Death Anxiety, Spiritual Well-Being, and Death Literacy Among Relatives of Patients Receiving Palliative Care in Türkiye: A Cross-Sectional Study

Background: Understanding the psychological and spiritual needs of family caregivers, including their experiences of death anxiety and levels of death literacy, is essential for delivering holistic palliative care. This study aimed to examine the relationships between death anxiety, spiritual well-being, and death literacy among relatives of patients receiving palliative care in Türkiye. Methods: A cross-sectional correlational study was conducted with 160 relatives of patients receiving treatment in a palliative care unit in Türkiye. The participants had a mean age of 47.56 ± 12.33 years, and 62.5% were male. Data were obtained using the Abdel-Khalek Death Anxiety Scale (ASDA), the Three-Factor Spiritual Well-Being Scale (SWBS), and the Death Literacy Index (DLI). Results: The mean scores were 61.34 ± 17.45 for ASDA, 122.94 ± 15.84 for SWBS, and 96.13 ± 16.36 for DLI. Participants exhibited relatively elevated death anxiety scores, comparatively higher spiritual well-being scores, and moderate death literacy scores within the study sample. Correlation analyses showed that death anxiety was positively associated with spiritual well-being and negatively associated with death literacy, whereas death literacy was positively associated with spiritual well-being. Regression analyses further indicated that spiritual well-being was independently and positively associated with both death anxiety and death literacy, whereas death literacy was independently and negatively associated with death anxiety. Conclusions: The findings suggest that psychosocial, spiritual, and informational dimensions should be considered together in holistic palliative care. Supporting death literacy and spiritual well-being may contribute to better coping with death-related concerns among relatives of patients receiving palliative care.