The Relationship Between Religious Orientation and Death Anxiety in Iranian Muslim Patients with Cancer: The Mediating Role of Hope

Cancers are globally prevalent often life-threatening diseases that carry an immense psychological burden such as death anxiety. Thus, identifying protective psychological factors affecting death anxiety in individuals with cancer is of strong relevance. This study investigated the potential mediating role of hope in the relationship between religious orientation and death anxiety in Iranian patients with cancer. A cross-sectional design was used to evaluate death anxiety, hope, and religious orientation in a convenience sample of 320 patients (age range 18-89 years) with cancer. Measures included demographic factors, health characteristics, and validated instruments of the study constructs. Path analysis was used to evaluate mediation models. The findings indicated a direct path from intrinsic religious orientation (β = - 0.122, p < 0.001) to death anxiety and a direct path from hope (β = - 0.258, p < 0.001) to death anxiety. However, when hope was introduced as a mediating variable, the relationship between intrinsic religious orientation and death anxiety became non-significant (β = 0.001, p = 0.983). In this study, hope largely explained the relationship between intrinsic religiosity and death anxiety. In countries such as Iran where religiosity is an important psychological construct, greater hope among the more intrinsically religious may help to explain why more deeply religious persons experience less anxiety.