| Abstract [eng] |
ABSTRACT Background and Objectives: Death anxiety is defined in a broader sense as forms of existential distress in palliative care. It is a key mental struggle in terminal illness. This thesis understands “Death Anxiety” as a spectrum of mortality-related anxiety. It is originating from a mixture of complex biological, psychological, and socio-cultural factors. Although existing theoretical frameworks are established, its abstract nature is still posing challenges for clinical management. This approach doesn't intend to develop new theories but tries to integrate existing literature, therapeutic models, and clinical insights to create a comprehensive perspective, facilitating the interpretation and derivation of related concepts. The scientific aim is to map the spectrum of death anxiety in terminal illness and identify areas needing improvement for better approaches in the future. Method: The thesis uses a narrative-integrative approach. Extended literature search has been conducted primarily on PubMed, Google Scholar, and PsycINFO. Focus lay on existential, psychoanalytic, CBT, and attachment theories. To gain clinical insights, semi-structured interviews were conducted with clinicians specialized in palliative care and geriatric psychiatry. A biopsychosocial model was then adapted to synthesize cross-disciplinary findings. The thesis integrates existential theory to provide a descriptive-interpretative framework that facilitates a deeper understanding of existential reconstruction. Results: The work resulted in a macro- and micro-perspective of the entity of mortality-related anxiety in terminal illness as a complex, evolving phenomenon that is varying across factors such as age, medical history, symptomatic intensity, and attachment styles. A major insight was the importance of distinguishing normal existential distress from treatable underlying mental health issues. The study identified various therapeutic approaches suitable for personalized treatment. Experts stated that timing, therapeutic presence, and adaptability are essential for effective intervention. Integrating existential-philosophical ideas into a psychiatric context resulted in an understanding not just as a symptom but as a main focus for psycho-palliative approaches in non-curative care. The holistic integrative approach makes abstract distress more tangible, suggesting future directions in research and patient-centered care. Conclusions: Managing death anxiety effectively depends on personalized, context-aware approaches instead of generic methods. Clinical practices need to stay adaptable, helping to make existential distress more concrete and manageable. Closing gaps in clinical training is crucial to applying these insights and decreasing patient suffering. Additionally, encouraging society to de-taboo mortality could support individuals confront finitude earlier, which might reduce both terminal existential distress and irrational death fear among healthy individuals. Keywords: “Death anxiety”; “terminal illness”; “psycho-oncology”; “palliative care”; “existential distress”; “meaning-making”; “existential psychotherapy”; “coping”. |
