Laughing in the face of death: The association among humor styles, religious fatalism, and thanatophobia in hospitalized geriatric patients

Background

Aging often accompanies various cognitive, physical, and psychological changes, including confronting mortality. As individuals approach the end of their lives, they may experience death anxiety or thanatophobia, an intense fear of dying. This fear of death can have a significant impact on the psychological well-being of older adults. This study investigated the relationship among humor styles, religious fatalism, and thanatophobia in hospitalized geriatric patients.

Methods

A cross-sectional survey was conducted on 270 older adults using non-probability convenience sampling. Four tools were employed to collect the data: the Sociodemographic and Clinical Data Sheet, the Arabic Scale of Death Anxiety, the Religious Health Fatalism Questionnaire, and the Humor Styles Questionnaire.

Results

The study found a relatively high level of death anxiety among hospitalized geriatric patients, with a mean death anxiety score of 75.23 (8.86). The participants’ dominant humor styles were self-enhancing (mean = 33.53, SD = 5.11) and affiliative (mean = 27.50, SD = 4.85). Correlation analysis showed significant negative relationships between sense of humor styles and death anxiety (r = -0.553, p < 0.001). This included self-enhancing humor, which helps cope with adversity; affiliative humor, which builds social bonds; aggressive humor, which belittles others; and self-defeating humor, which seeks approval at the cost of self-esteem. Conversely, religious health fatalism and its subscales positively correlated with death anxiety (r = 0.45, p < 0.01).

Conclusion

The findings showed that religious health fatalism—beliefs in divine providence, predetermined fate, and helplessness—predicts increased death anxiety. In contrast, self-enhancing, affiliative, aggressive, and self-defeating humor styles are negatively linked to thanatophobia, suggesting they may serve as psychological buffers. These humor styles could aid coping by reducing death anxiety. The study also found a negative correlation between religious health fatalism and humor, indicating that deeply held beliefs in divine control might limit humor's use as a coping mechanism. These results highlight the potential of humor-based interventions to alleviate death anxiety in geriatric patients while considering the complex role of religious fatalism in coping strategies.