key: cord-0917300-617bvjz2 authors: Khajoei, Rahimeh; Dehghan, Mahlagha; Heydarpour, Nabiollah; Mohseni, Mina; Shokohian, Sajad; Maazallahi, Mahboobeh; Forouzi, Mansooreh Azizzadeh title: Comparison of Death Anxiety, Death Obsession, and Humor in Nurses and Medical Emergency Personnel in COVID-19 Pandemic date: 2022-03-04 journal: J Emerg Nurs DOI: 10.1016/j.jen.2022.02.004 sha: 6f09c93092219638b62bc3fc6fc9e60bc3aa4626 doc_id: 917300 cord_uid: 617bvjz2 INTRODUCTION: COVID-19 has created numerous challenges for the health system. Nurses and medical emergency personnel are at the forefront of fighting COVID-19 and exposed to psychological disorders such as death anxiety and death obsession. Humor is a defense and coping mechanism against the anxiety and obsession associated with death. This study aimed to compare death anxiety, death obsession and humor among nurses and medical emergency personnel during the COVID-19 pandemic. METHOD: This descriptive-analytical study was conducted on 230 nurses and medical emergency personnel. To collect data, the Templer death anxiety scale (TDAS), Death obsession scale (DOS), and Humor styles questionnaire (HSQ) were used. SPSS 19 was used for data analysis. The significance level was considered P < .05. RESULTS: Mean and standard deviation of death anxiety in the nurses and medical emergency personnel were 6.86 ±4.04 and 5.68±3.57, respectively; these values for death obsession were 29.82±12.30 and 25.30±12.66 and for humor 116.75±30.87 and 118.48±24.66, respectively. The nurses had significantly higher death anxiety (P = .02) and death obsession (P = .008) compared with the medical emergency personnel; moreover, there was no significant relationship between humor, death anxiety (P = .10) and death obsession(P = .31) in nurses and emergency personnel. CONCLUSION: The results of this study showed that the levels of death anxiety and death obsession were higher in the nurses compared with the medical emergency personnel. There was no significant difference between the hospital nurses and medical emergency personnel in terms of humor Introduction: COVID-19 has created numerous challenges for the health 28 system. Nurses and medical emergency personnel are at the forefront of 29 fighting COVID-19 and exposed to psychological disorders such as death 30 anxiety and death obsession. Humor is a defense and coping mechanism 31 against the anxiety and obsession associated with death. This study aimed to 32 compare death anxiety, death obsession and humor among nurses and medical 33 emergency personnel during the COVID-19 pandemic. The nurses had significantly higher death anxiety (P = .02) and death obsession 44 (P = .008) compared with the medical emergency personnel; moreover, there 45 was no significant relationship between humor, death anxiety (P = .10) and death 46 obsession(P = .31) in nurses and emergency personnel. virus was first identified in Wuhan, China, and then turned into a pandemic in 57 February 2020(1). COVID-19 is acutely contagious and its symptoms usually 58 include fever, dry cough, fatigue, gastrointestinal symptoms, and in severe 59 cases, acute respiratory syndrome, multiple organ dysfunction, and, high 60 mortality (2). by August 7, 2021, more than 200 million people have been 61 infected and more than 4 million people have died of this disease in the world. 62 Also the numbers of the infected and the dead are still increasing in Iran, and 63 93086 deaths have been recorded until this time (3). The COVID-19 pandemic has created challenges for people in various 65 professions; however, the emotional stress the medical staff has been facing is 66 remarkably higher and may remain with them permanently (4). Nurses and 67 medical emergency personnel play a key role in providing care for patients 68 during the COVID-19 pandemic (5, 6); they are also exposed to various 69 psychological disorders due to several stressors such as increased workload, 70 an increase in the number of patients in need of critical care, frequent 71 encounters with patients' death, fear of being infected and transmit the disease 72 to their friends, family, and relatives, and these stressors may impose 73 psychological effects on them (7). A wide range of psychological disorders 74 such as stress, depression, and anxiety have been reported in medical staff 75 during 9) . One psychological disorder medical staff may face is death anxiety(10). Death 77 anxiety is a multidimensional concept with emotional, cognitive, and 78 experimental features and is defined as the feeling of anxiety or fear regarding 79 the thought of death (10). Death anxiety is the most crucial concern of human 80 life and the core of all anxiety disorders and is considered as one of the most 81 J o u r n a l P r e -p r o o f important factors of mental health (11). medical staff may experience death 82 anxiety due to frequent encounters with patients' death during Najafi confirmed this scale's validity using factor analysis and its reliability 171 using test-retest, split-half, and internal consistency coefficient (27). of the information and of the fact that participating in the study was optional. After receiving informed consent from the participants, the questionnaires 197 were given to them, and they were asked to complete them and return them to (Table 1) . The means of death anxiety in the nurses did not have any significant (Table 4) . In the nurses, the mean of death obsession was significantly higher in women. Also, the mean of death obsession was higher in the nurses with a bachelor's 266 degree. In the medical emergency personnel, the mean of death obsession was 267 higher in the personnel with a bachelor's degree. Death obsession levels were 268 not significantly different based on the other demographic variables in the 269 nurses and medical emergency personnel (Table 5) . The means of humor did show any significant difference based on 280 demographic variables in the nurses; however, in the medical emergency 281 personnel, the mean of humor was significantly higher in men, and it was 282 higher in the urban center personnel. Humor did not show any significant 283 difference based on the other demographic variables in this group (Table 6) . In the present study, the mean score of death obsession was higher in the nurses Other results of the present study included significant relationships between 387 death obsession and gender in nurses, and between death obsession and 388 education level in nurses and medical emergency staff. Regarding gender, the 389 mean of death obsession was significantly higher in female nurses, which was The results of the present study also indicated that the mean of humor is 404 significantly higher in men among medical emergency personnel. Hofmann et 405 al., in a systematic review, found that men generally acquire higher humor 406 scores, and this is due to personality differences such as an ability to use and 407 understand humor (51). Limitations: One of the limitations of the present study was the personality traits of the 410 personnel which were not evaluated. 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