Factors associated with death anxiety in family caregivers of cancer patients: a systematic review

OBJECTIVES: This systematic review synthesizes existing literature to identify the current status and key influencing factors related to death anxiety in family caregivers of cancer patients. METHODS: A comprehensive search was conducted across seven databases-PubMed, Embase, PsycINFO, Scopus, Web of Science, MEDLINE, and CNKI on July 26th, 2025, with no time restrictions applied. The quality of all included studies was assessed using the Joanna Briggs Institute critical appraisal tools for cross-sectional studies. RESULTS: Eighteen studies were included in the systematic review. Based on our analysis, death anxiety among family caregivers of cancer patients may be influenced by the following six categories of factors: (a) personal factors, (b) disease and caregiving-related factors, (c) psychosocial factors, (d) self-regulatory factors, (e) other factors, and (f) actor and partner effects. Several specific protective and risk factors related to death anxiety were also identified. CONCLUSION: This review categorizes influencing factors, including protective factors, risk factors, and several contested personal variables, associated with death anxiety. There is a need for longitudinal research to further elucidate the dynamic nature of death anxiety over time. Future studies should adopt a dyadic perspective encompassing both cancer patients and their family caregivers to provide comprehensive insights for healthcare professionals and facilitate the development of effective interventions targeting death anxiety.