeling of loneliness, elderly discrimination, helplessness	Home	TDAS
Park (2014)	Death anxiety factors of eldery parents caring for their adult children with developmental disabilities - focusing on ego-integrity, family cohesion, and social support	196	Thesis	Social support, ego integrity, family cohesion	Home	TDAS
Yoon (2014)	The factors that affect death anxiety of the elderly with heart disease	168	Thesis	Social support, depression, helplessness	Home Facility	FODS
Kim (2015)	Effects of death anxiety and meaning of life on somatization of grandparent raising grandchildren.	92	Journal	Life meaning, somatization	Home	TDAS
Lee (2015)	The effects of life goal attainment on death anxiety in elderly -focusing on the mediating effect of ego integrity-	426	Thesis	Life goal achievement, ego integrity	Home	PDAS
Ko (2015)	The effects of ego-integrity and intrinsic religious orientation on death anxiety for elderly people	259	Thesis	Ego integrity, implicit religion tends	Home	FODS
Kim (2015)	Relationships among networks, death anxiety, and self-rated health in the elderly	112	Thesis	Subjective health status, social network	Home	TDAS
Lee (2015)	Factors influencing fears of death of elderly patients in geriatric hospitals	273	Thesis	Ego integrity	Facility	PDAS

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A Meta Analysis on Variables related to Death Anxiety of Elderly in Korea

Korean J Adult Nurs. 2016;28(2):156-168. Published online April 30, 2016

DOI: https://doi.org/10.7475/kjan.2016.28.2.156

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A Meta Analysis on Variables related to Death Anxiety of Elderly in Korea

Korean J Adult Nurs. 2016;28(2):156-168. Published online April 30, 2016

DOI: https://doi.org/10.7475/kjan.2016.28.2.156

Figure

A Meta Analysis on Variables related to Death Anxiety of Elderly in Korea

Figure 1. Inclusion flow of studies from database search.

Figure 1.

A Meta Analysis on Variables related to Death Anxiety of Elderly in Korea

Table 1.

Quality Evaluation of the Study

Variables	Yes	No
Variables	n (%)	n (%)
Did you clearly present the study?	62 (100.0)	0 (0.0)
Did you talk about sampling?	42 (68.0)	20 (32.0)
Did you gain a measure of science and technology (reliability, validity)?	62 (100.0)	0 (0.0)
Did you clearly present the analytical method?	62 (100.0)	0 (0.0)
Has presented the sample size can be calculated based?	12 (19.0)	50 (81.0)

Table 2.

Effect Size of Variables related to Death Anxiety

Variables	Categories	K	ES	95%	% CI	I² (%)	N	Q (p)	ERI (p)	Fisher's Z and 95% CI
Demographic	Age	8	-0.18	-0.26	-0.10	85.4	2,176	4.03 (.400)	-2.74
	Education	10	-0.16	-0.23	-0.09	53.8	2,270		(.12)
	Economic conditions	9	-0.14	-0.21	-0.06	68.3	2,280
	Religious status	6	-0.13	-0.22	-0.04	24.0	1,514
	Marital status	5	-0.11	-0.21	-0.01	0.0	1,185
	Sub total	38	-0.15	-0.20	-0.10	65.4	9,425	107.01 (＜.001)
Familial	Family support	5	-0.42	-0.72	-0.13	96.7	778	18.22 (＜.001)	2.40
	Family cohesion	7	-0.30	-0.55	-0.06	94.1	1,721		(.76)
	Sub total	12	-0.35	-0.45	-0.26	95.4	2,499	239.46 (＜.001)
Physical	HPB	2	-0.23	-0.39	-0.07	0.0	487	5.04 (.080)	0.97
	Objective health status	6	-0.21	-0.30	-0.11	85.1	1,155		(.63)
	Subjective health status	13	-0.16	-0.22	-0.10	44.1	3,457
	Sub total	21	-0.18	-0.25	-0.11	66.7	5,099	60.04 (＜.001)
Social	Religious activities	6	-0.25	-0.36	-0.13	87.3	1,551	6.72 (.030)	-4.59
	Social support	12	-0.22	-0.30	-0.14	84.9	2,978		(.11)
	Social activities	8	-0.17	-0.27	-0.07	75.0	3,527
	Sub total	26	-0.21	-0.27	-0.15	83.1	8,056	147.43 (＜.001)
Psychological	Ego integrity	21	-0.35	-0.42	-0.29	85.4	6,347	98.71 (＜.001)	-1.40
	Depression^†	24	-0.28	-0.34	-0.21	84.6	6,420		(.72)
	Spiritual well-being	9	-0.26	-0.36	-0.16	94.5	2,838
	Life satisfaction	16	-0.26	-0.34	-0.17	80.5	3,431
	Self-esteem	4	-0.24	-0.41	-0.08	0.0	716
	Death readiness	7	-0.18	-0.29	-0.06	71.3	2,117
	Mental health	2	-0.17	-0.40	0.06	0.0	371
	Meaning of life	3	-0.17	-0.35	0.02	0.0	702
	Afterlife view	5	-0.16	-0.30	-0.02	58.0	1,670
	Sub total	91	-0.27	-0.30	-0.23	86.1	24,612	640.53 (＜.001)
Whole variable effect size of death anxiety		188	-0.23	-0.26	-0.21	86.2	49,691 1	,359.14 (＜.001)	-0.70
									(.43)	-0.8 -0.6 -0.4 -0.2 0

K=number of studies; ES=effect size; CI=confidence interval, Q=Q-value between subgroups; I

²=the proportion of true variance; N=sample size; ERI=Egger's regression intercept; HPB=health promoting behaviors;

^†Coding reverse.

Table 3.

Effect Size of the Adjustment Factors

Variables	Categories	K	ES	95% CI	I² (%)	Q	p
Type of residence	Facility	26	-0.26	-0.33 -0.20	82.3	1.79	.410
	Home	158	-0.23	-0.25 -0.20	86.9
	Facility· Home	4	-0.15	-0.32 0.02	0.0
Source	PhD. dissertation	15	-0.23	-0.31 -0.14	84.2	4.04	.130
	Master's thesis	82	-0.20	-0.24 -0.17	77.4
	Journal	91	-0.26	-0.29 -0.22	89.8
Measurement of death anxiety	FODS	94	-0.22	-0.25 -0.18	86.6	3.76	.290
	PDAS	26	-0.27	-0.34 -0.20	89.4
	RDAS	12	-0.29	-0.38 -0.20	91.6
	TDAS	56	-0.22	-0.27 -0.18	78.9

K=Number of studies; ES=Effect Size; CI=Confidence interval; I

²=the proportion of true variance; Q=Q-value between subgroups; FODS=Fear of Death Scale; TDAS=Templer Death Anxiety Scale; RDAS=Revised Death Anxiety Scale.

Appen dix: Summary of Characteristic cs of f Studi ies included for Meta- -Analy sis

Researchers	Title	SS	Source	Related variables	TR	DM
Yim (2001)	A study on the social support, self-esteem and death anxiety of the elderly	311	Thesis	Social support, self-esteem	Home	PDAS
Sim (2001)	The relationships between death anxiety and social support in the elderly people	263	Thesis	Social support	Home	FODS
Bae (2002)	The relationships between death anxiety and family support in the elderly people	70	Thesis	Family support	Home	FODS
Kwon et al. (2003)	A correlation study on spiritual well-being and death anxiety of the elderly	358	Journal	Spiritual well-being	Home	PDAS
Yim (2003)	A study on death-fear, health improvement activity and life satisfaction of old people	130	Thesis	Health improvement activity, life satisfaction	Home	FODS
Yeo et al. (2005)	The impact of the death anxiety and social activity on the depression in the elderly	517	Journal	Social activity, depression	Home	RDAS
Lee (2005)	A study of factors influencing the death anxiety of the aged in nursing home for the patients with the mental disorders	151	Thesis	Family relation ship, family support, education, age, ego integrity, religious activities, sense of alienation, personality change	Facility	TDAS
Yeo et al. (2006)	Effects of reminiscence function, depression, death-anxiety and social activity on the ego-integrity in the elderly	517	Journal	Social activity, ego integrity	Home Facility	TDAS
Kim (2006)	Meaning in life and death anxiety in the elderly	285	Thesis	Meaning in life	Home	FODS
Jang et al. (2007)	The effect of family factors on death anxiety of the aged	238	Journal	Family cohesion, family support	Home	FODS
Kim et al. (2007)	A study of quality of life, death anxiety and spiritual well being in elders	76	Journal	Quality of life, spiritual well-being	Facility	PDAS
Kim (2007)	Relationship between spiritual well-being and anxiety toward death of the elderly	156	Thesis	Spiritual well-being	Facility	PDAS
Kim (2007)	Death anxiety of hospitalized elderly patients	104	Thesis	Health status	Facility	FODS
Lee (2008)	Impact of religious activities on life satisfaction and death anxiety in the elderly	137	Thesis	Life satisfaction, religious activities	Home	FODS
Moon et al. (2008)	The relaeionship between the death preparation of the aged and successful aging: focusing depression and death anxiety as mediators	283	Journal	Depression, ego integrity	Home	RDAS
Park (2008)	Elderly preparation for death and anxiety of death	200	Thesis	Preparation for death	Home	PDAS
Oh (2008)	Study of senior housing residents’ fear of death	140	Thesis	Self-esteem	Facility	FODS
Kwon (2008)	A survey on the determinants of death anxiety in nursing-home residents	280	Journal	Depression, ADL, ego integrity, self-esteem, mental health, social support, health status	Facility	TDAS
Suh et al. (2008)	A study on death anxiety of older adults focusing on gender and spouse -on the basis of the four dimensions of death anxiety-	296	Journal	Preparation for death, afterlife view, education	Home	FODS
Kim (2009)	Effects of spirituality in old age on death anxiety	247	Thesis	Family function, living together family, age, spirituality, ego integrity, chronic disease, subjective health status, subjective economy status,	Home	TDAS
Kim et al. (2009)	Death anxiety and quality of life among the elderly	156	Journal	Life satisfaction	Home	PDAS
Kim et al. (2009)	The relationship between sociodemographic variables and death anxiety among the elderly	156	Journal	Family relation ship, education, gender, age, living together family, past occupation, subjective economy status, religious activities, subjective health status	Home	PDAS
Choi (2009)	The effect of the spiritual well-being of the aged on ego integrity and death anxiety	405	Thesis	Spiritual well-being, ego integrity	Home	TDAS
Seo (2009)	The effect of anxiety of death of the elderly on mental health: focused on the mediating effect verification of preparation of death	231	Thesis	Preparation for death, mental health	Home	FODS
Moon (2009)	The influence of death preparation and forgiveness of the elderly on successful aging: focused on the mediating effects of depression and death anxiety	498	Thesis	Depression, ego integrity, preparation for death, forgiveness, psychological well-being, afterlife view	Home	RDAS
Jung (2009)	Social support of the elderly are factors impact on death anxiety	157	Thesis	Social support	Home	FODS
Park (2009)	Structural model for the death anxiety factors of home-staying elderly people	494	Thesis	Social support, social activities, age, spiritual well-being, ego integrity, religious activities, death readiness, preparation for death,	Home	FODS
Lee et al. (2010)	A study on the factors influencing death anxiety: examintion of impact of family function. Spirtual well-being and ego-integrity	247	Journal	Family function, life satisfaction	Home	TDAS
Hwang (2005	) The effect that self-esteem, level of preparation for death and view of life after death influence on the death anxiety in the elderly	150	Thesis	Afterlife view, self-esteem, preparation for death	Home	FODS
Yoon (2010)	The impact on the participation of the elderly religious life satisfaction: mediated death anxiety and depression	154	Thesis	Life satisfaction, depression, religious activities	Home	FODS
Jang (2010)	Study on the ecological factors affecting the death anxiety among the elderly	236	Journal	Education, afterlife view, religious activities, the presence of a spouse, social support, age, social activity, gender, subjective health status, ego integrity, subjective economy status	Home	PDAS
Nam et al. (2010)	The influence of participation in religious and social activities of the elderly on their life satisfaction -focusing on depression and death anxiety-	320	Journal	Life satisfaction, depression, religious activities, social activity	Home	TDAS
Kim (2010)	A study on the influence of ego integrity on death anxiety for elderly people and the moderating effect of death preparation: mainly focus on users of senior leasure welfare facilities	200	Thesis	Education, social support, gender, ego integrity, Leisure activity, religious activities, subjective health status, subjective economy status, preparation for death, marital state, economic activity, age,	Home	FODS
Kim et al. (2010)	Psychological and spiritual factors associated with death anxiety of elderly people living at home	494	Journal	Ego integrity, psychological well-being, depression, afterlife view, preparation for death	Home	FODS
Lee (2010)	A study on the effects of depression on death anxiety and the moderating effect of life satisfaction of elders	81	Journal	Life satisfaction, depression	Home	TDAS
Ju (2011)	The influence of spirituality, ego integrity, and death anxiety on life satisfaction among Korean elderly	194	Thesis	Education, the presence of a spouse, gender, life satisfaction, subjective economy status, ego integrity, religious activities, spirituality, subjective health status, age,	Home	TDAS
Jang (2000)	The effects of ego integrity on death anxiety of the elderly: focusing on the mediating effect of depression	313	Journal	Depression, ego integrity	Home	TDAS
Lim et al. (2011)	A study about the model of subjective quality of life for the elderly: focused on the mediating effects of death anxiety	330	Journal	Depression, monthly income, subjective health status, subjective economy status	Home	RDAS
Lee et al. (2011)	Factors influencing death anxiety in the aged.	357	Journal	Family function, health promotion behaviors, ego integrity, morale	Home	FODS
Nam et al. (2011)	The influence of social activity and social support perceived by elderly women living alone on their quality of life: focusing on the mediating effect of depression and death-anxiety	353	Journal	Education, social support, quality of life, age, social activity, depression, religious activities	Home	FODS
Nam et al. (2011)	The effects of group reminiscence counseling on ego integrity, depression, death anxiety of the elderly	27	Journal	Depression, ego integrity	Facility	TDAS
Jo et al. (2012)	Effect of family cohesion, subjective happiness and other factors on death anxiety in Korean elders	280	Journal	Family cohesion, subjective happiness	Home	FODS
Lee (2012)	Relationship between senior citizens' social support and anxiety over death: by comparing senior citizens participating' elderly care by elderly' project with non-participating ones	203	Thesis	Education, the presence of a spouse, social support, gender, age, monthly income, religious activities, subjective health status	Home	FODS
Oh et al. (2012)	Influence of depression on psychological death anxiety of the elderly: moderate effect of self-esteem.	146	Journal	Education, gender, age, depression, self-esteem	Home	FODS
Song (2012)	Relationships among religious activity, life satisfaction and death anxiety in elders	199	Thesis	Life satisfaction, religious activities	Home	FODS
Park et al. (2012)	Determinants of the death anxiety among the elderly	250	Journal	Education, the presence of a spouse, gender, age, subjective health status, social support, leisure activity, depression, monthly income, ego integrity, religious activities	, Home	FODS
Lee (2013)	A study institutionalized elderly depression, death anxiety and end-of-life medical care. Treatment preference	189	Thesis	Depression	Facility	TDAS
Park et al. (2013)	Correlation among depression, death anxiety, and quality of life of aged women	115	Journal	Quality of life, depression	Home	PDAS
Kim et al. (2013)	Self-transcendence, spiritual well-being, and death anxiety of the elderly.	243	Journal	Spiritual well-being, self-transcendence	Home	TDAS
Lee (2013)	A study on the effects of the social activity of the elderly to death anxiety	238	Journal	Education, the presence of a spouse, gender, age, subjective health status, social activity, subjective economy status, religious	Home	FODS
Jung (2013)	The effect of a well-dying program on death anxiety and successful aging of elderly	60	Thesis	Self efficiency, life satisfaction	Facility	FODS
Park (2013)	The impact of depression and death anxiety in the elderly life satisfaction	303	Thesis	Education, the presence of a spouse, age, social activity, depression, religious activities, subjective health status, subjective economy status, life satisfaction	Home	FODS
Choi (2014)	The effects of availability of social support, meaning of life and the sense of loss on death anxiety in elderly	325	Thesis	Social support, meaning in life, sense of loss	Home	PDAS
Kim (2014)	The relationship between illness perception, death anxiety, family support and life satisfaction in elderly inpatients	147	Thesis	Family support, life satisfaction, illness perception	Facility	PDAS
Kim et al. (2014)	Relationships among family support, ageism experience, loneliness, helplessness and death anxiety in elders	155	Journal	Family support, feeling of loneliness, elderly discrimination, helplessness	Home	TDAS
Park (2014)	Death anxiety factors of eldery parents caring for their adult children with developmental disabilities - focusing on ego-integrity, family cohesion, and social support	196	Thesis	Social support, ego integrity, family cohesion	Home	TDAS
Yoon (2014)	The factors that affect death anxiety of the elderly with heart disease	168	Thesis	Social support, depression, helplessness	Home Facility	FODS
Kim (2015)	Effects of death anxiety and meaning of life on somatization of grandparent raising grandchildren.	92	Journal	Life meaning, somatization	Home	TDAS
Lee (2015)	The effects of life goal attainment on death anxiety in elderly -focusing on the mediating effect of ego integrity-	426	Thesis	Life goal achievement, ego integrity	Home	PDAS
Ko (2015)	The effects of ego-integrity and intrinsic religious orientation on death anxiety for elderly people	259	Thesis	Ego integrity, implicit religion tends	Home	FODS
Kim (2015)	Relationships among networks, death anxiety, and self-rated health in the elderly	112	Thesis	Subjective health status, social network	Home	TDAS
Lee (2015)	Factors influencing fears of death of elderly patients in geriatric hospitals	273	Thesis	Ego integrity	Facility	PDAS

Table 1. Quality Evaluation of the Study

Table 2. Effect Size of Variables related to Death Anxiety

K=number of studies; ES=effect size; CI=confidence interval, Q=Q-value between subgroups; I

=the proportion of true variance; N=sample size; ERI=Egger's regression intercept; HPB=health promoting behaviors;

†

Coding reverse.

Table 3. Effect Size of the Adjustment Factors

K=Number of studies; ES=Effect Size; CI=Confidence interval; I

=the proportion of true variance; Q=Q-value between subgroups; FODS=Fear of Death Scale; TDAS=Templer Death Anxiety Scale; RDAS=Revised Death Anxiety Scale.

Appen dix: Summary of Characteristic cs of f Studi ies included for Meta- -Analy sis

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A Meta Analysis on Variables related to Death Anxiety of Elderly in Korea

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