Moderating role of meaning in life in the relationship of death anxiety, experiential avoidance and health-related quality of life among type 2 diabetes patients

Individuals diagnosed with type 2 diabetes mellitus may experience death anxiety and experiential avoidance, which may impact negatively on health-related quality of life. Meaning in life is a positive psychological resource that protects against negative psychosocial outcomes. Although a direct relationship between these variables exists, to our knowledge, previous research has not explored their interaction effect. The present study examined whether meaning in life moderates the relationship between (1) the multidimensional death anxiety and health-related quality of life, and (2) experiential avoidance and health-related quality of life among type 2 diabetes mellitus patients. The pool of participants consisted of 311 type 2 diabetes outpatients drawn from a tertiary health care institution in South-East Nigeria. The participants completed several self-report measures, such as the short form of the Diabetes Quality of Life Questionnaire, Death Anxiety Inventory–Revised, Acceptance and Action Questionnaire, and the Presence of Meaning in life subscale of Meaning in Life Questionnaire. The results of a regression analysis showed that death anxiety in terms of death acceptance, death finality, and thoughts about death were independently associated with poor health-related quality of life at low, but not at average and high levels of meaning in life. Externally generated death anxiety was associated with poor health-related quality of life at low and average, but not at high levels of meaning in life. Finally, experiential avoidance was associated with poor health-related quality of life at low and average, but not at high levels of meaning in life. We concluded that psychological interventions geared towards promoting health-related quality of life of type 2 diabetes mellitus patients should consider integrating meaning in life for its protective nature in improving positive health outcomes and recovery.