The Role of Rumination, Sense of Coherence, and Death Anxiety in Predicting Existential Distress Among Individuals Bereaved Due to Cancer

Abstract

Existential distress is one of the common psychological consequences experienced by individuals bereaved due to cancer-related loss. The present study was conducted to examine the role of rumination, sense of coherence, and death anxiety in predicting existential distress among individuals bereaved due to cancer. This research employed a descriptive–correlational design. The statistical population consisted of individuals bereaved due to cancer residing in Tehran in 2023. Using a convenience sampling method and considering inclusion and exclusion criteria, 300 participants were selected as the study sample. Research instruments included the Ruminative Responses Scale (RRS), the Sense of Coherence Scale (SOC-29), Templer Death Anxiety Scale (DAS), and the Existential Distress Questionnaire (EDQ). Data were analyzed using SPSS-26 software through Pearson correlation coefficients and hierarchical multiple regression analysis. The mean age of participants was 45.6 years (SD = 10.2). The findings indicated a significant positive correlation between rumination (r = 0.51, p < .001) and death anxiety (r = 0.43, p < .001) with existential distress, and a significant negative correlation between sense of coherence and existential distress (r = −0.56, p < .001). Results of hierarchical regression analysis showed that the predictor variables collectively explained 78% of the variance in existential distress (R² = 0.78). In the final model, sense of coherence, with a standardized beta coefficient of −0.41, emerged as the strongest negative predictor, while death anxiety, with a beta coefficient of 0.37, was the strongest positive predictor of existential distress. The results suggest that rumination and death anxiety function as vulnerability factors, whereas sense of coherence operates as a strong protective factor against existential distress. These findings highlight the importance of an integrated consideration of cognitive, psychological, and existential dimensions in designing psychological interventions for individuals bereaved due to cancer.