Death Anxiety Scale; Translation and Validation in Patients with Cardiovascular Disease

.. Patients with cardiovascular disease (CVD) have the symptoms of anxiety in common that may result in adverse outcomes. Objectives: Due to the significant association of anxiety and CVD, scheduled screening of all cardiac patients has been recommended by the medical authorities like the American Heart Association. But in Pakistan it is not a common practice to use such tools, reason being unavailability of such screening tools in national language therefore specifically death anxiety is unrecognized and no measures are taken for it and patients remain undertreated with death anxiety that may eventually influence on the treatment and prognosis of the patients. Data source& Settings: Colleges and hospitals of the Rawalpindi and Islamabad. Period: 6 months. Methods: The study was designed to translate and validate the Death Anxiety Scale in Urdu language to be used with Pakistani population. The sample consisted of 210 participants (70 Youngsters (normal group) 70 Elderly and 70 patients with cardiovascular diseases (clinical group) from colleges and hospitals of the Rawalpindi and Islamabad. To determine the psychometric properties, reliability and validity; cronbach alpha, split-half reliability, correlation, factor analysis were computed. Results: Death Anxiety Scale-Urdu (DAS-U)( ) has adequate reliability and validity. Factor analysis showed multifaceted structure for the DAS-U, bearing in mind the apposite psychometric characteristics; it can be used in researches about death anxiety. Conclusions: The use of the scale is reasonable for the measurement of death anxiety in CVD patients and it can be employed in order to have successful treatment and improve the prognosis of the patients. Key Terms: Death anxiety, Templer Death Anxiety Scale, Reliability, Validity 1. Lecturer, Department of Psychology, International Islamic University, Islamabad. 2. Associate Professor, Department of Psychology, International Islamic University, Islamabad. 3. Associate Professor (Physiology) Federal Medical and Dental College, Islamabad Correspondence Address: Dr. Shemaila Saleem Associate Professor (Physiology) Federal Medical and Dental College Chak Shehzad, Islamabad [email protected] Article received on: 01/01/2015 Accepted for publication: 16/03/2015 Received after proof reading: 02/06/2015 Article Citation: Saleem T, Gul S, Saleem S. Death anxiety scale; translation and validation in patients with cardiovascular disease. Professional Med J 2015;22(6):723732. INTRODUCTION A cardiac event directs the patient towards a misinterpretation of his health state and restrains him from resuming the former activities and also evokes a state of fear for another cardiac event or even death which can hinder his successful rehabilitation. This also infuses a state of anxiety and fear of death among the patients.1 A significant and reliable association between cardiovascular disease (CVD) and psychological factors have been found in the literature.2,3 The psychological factors considered as an important contributors to health important contributors to impoverished health in the patients with cardiovascular disease are stress, depression and anxiety.4,5 In contrast to the immense literature available on depression in patients with CVD, the studies that have examined the role of anxiety in CVD are few. But the researches indicate that the comorbidity of anxiety symptoms are found commonly in patients with CVD, with prevalence rates ranging between 24%-31%.6,-8 Heart patients with anxiety disorder experience more cardiovascular events, deaths.9 Death is a phenomenon that is largely beyond the control of human beings, it produces immense worry, distress and apprehension among nearly every human being.10 Nevertheless, the degree upon which death anxiety is felt and communicated seems appears to divergesignificantly from oneperson to another. Measurement of death related anxiety is an imperative subject of interest in empirical research work as well as for the therapeutic treatment. Up till now at hand have been various direct and indirect techniques of evaluating death anxiety.11,12,13 “Death anxiety” is a notion utilized to theorize the