The Effect of Coping With Stress in Predicting the Needs, Death Anxiety, and Depression of Patients’ Relatives in Intensive Care Units

The Effect of Coping With Stress in Predicting the Needs, Death Anxiety, and Depression of Patients’ Relatives in Intensive Care Units | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The Effect of Coping With Stress in Predicting the Needs, Death Anxiety, and Depression of Patients’ Relatives in Intensive Care Units Havva KAÇAN, Şevval YEYİT This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7820598/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 28 Jan, 2026 Read the published version in BMC Public Health → Version 1 posted 12 You are reading this latest preprint version Abstract Background The study aimed to examine the effects of coping with stress in predicting the needs, death anxiety, and depression of relatives of patients hospitalized in Intensive Care Units. Materials and Methods A sample of 367 relatives of patients hospitalized in intensive care units was formed, and data were collected face-to-face using a General Information Form, the Needs Scale for Patient Relatives in Intensive Care Units, Turkish Death Anxiety Scale, the Beck Depression Inventory and the Ways of Coping with Stress Scale. The data were analyzed using numbers, percentages, means, standard deviations, Pearson Correlation, and regression analysis Results The mean total needs score of the patient relatives was found to be 123.462 ± 24.918, the mean death anxiety score was 42.653 ± 19.881, and the mean depression score was 10.500 ± 8.270. In the dimension of coping styles, the means were as follows: self-confident approach 18.954 ± 4.389, desperate approach 20.820 ± 4.306, submissive approach 15.863 ± 3.162, optimistic approach 15.093 ± 2.788, and seeking social support 9.396 ± 2.251. A positive and significant relationship was detected between death anxiety and the need score (r = 0.393, p < 0.01), and a negative and strong and significant relationship was detected between the self-confident approach and the need total score (r=-0.326, p < 0.01), and the optimistic approach and the need total score (r=-0.359, p < 0.01) and the sub-dimensions Conclusion Patients’ families have several needs. Increasing the level of needs of patients’ families leads to increased death anxiety, while decreasing self-confidence and optimistic coping strategies. This demonstrates that a holistic approach, focusing not only on the patients but also on the needs of their families, is crucial for preventing potential psychological symptoms. Intensive care Patient relatives Death anxiety Depression Introduction Intensive Care Units (ICUs) are healthcare areas where critically ill patients receive advanced medical care and high-technology and multidisciplinary approaches are used [ 1 ]. Naturally, all attention is focused on the patient and the disease in intensive care units. However, during this time, feelings such as fear, anxiety, curiosity, etc., experienced by the family waiting outside the door of the unit and the patient inside are not taken into consideration. The family is seen only as the ones who carry out processes such as procuring some necessary supplies for the patient or registering documents [ 1 , 2 , 3 ]. Family members who witness their patients’ struggle for life face psychological difficulties such as uncertainty, fear, anxiety, intense stress, physical and mental fatigue, death anxiety, and symptoms of depression [ 1 , 3 , 4 , 5 , 6 ]. The emotional burden of patients’ families shapes their expectations, needs, and coping mechanisms regarding healthcare services. In this process, information, emotional support, spiritual needs, and basic physical needs are of paramount importance to patients’ families[ 3 ]. However, the needs of family members must be taken into account in the treatment and care services provided by health personnel. It is observed that little or no space is given to the subject [ 7 ]. The limitations of the intensive care settings, uncertainty about the patient’s condition [ 8 , 9 , 10 ], and a focus on the patient and the disease rather than the patient’s relatives [ 8 ], can make it difficult to meet these needs. Also, the fear of losing a loved one for the patient’s relatives [ 10 ], the uncertainty of the situation, economic problems, role changes, inadequate needs of the patient’s relatives, inability to obtain sufficient information about the patient’s health status, inability to participate in the patient’s care, complex tools and equipment in the intensive care unit, and inability to see the patient adequately are sources of stress and cause anxiety for the patient’s relatives[ 3 ]. The fear of losing the patient at any moment and thoughts of grief can cause death anxiety in the patient’s relatives[ 10 ]. Relatives of patients in intensive care are negatively affected both psychologically and physically due to the anxiety they experience [ 4 ]. The stress that arises during this process hinders their coping skills and increases the risk of encountering psychological problems such as anxiety and depression [ 11 ].For this reason, the psychological support provided both makes it easier for them to cope with stress and contributes to the home care processes of patients. Also, relatives of patients whose needs are not adequately met tend to exhibit more desperate and submissive approaches, while those whose needs are met tend to act self-confidently and seek social support [ 9 ]. In the study conducted by Görücü (2019), it was reported that as the level of death anxiety of patient relatives increases, their spiritual well-being levels also increase, which is explained by the fact that individuals who fear losing their patients treated in intensive care tend to turn more to spiritual feelings to cope with increased death anxiety[ 10 ]. For this reason, it is stated that the families of patients in intensive care units need support to reduce their death anxiety, provide emotional relief, be informed, be with their patients, offer them support, share their feelings, and meet their individual needs [ 12 ]. For patients’ families to manage this process successfully, intensive care nurses must focus on two primary goals to identify and meeting the needs of their families. Firstly, considering the needs of patients’ families in care planning to effectively implement holistic care [ 3 ]. Secondly, ensuring effective stress management by meeting the needs of patients’ families [ 11 ]. At this point, identifying the needs of families of patients admitted to intensive care can contribute to the prevention of potential psychological symptoms such as death anxiety and depression. In our country, studies conducted on providing the necessary information and support to the families of patients in intensive care are quite inadequate[ 3 , 10 ]. The study aimed to examine the impact of stress management on the prediction of family needs, death anxiety, and depression. To maintain ideal healthcare, patients and their families must be considered as a whole. Nurses must not only address the needs of patients but also support the needs of their relatives within a holistic approach, remembering that the patient and their family are integrated, as stated in nursing philosophy [ 13 ]. Recommendations that patients’ relatives receive regular support and counseling within the scope of consultation-liaison nursing, a field of psychiatric nursing, regarding their identified needs and death anxiety, and also to inform the nursing literature with the research results. In the present study, the aim was to examine the effects of coping with stress in predicting the needs, death anxiety, and depression of relatives of patients in intensive care. To this end, the following hypotheses were formulated. H 0 : According to the needs of the patient’s relatives, the methods of coping with stress affect the prediction of death anxiety and depression. H 1 : According to the needs of patient relatives, methods of coping with stress have no effect in predicting death anxiety and depression. Methods Design The study had a cross-sectional, correlational, and descriptive design. Population and Sample The study was conducted with relatives of patients hospitalized in adult intensive care units at Kastamonu Training and Research Hospital. The sample of the study consisted of relatives of patients hospitalized in intensive care between 01.10.2021 and 01.06.2022. The population consisted of individuals who had at least one family member who cared for patients admitted to the intensive care unit during the last year between the dates of the study. The sample size was determined using the formula (n = N.t2.pq / d2.(N-1) + t2.p.q). Based on the data, the number of patients hospitalized in all intensive care units in the last year was 3496. The sample size was calculated as 357. Face-to-face interviews were conducted with 367 relatives of patients between the specified dates. Data collection forms were read and marked by the researchers. Data Collection The data collection tools consisted General Information Form, Needs Scale for Patient Relatives in Intensive Care Units, Turkish Death Anxiety Scale, Beck Depression Inventory, and Ways of Coping with Stress Scale. General Information Form The General Information Form used in the study was prepared by the researchers and consisted of 15 questions on socio-demographic characteristics[ 3 , 10 , 11 , 12 ]. Needs Scale for Patient Relatives in Intensive Care Units (NCPRICU) The Critical Care Family Needs Inventory (CCFNI) was developed by Molter in 1979 to determine the needs of family members of patients in intensive care units. The scale was developed to emphasize the importance of the needs of families of patients in intensive care and to measure family needs. NCPRICU’s validity and reliability studies have been conducted in many languages and cultures. The validity and reliability study was conducted in Turkish society by Büyükçoban et al. (2016). The Cronbach’s Alpha Value of the scale was determined to be 0.93 in the original study and was 0.92 in the present study[ 13 ]. The NCPRICU consisted of 40 statements rated from 1 to 4 (1 = Not important, 2 = Less important, 3 = Important, 4 = Very important). The scale has five subscales: Trust, Information, Closeness, Support, and Comfort. The maximum possible score on the Likert-type scale is 160, and the minimum score is 40. The subscales can also be scored separately. Low total and subscale scores indicate a decrease in needs, while increasing mean scores indicate an increase in needs. Turkish Death Anxiety Scale (TDAS) The Turkish Death Anxiety Scale was developed by Sarıkaya and Baloğlu (2016) with a total of 20 items on a 5-point Likert scale. Responses to the items are scored as “never = 0,” “rarely = 1,” “occasionally = 2,” “often = 3,” and “always = 4.” The scores of the Turkish Death Anxiety Scale range from 0 to 80, with a high score indicating high death anxiety. There are no reverse-scored items in the Turkish Death Anxiety Scale. The Turkish Death Anxiety Scale consists of three sub-dimensions: uncertainty of death, suffering, and exposure. Exploratory factor analysis revealed that the 20-item scale has a three-factor structure that explains 67.27% of the total variance. This three-factor structure was tested with confirmatory factor analysis. The T-Test revealed a significant difference between the 27% lower and upper group means. The correlation between the Death Anxiety Scale and TP-DAS was .76, the correlation between the Death Anxiety Scale and trait anxiety was .43, the correlation between the Death Anxiety Scale and state anxiety was .28, and the correlation between the Death Anxiety Scale and BDI was .24 (p < .01).[ 14 ]. The Cronbach’s alpha coefficient and the test-retest reliability over two weeks of the Death Anxiety Scale were .95 and .82, respectively. The Cronbach’s alpha internal consistency reliability coefficient of this study was .95. Beck Depression Inventory (BDI) The Beck Depression Inventory (BDI) was developed by Beck in 1961 to identify individuals at risk for depression and to measure the level and severity of depressive symptoms. It was revised in 1978. It consists of 21 items and provides a 4-point Likert-type measurement. Each item receives a progressively increasing score between 0 and 3, with the maximum total score being 63. The scale included 21 categories of depressive symptoms: 1. Mood, 2. Pessimism, 3. Sense of failure, 4. Dissatisfaction, 5. Feelings of guilt, 6. Feelings of punishment, 7. Self-hatred, 8. Self-blame, 9. Desire to punish oneself, 10. Crying spells, 11. Irritability, 12. Social withdrawal, 13. Indecisiveness, 14. Body image, 15. Inhibition of workability, 16. Sleep disturbances, 17. Fatigue/weariness, 18. Decreased appetite, 19. Weight loss, 20. Somatic complaints, and 21. Loss of sex drive. Each of these categories consists of 4 self-report items. [ 15 ]. The individual is asked to select and mark one of the four items in each group that best describes how they have felt during the past week, including the current day. The number next to each item (between 0 and 3) indicates the score to be given for that item. A depression score is obtained by summing these scores[ 16 ]. Ways of Coping with Stress Scale (WCSC) The Ways of Coping with Stress Scale (WCSC) was developed by Folkman and Lazarus (1980) under the name Coping with Stress Inventory [ 17 ]. The 4-point Likert-type scale consists of 66 items (0 = never used, 3 = frequently used). The scale was first used in Turkey by Siva (1988) [ 18 ]. Three separate studies were conducted to examine the factor structure of the shortened version of the Coping with Stress Inventory. As a result of these studies, it was determined that the scale consisted of five factors in total: “ self-confident approach “ (items 8, 10, 14, 16, 20, 23, and 26), “desperate approach “ (items 3, 7, 11, 19, 22, 25, 27, and 28), “submissive approach “ (items 5, 13, 15, 17, 21, and 24), “optimistic approach” (items 2, 4, 6, 12, and 18), and “seeking social support ” (items 1, 9, 29, and 30). Among the effective methods (problem-focused), a self-confident approach indicates that the individual has the power and belief to cope with stress, the optimistic approach indicates that the individual can control stress by looking at events from a logical framework, and seeking social support indicates that the individual tries to cope with the stressful situation by getting help from others. The desperate approach, an ineffective (emotion-focused ) approach, refers to a situation in which an individual lacks faith and confidence in coping with stress, while the submissive approach refers to a situation in which stressful events are accepted, believing them to be fateful. In the scale’s scoring, items 1 and 9 in the seeking social support subfactor are reverse-scored, while all other items are straight-scored. High scores on each of these five subscales indicate the intensity of use of the coping style represented by that subscale. If a single total score is desired, a total score is obtained by reversing all items from the submissive and desperate approaches, as well as items 1 and 9. Reliability coefficients for the WCSC subscales obtained from three separate studies were detected to be between Cronbach’s alpha values for the self-confident approach, between .73 and .68 for the desperate approach, between .47 and .72 for the submissive approach, between .68 and .49 for the optimistic approach, and between .47 and .45 for seeking social support [ 19 ]. In this study, Cronbach’s alpha value for the Ways of Coping with Stress Scale was detected to be .82. When examined in terms of factors, Cronbach’s alpha value was detected to be .77 for the self-confident approach, .74 for the desperate approach, .65 for the submissive approach, .75 for the optimistic approach, and .59 for seeking social support. Ethical Dimensions of the Study It was approved by the Kastamonu University Training and Research Hospital Clinical Research Ethics Committee (September 22, 2021, 2020-KAEK-143-112).Written permission from the hospital chief physician, and institutional permission from the Kastamonu Provincial Health Directorate. Verbal and written information was provided to the participating first-degree relatives (mother, father, spouse, child), and their written permissions were obtained using the Informed Consent Form. The study was conducted in line with the Helsinki Declaration and informed consent was obtained from the participants. Statistical Analysis of Data The data obtained in the study were analyzed using the SPSS (Statistical Package for Social Sciences) for Windows 22.0 program. Descriptive statistical methods used in the evaluation of the data were number, percentage, mean, and standard deviation. Kurtosis (Kurtosis) and Skewness (Skewness) values were examined to determine whether the research variables showed a normal distribution. For total need, kurtosis is 0.548, and skewness is -1.027. The kurtosis values of the support, information, closeness, trust, and comfort sub-dimensions are 1.208, 2.135, 0.854, 1.415, and 0.841, respectively, and skewness values are − 0.962, -1.194, -1.056, -1.369, and − 1.036. The kurtosis values for total death anxiety and its sub-dimensions, uncertainty of death, thinking about death, witnessing death and suffering, are − 0.563; -0.565; -0.854; -0.699; and skewness values are − 0.343; -0.48; 0.257 and − 0.63. Depression total kurtosis is 0.745, and skewness is 1.319. For the sub-dimensions of coping with stress, confident approach, desperate approach, submissive approach, optimistic approach, and seeking social support, kurtosis values are 0.425, -0.448, 0.143, -0.359, -0.482, and skewness values are − 0.454, -0.104, -0.268, -0.035, and 0.046. In the relevant literature, a normal distribution is considered when the skewness and kurtosis values of the variables are between + 1.5 and − 1.5 [ 20 ] and + 2.0 and − 2.0 [ 21 ] It was determined that the variables exhibited a normal distribution. Pearson correlation and regression analysis were applied to the continuous variables of the study. Inclusion Criteria Inclusion criteria were having first-degree relative (mother, father, sibling, spouse, child), or having second-degree relative (aunt, uncle, paternal uncle) for patients without first-degree relatives, family members over the age of 18 and under the age of 65, family members with good hearing and comprehension skills, at least literacy, and Turkish as a native language. Family members were selected if the patient's first 24 hours of intensive care unit admission had been completed, and those who agreed to participate in the study voluntarily were included. Furthermore, family members of patients who had been under intensive care monitoring for less than 24 hours or more than six months (the needs and expectations of family members who have been in the intensive care unit for more than six months vary as they adapt to the situation), and family members whose mental state (intense anxiety, stress, crying, etc.) made them unsuitable for communication were excluded from the study. Results Table 1 shows the distribution of employees according to their descriptive characteristics. Among the patient relatives who participated in the study, 64.2% were female, 56.0% were primary school graduates, 78.1% were married, and 61.5% were unemployed. In terms of degree of relationship, 62.0% were first-degree relatives and 38.0% were second-degree relatives. Regarding losing a relative, 66.4% responded “yes” and 33.6% responded “no.” A total of 34.4% of patient relatives reported having serious health problems, and 65.6% reported not having serious health problems. The proportion of patient relatives who received information during the intensive care process was 73.8%, while the proportion of those who did not receive information was 26.2%. 60.0% reported receiving information from a physician, and 40.0% from a nurse. Among the individuals responsible for care, 15.0% were mothers, 7.4% were fathers, 4.1% were grandmothers, 7.7% were spouses, 5.2% were children, and 60.7% indicated this as “none.” The average age of the participants was detected to be 45.780 ± 15.401 (min = 18, max = 88). Table 1 Distribution of Relatives According to Descriptive Characteristics Groups Frequency (n) Percentage (%) Sex Female 235 64.2 Male 131 35.8 Educational Status Primary school 205 56.0 High school 101 27.6 College 60 16.4 Marital status Married 286 78.1 Single 80 21.9 Job Working 141 38.5 Not working 225 61.5 Degree of Closeness 1st degree 227 62.0 2nd degree 139 38.0 Relative of a Patient Previously Hospitalized in ICU Yes 178 48.6 No 188 51.4 Death-Risk Yes 62 16.9 No 304 83.1 Loss of a loved one Yes 243 66.4 No 123 33.6 Serious Health Problem Yes 126 34.4 No 240 65.6 Duration of Stay in YB 2–5 Days 181 49.5 6–9 Days 87 23.8 10–13 Days 77 21.0 13 and Above 21 5.7 Getting Information During the ICU Process Yes 270 73.8 No 96 26.2 Source of information Physician 162 60.0 Nurse 108 40.0 Type of ICU Where the Patient’s Relative was Admitted 1st degree 114 31.1 2nd degree 128 35.0 General Intensive Care 105 28.7 Cardiovascular Surgery 19 5.2 Mean SD Age 45.780 15.401 Table 2 shows the descriptive statistics regarding the total mean scores of the scales used in the study. When the mean scores for needs, death anxiety, depression, and styles of coping with stress were examined, the participants’ mean total needs score was detected to be 123.462 ± 24.918 (min = 40.00; max = 160.00). The mean total death anxiety score was 42.653 ± 19.881, and the means according to the sub-dimensions were: uncertainty of death 22.762 ± 10.507, thinking about and witnessing death 12.434 ± 7.645, and suffering 7.456 ± 3.550. The total depression score was detected to be 10.500 ± 8.270 (min = 0.00; max = 46.00). In terms of styles of coping with stress, the means were as follows: self-confident approach 18.954 ± 4.389, desperate approach 20.820 ± 4.306, submissive approach 15.863 ± 3.162, optimistic approach 15.093 ± 2.788, and seeking social support 9.396 ± 2.251. Table 2 Mean scores of Needs. Death Anxiety, Depression, and Styles of Coping with Stress N Mean SD Min. Max. Needs Scale Total Score 366 123.462 24.918 40.000 160.000 Support 366 36.533 8.356 13.000 52.000 Information 366 26.511 5.793 9.000 36.000 Relationship 366 23.186 4.993 7.000 28.000 Trust 366 16.355 3.859 5.000 20.000 Comfort ​ 366 20.877 4.578 6.000 24.000 Death Anxiety Total Score 366 42.653 19.881 0.000 80.000 Uncertainty of Death 366 22.762 10.507 0.000 40.000 Thinking of Death Witnessing 366 12.434 7.645 0.000 28.000 Suffering 366 7.456 3.550 0.000 12.000 Depression Scale Total Score 366 10.500 8.270 0.000 46.000 Self-Confident Approach 366 18.954 4.389 7.000 28.000 Desperate Approach 366 20.820 4.306 11.000 32.000 Submissive Approach 366 15.863 3.162 7.000 24.000 Optimistic Approach 366 15.093 2.788 8.000 20.000 Seeking Social Support 366 9.396 2.251 5.000 14.000 Table 3 shows the correlation analysis between the scores of Needs, Death Anxiety, Depression and Coping Styles. A significant positive correlation was detected between the total death anxiety score and the total needs score (r = 0.393, p < 0.01). Similarly, significant positive correlations were detected between the sub-dimensions of uncertainty of death (r = 0.374, p < 0.01), thinking about and witnessing death (r = 0.359, p < 0.01), and suffering (r = 0.320, p < 0.01) and the total needs score. Statistically significant and positive correlations were also detected between all of the needs sub-dimensions and death anxiety and its sub-dimensions. Although there was no significant relationship between depression and the total needs score (r=-0.092, p > 0.05), only weak but significant negative relationships were observed with the closeness (r=-0.123, p < 0.05) and trust (r=-0.115, p < 0.05) sub-dimensions. Significant negative correlations were detected between the self-confident approach and the total needs score (r=-0.326, p < 0.01) and all sub-dimensions of coping styles. Similarly, strong and significant negative correlations were found between the optimistic approach and the total needs score (r=-0.359, p < 0.01) and all sub-dimensions. However, no significant relationship was found between the helpless approach and the submissive approach and the total needs score, and only a weakly significant relationship was found with the support sub-dimension (r=-0.109, p < 0.05 for the helpless approach; r = 0.105, p 0.05). In general, it can be said that as death anxiety increases, the needs levels of patients' relatives also increase, whereas needs levels are lower in individuals who use positive coping strategies (e.g., self-confident and optimistic approaches). Table 3 Correlation Analysis Between Need, Death Anxiety, Depression, and Stress Coping Styles Scores Requirement Total Support Information Relationship Trust Comfort Death Anxiety Total r 0.393** 0.451** 0.407** 0.273** 0.379** 0.186** p 0.000 0.000 0.000 0.000 0.000 0.000 The Uncertainty of Death r 0.374** 0.434** 0.367** 0.263** 0.368** 0.185** p 0.000 0.000 0.000 0.000 0.000 0.000 Thinking of Death Witnessing r 0.359** 0.416** 0.391** 0.239** 0.330** 0.163** p 0.000 0.000 0.000 0.000 0.000 0.002 Suffering r 0.320** 0.344** 0.349** 0.235** 0.325** 0.141** p 0.000 0.000 0.000 0.000 0.000 0.007 Depression Total r -0.092 -0.030 -0.097 -0.123* -0.115* -0.092 p 0.079 0.566 0.063 0.018 0.028 0.080 Self-Confident Approach r -0.326** -0.352** -0.298** -0.283** -0.285** -0.210** p 0.000 0.000 0.000 0.000 0.000 0.000 Desperate Approach r -0.051 -0.109* -0.042 0.018 -0.012 -0.033 p 0.334 0.038 0.420 0.731 0.812 0.531 Submissive Approach r 0.037 0.105* 0.070 -0.017 0.034 -0.087 p 0.476 0.045 0.180 0.744 0.513 0.096 Optimistic Approach r -0.359** -0.340** -0.379** -0.304** -0.311** -0.259** p 0.000 0.000 0.000 0.000 0.000 0.000 Seeking Social Support r 0.045 0.040 -0.022 0.081 0.038 0.078 p 0.394 0.449 0.674 0.121 0.469 0.136 **<0.01; Pearson Correlation Analysis Table 4 shows the variables affecting the needs of patient relatives. In the regression analysis, the total need score was detected to have a significant and positive effect on death anxiety (β = 0.393; p < 0.001). The explanatory power of the model was 15.2% (R² = 0.152), and the model was generally significant (F = 66.571; p < 0.001). The increase in death anxiety increased with the increase in need scores. Similarly, when the effect of the total need score on the self-confident coping style was examined, a negative and significant relationship was detected between them (β = -0.326; p < 0.001). The explanatory power of the model was 10.4% (R² = 0.104), and a significant model was obtained (F = 43.425; p < 0.001), which suggests that as the need level increases, individuals’ tendency to use the self-confident coping style decreases. Also, the effect of the total need score on optimism was detected to be negative and significant (β = -0.359; p < 0.001). The model’s explanatory power was 12.6% (R² = 0.126), and the model was statistically significant (F = 53.787; p < 0.001), which suggests that individuals with higher need levels tend to use optimistic coping less. Table 4 Variables Affecting the Needs of Patient Relatives Dependent Variable Unstandardized Coefficients Standardized Coefficients t p 95% Confidence Interval B SE β Min Max Death Anxiety Total 0.314 0.038 0.393 8,159 0,000 0.238 0.389 *Dependent Variable = Death Anxiety Total, R = 0.393; R 2 =0.152; F = 66.571; p = 0.000; Durbin Watson Value = 0.139 Self-Confident Approach -0.058 0.009 -0.326 -6,590 0,000 -0.075 -0.040 *Dependent Variable = Self-Confident Approach, R = 0.326; R 2 =0.104; F = 43.425; p = 0.000; Durbin Watson Value = 0.591 Optimistic Approach -0.040 0.005 -0.359 -7,334 0,000 -0.051 -0.029 *Dependent Variable = Optimistic Approach, R = 0.359; R 2 =0.126; F = 53.787; p = 0.000; Durbin Watson Value = 0.275 Discussion Significant and positive relationships were detected between the need levels of relatives of patients in Intensive Care Units (ICU) and death anxiety (β = 0.393; p < 0.001). The analysis results show that need scores significantly predict death anxiety, and the explanatory level of the model was 15.2% (R² = 0.152). This result shows that death anxiety increases when the needs of relatives of patients are not met or are not met adequately. This can directly affect the psychological states of family members, especially in environments such as ICUs where uncertainty, isolation, and life-threatening situations prevail. This result is parallel to those of many studies in the literature. For example, the study by Görücü (2024) reported that the death anxiety of individuals with relatives of patients in intensive care is significantly related to their spiritual well-being[ 10 ]. Family members experience more anxiety when thinking about the death of their patients, and their need for spiritual support during this process also increases. Likewise, Chiang et al. (2016) emphasized that relatives of patients in the ICU experienced high levels of stress and anxiety, and that this was related to unmet needs such as information, support, and comfort[ 22 ]. The same study also reported that a short-term cognitive-behavioral psychoeducation program offered to family members reduced anxiety, stress, and depression levels, indicating that meeting the needs of relatives reduced psychological burden. Another study by Naef et al. (2021) revealed that symptoms of depression, anxiety, and post-traumatic stress experienced by family members after ICU were negatively correlated with their satisfaction with the intensive care process[ 23 ]. In other words, as the perception that needs were adequately met increased, psychological distress decreased. The results also show that the death anxiety levels of patients’ relatives are generally moderate. The highest mean score in the “uncertainty of death” subscale, in particular, suggests that uncertainty has a strong psychological impact on individuals. The scores in the “thinking about and witnessing death” and “suffering” subscales are also notable, demonstrating that witnessing the death process and related mental images have the potential to create anxiety in individuals. Furthermore, the significantly high mean depression score suggests that the intensive care process triggers not only death anxiety but also depressive symptoms in patients’ relatives. These results highlight the necessity of psychosocial support interventions for patients’ relatives and the importance of informative and supportive approaches, particularly for coping with uncertainty. Kynoch et al. (2018) similarly detected that family members’ anxiety and depression levels are significantly linked to unmet needs and inadequate support[ 24 ]. Leske (2002) supported the positive effects of meeting families’ needs on stress, anxiety, and depression in his study[ 25 ]. This is consistent with our study results. Studies show that failure to meet basic needs, particularly those related to information, emotional support, and close contact with the patient, can further increase families’ death anxiety. The regression analysis yielded a negative and significant relationship was detected between the need levels of individuals who are relatives of patients in the intensive care unit (ICU) and their assertive coping style (β = -0.326; p < 0.001), consistent with various results in the literature, which suggests that as individuals’ needs increase, they become under psychological pressure and for this reason move away from active and assertive coping strategies. While the model’s explanatory power of 10.4% suggests that need levels have a certain but limited impact on coping styles, it does reveal a significant psychosocial relationship. These results directly align with the study conducted by Özçelik and Erdoğan (2020) with relatives of patients in ICUs in Turkey. The study detected that when basic needs such as information, support, and reassurance were not met, relatives used more desperate and submissive coping styles, whereas when these needs were met, they used more self-assured and problem-focused coping styles. This suggests that unmet needs weaken an individual’s reliance on internal resources and lead to passivity[ 26 ]. Similarly, in a study conducted in Nigeria by Olabisi et al. (2020), they reported that task-focused coping styles were negatively correlated with depression, anxiety, and stress levels. When individuals used task-focused and self-confident coping styles more, a decrease in psychological symptoms was observed. However, it was found that individuals with high needs were more likely to employ emotion-based or avoidance-based methods instead of these coping styles [ 11 ].In a review study by Rückholdt et al. (2019), it was shown that avoidant and submissive coping styles were associated with intense psychological stress, whereas active coping methods were positively associated with psychological resilience. This study suggests that factors such as social support, previous ICU experience, and individual awareness also shape coping skills [ 27 ]. Also, Butler et al. (2016) demonstrated that the coping styles of relatives of ICU patients are closely related to personality traits, level of social support, and psychological history (history of anxiety, depression). This study also detected that individuals with “maladaptive” or “avoidant” coping profiles were less likely to use confident and task-oriented strategies[ 28 ]. In the study, the need total score had a negative and significant effect on optimistic coping style (β = -0.359; p < 0.001), suggesting that as an individual's need level increases, their tendency to approach events with an optimistic perspective decreases. The explanatory power was significant at 12.6% (R² = 0.126). This finding suggests that individuals receiving treatment in high-stress environments, such as intensive care, may experience a decline in their hopes for the future and positive coping tendencies if their needs are not adequately met. This result differs from some studies in the literature but is consistent with others. For example, a study by Nadig et al. (2016) reported that optimism in family members of patients recovering from mechanical ventilation in intensive care units is a protective factor against psychological distress. However, the important point emphasized here is that high optimism is already associated with low stress levels; in other words, as need levels rise and remain unmet, this protective optimistic effect diminishes [ 29 ]. Similarly, Tokem et al. (2015) conducted a study with families of oncology patients, finding that optimistic coping decreased in individuals with increased levels of hopelessness, while emotional and negative coping styles, such as helplessness, increased [ 30 ]. Also, a study by Shao (2016) found a significant relationship between illness uncertainty and coping styles among families of sepsis patients in intensive care. This study found a negative correlation between positive coping styles and low uncertainty, suggesting that meeting needs and reducing uncertainty may increase optimistic coping tendencies[ 31 ]. Conclusion Based on a holistic perspective, the needs of individuals who are relatives of patients in the intensive care unit (ICU) can be said to play a significant role in their stress coping processes. When these needs are not adequately met, the resulting anxiety and depressive symptoms reduce individuals’ self-esteem, leading to a shift in coping styles to more passive, avoidant, and emotion-based styles. For this reason, healthcare professionals must identify the needs of family members early and develop supportive approaches to address these needs to increase individuals’ psychological resilience and encourage more active coping strategies. Holistic assessments and necessary measures must be conducted to meet the physical, psychological, and psychosocial needs of relatives of patients receiving intensive care. This approach aligns with the family-centered approach and forms a fundamental cornerstone in providing quality healthcare. The results of the present study highlights the importance of addressing not only the treatment and care needs of patients but also the holistic approach of patients, including their families and social environments. In this context, it is recommended to increase similar studies focusing on the needs of patient relatives and to develop institutional or individual interventions for these problems detected in clinical settings. In conclusion, identifying the needs of patient relatives in intensive care units at an early stage and developing supportive approaches to these needs strengthens the psychological resilience of individuals, enables them to cope with stress more healthily, and forms the basis of a quality, family-centered care approach. It is important for nurses and healthcare professionals to support the psychological health of family members with an empathic approach during the intensive care process (Velasco Bueno et al., 2018). Multi-center, qualitative studies are needed in this field, and effective social support systems for family caregivers need to be established in Türkiye. Declarations Acknowledgements The authors thank all the volunteers who participated in the study. Authors’ contributions HK and ŞYB conceived the study and contributed to the interpretation of the results. HK did statistical analyses and drafted the first manuscript. ŞYB and HK provided oversight and managed the research activity. HK, ŞYB contributed to the review and revision of the manuscript. All authors contributed to the design of the study protocol and reviewed the manuscript. The authors have read and approved the final manuscript. Funding : This paper did not receive any funding from public, com-mercial, or not-for profit sectors. Data availability The data that supports the findings of this study is available from the corresponding author upon reasonable request. Ethics approval and consent to participate The study was approved by the Kastamonu University Training and Research Hospital Clinical Research Ethics Committee. Ethical permission (22.09.2021, 2020/143– 112) and institutional permission was obtained from Kastamonu University Rectorate. All study procedures were performed following relevant guidelines. Institutional permission was obtained for the study. All study procedures were performed in accordance with relevant guidelines. All participants were given an oral explanation of the purpose and content of the study and informed consent was obtained from all participants. The study was conducted in line with the Helsinki Declaration and informed consent was obtained from the participants. Consent for publication Not applicable. Competing interests The authors declare no competing interests. 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Yogun bakim ünitesinde yatan hastalarin yakinlarinin gereksinimleri ve stresle bas etme tarzlarinin belirlenmesi, Nevsehir Haci Bektas Veli Üniversitesi Fen Bilimleri Enstitüsü, Hemsirelik Anabilim Dali Yüksek Lisans Tezi. - Görücü, S., & Gürol Arslan, G. (2024). The investigation of death anxiety and spiritual well-being levels of family members of patients admitted to intensive care unit. Journal of Caring Sciences, 13(1), 20–26. https://doi.org/10.34172/jcs.2024.33069 Olabisi, O., Olorunfemi, O., Bolaji, A., Azeez, F. O., Olabisi, T. E., & Azeez, O. (2020). Depression, anxiety, stress and coping strategies among family members of patients admitted in intensive care unit in Nigeria. International Journal of Africa Nursing Sciences, 13,100223. https://doi.org/10.1016/j.ijans.2020.100223 - Akça Ay, F. (2018). Saglik Uygulamalarinda Temel Kavramlar ve Beceriler (1. Baski). Istanbul: Nobel Tip Kitabevi Büyükçoban, S., Çiçeklioglu, M., Yilmaz Demiral, N. & Civaner, M. M. (2016). 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Stresle Basa Cikma Tarzlari Olcegi: Universite Ogrencileri Icin Uyarlanmasi. Turk Psikoloji Dergisi, 10, 56–73. Tabachnick, B. G., & Fidell, L. S. (2013). Using Multivariate Statistics (6. baski). Boston: Pearson. s. 79. George, D., & Mallery, P. (2010). SPSS for Windows Step by Step: A Simple Guide and Reference, 17.0 Update (10. baski). Boston: Pearson. s. 41. Chiang, V. C. L., Chien, W. T., Wong, H. T., Lee, R. L. T., Ha, J. Y., Leung, S. S. Y., & Wong, D. F. K. (2016). A brief cognitive-behavioral psychoeducation (B-CBE) program for managing stress and anxiety of main family caregivers of patients in the intensive care unit. International Journal of Environmental Research and Public Health, 13(10), 962. https://doi.org/10.3390/ijerph13100962. Naef, R., von Felten, S., & Ernst, J. (2021). Factors influencing post-ICU psychological distress in family members of critically ill patients: A linear mixed-effects model. BioPsychoSocial Medicine, 15, Article 6. https://doi.org/10.1186/s13030-021-00206-1 Kynoch, K., Chang, A. M., Coyer, F., & McArdle, A. (2018). Developing a model of factors that influence meeting the needs of family with a relative in ICU. International Journal of Nursing Practice, 25(1). https://doi.org/10.1111/ijn.12693 Leske, J. S. (2002). Interventions to decrease family anxiety. Critical Care Nurse, 22(6), 61–65. Özçelik, H., & Erdogan, N. (2020). Relationship between the needs of Turkish relatives of patients admitted to an intensive care unit and their coping styles. OMEGA–Journal of Death and Dying, 85(4), 990–1006. https://doi.org/10.1177/0030222820960963 Rückholdt, M., Tofler, G., Randall, S., & Buckley, T. (2019). Coping by family members of critically ill hospitalised patients: An integrative review. International Journal of Nursing Studies, 97, 40–54. https://doi.org/10.1016/J.IJNURSTU.2019.04.016 Butler, J. M., Hirshberg, E., Hopkins, R., Wilson, E., Orme, J., Beesley, S., Kuttler, K., & Brown, S. M. (2016). Preliminary identification of coping profiles relevant to surrogate decision making in the ICU. PLoS ONE, 11(11),e0166542. https://doi.org/10.1371/journal.pone.0166542 Nadig, N., Huff, N. G., Cox, C. E., & Ford, D. W. (2016). Coping as a multifaceted construct: Associations with psychological outcomes among family members of mechanical ventilation survivors. Critical Care Medicine, 44(9), 1710–1717. https://doi.org/10.1097/CCM.0000000000001761 Tokem, Y., Özçelik, H., & Cicik, A. (2015). Examination of the relationship between hopelessness levels and coping strategies among the family caregivers of patients with cancer. Cancer Nursing, 38(2),E28–E34. https://doi.org/10.1097/NCC.0000000000000189 Shao, X. (2016). Associations between uncertainty in illness and coping style about family members of patients with severe sepsis in intensive care unit. Chinese Journal of Modern Nursing, 18(3), 358–361. https://doi.org/10.3760/CMA.J.ISSN.1008-1372.2016.03.010 Additional Declarations No competing interests reported. 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13:33:31","extension":"html","order_by":7,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":136135,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7820598/v1/24d00d736455cfc96e2f3936.html"},{"id":101690440,"identity":"49ebd946-925e-4667-867b-5586a7a36ba7","added_by":"auto","created_at":"2026-02-02 16:02:50","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1299444,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7820598/v1/db240505-450e-4ca6-b7c8-735408a3fd00.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eThe Effect of Coping With Stress in Predicting the Needs, Death Anxiety, and Depression of Patients’ Relatives in Intensive Care Units\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eIntensive Care Units (ICUs) are healthcare areas where critically ill patients receive advanced medical care and high-technology and multidisciplinary approaches are used [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Naturally, all attention is focused on the patient and the disease in intensive care units. However, during this time, feelings such as fear, anxiety, curiosity, etc., experienced by the family waiting outside the door of the unit and the patient inside are not taken into consideration. The family is seen only as the ones who carry out processes such as procuring some necessary supplies for the patient or registering documents [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Family members who witness their patients\u0026rsquo; struggle for life face psychological difficulties such as uncertainty, fear, anxiety, intense stress, physical and mental fatigue, death anxiety, and symptoms of depression [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe emotional burden of patients\u0026rsquo; families shapes their expectations, needs, and coping mechanisms regarding healthcare services. In this process, information, emotional support, spiritual needs, and basic physical needs are of paramount importance to patients\u0026rsquo; families[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. However, the needs of family members must be taken into account in the treatment and care services provided by health personnel. It is observed that little or no space is given to the subject [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. The limitations of the intensive care settings, uncertainty about the patient\u0026rsquo;s condition [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e], and a focus on the patient and the disease rather than the patient\u0026rsquo;s relatives [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e], can make it difficult to meet these needs. Also, the fear of losing a loved one for the patient\u0026rsquo;s relatives [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e], the uncertainty of the situation, economic problems, role changes, inadequate needs of the patient\u0026rsquo;s relatives, inability to obtain sufficient information about the patient\u0026rsquo;s health status, inability to participate in the patient\u0026rsquo;s care, complex tools and equipment in the intensive care unit, and inability to see the patient adequately are sources of stress and cause anxiety for the patient\u0026rsquo;s relatives[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. The fear of losing the patient at any moment and thoughts of grief can cause death anxiety in the patient\u0026rsquo;s relatives[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Relatives of patients in intensive care are negatively affected both psychologically and physically due to the anxiety they experience [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. The stress that arises during this process hinders their coping skills and increases the risk of encountering psychological problems such as anxiety and depression [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].For this reason, the psychological support provided both makes it easier for them to cope with stress and contributes to the home care processes of patients. Also, relatives of patients whose needs are not adequately met tend to exhibit more desperate and submissive approaches, while those whose needs are met tend to act self-confidently and seek social support [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. In the study conducted by G\u0026ouml;r\u0026uuml;c\u0026uuml; (2019), it was reported that as the level of death anxiety of patient relatives increases, their spiritual well-being levels also increase, which is explained by the fact that individuals who fear losing their patients treated in intensive care tend to turn more to spiritual feelings to cope with increased death anxiety[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. For this reason, it is stated that the families of patients in intensive care units need support to reduce their death anxiety, provide emotional relief, be informed, be with their patients, offer them support, share their feelings, and meet their individual needs [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eFor patients\u0026rsquo; families to manage this process successfully, intensive care nurses must focus on two primary goals to identify and meeting the needs of their families. Firstly, considering the needs of patients\u0026rsquo; families in care planning to effectively implement holistic care [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Secondly, ensuring effective stress management by meeting the needs of patients\u0026rsquo; families [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. At this point, identifying the needs of families of patients admitted to intensive care can contribute to the prevention of potential psychological symptoms such as death anxiety and depression.\u003c/p\u003e\u003cp\u003eIn our country, studies conducted on providing the necessary information and support to the families of patients in intensive care are quite inadequate[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. The study aimed to examine the impact of stress management on the prediction of family needs, death anxiety, and depression. To maintain ideal healthcare, patients and their families must be considered as a whole. Nurses must not only address the needs of patients but also support the needs of their relatives within a holistic approach, remembering that the patient and their family are integrated, as stated in nursing philosophy [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Recommendations that patients\u0026rsquo; relatives receive regular support and counseling within the scope of consultation-liaison nursing, a field of psychiatric nursing, regarding their identified needs and death anxiety, and also to inform the nursing literature with the research results.\u003c/p\u003e\u003cp\u003eIn the present study, the aim was to examine the effects of coping with stress in predicting the needs, death anxiety, and depression of relatives of patients in intensive care. To this end, the following hypotheses were formulated.\u003c/p\u003e\u003cp\u003eH\u003csub\u003e0\u003c/sub\u003e: According to the needs of the patient\u0026rsquo;s relatives, the methods of coping with stress affect the prediction of death anxiety and depression.\u003c/p\u003e\u003cp\u003eH\u003csub\u003e1\u003c/sub\u003e: According to the needs of patient relatives, methods of coping with stress have no effect in predicting death anxiety and depression.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eDesign\u003c/h2\u003e\u003cp\u003eThe study had a cross-sectional, correlational, and descriptive design.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003ePopulation and Sample\u003c/h3\u003e\n\u003cp\u003eThe study was conducted with relatives of patients hospitalized in adult intensive care units at Kastamonu Training and Research Hospital. The sample of the study consisted of relatives of patients hospitalized in intensive care between 01.10.2021 and 01.06.2022. The population consisted of individuals who had at least one family member who cared for patients admitted to the intensive care unit during the last year between the dates of the study. The sample size was determined using the formula (n\u0026thinsp;=\u0026thinsp;N.t2.pq / d2.(N-1)\u0026thinsp;+\u0026thinsp;t2.p.q). Based on the data, the number of patients hospitalized in all intensive care units in the last year was 3496. The sample size was calculated as 357. Face-to-face interviews were conducted with 367 relatives of patients between the specified dates. Data collection forms were read and marked by the researchers.\u003c/p\u003e\n\u003ch3\u003eData Collection\u003c/h3\u003e\n\u003cp\u003eThe data collection tools consisted General Information Form, Needs Scale for Patient Relatives in Intensive Care Units, Turkish Death Anxiety Scale, Beck Depression Inventory, and Ways of Coping with Stress Scale.\u003c/p\u003e\n\u003ch3\u003eGeneral Information Form\u003c/h3\u003e\n\u003cp\u003eThe General Information Form used in the study was prepared by the researchers and consisted of 15 questions on socio-demographic characteristics[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e\n\u003ch3\u003eNeeds Scale for Patient Relatives in Intensive Care Units (NCPRICU)\u003c/h3\u003e\n\u003cp\u003eThe Critical Care Family Needs Inventory (CCFNI) was developed by Molter in 1979 to determine the needs of family members of patients in intensive care units. The scale was developed to emphasize the importance of the needs of families of patients in intensive care and to measure family needs. NCPRICU\u0026rsquo;s validity and reliability studies have been conducted in many languages and cultures. The validity and reliability study was conducted in Turkish society by B\u0026uuml;y\u0026uuml;k\u0026ccedil;oban et al. (2016). The Cronbach\u0026rsquo;s Alpha Value of the scale was determined to be 0.93 in the original study and was 0.92 in the present study[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. The NCPRICU consisted of 40 statements rated from 1 to 4 (1\u0026thinsp;=\u0026thinsp;Not important, 2\u0026thinsp;=\u0026thinsp;Less important, 3\u0026thinsp;=\u0026thinsp;Important, 4\u0026thinsp;=\u0026thinsp;Very important). The scale has five subscales: Trust, Information, Closeness, Support, and Comfort. The maximum possible score on the Likert-type scale is 160, and the minimum score is 40. The subscales can also be scored separately. Low total and subscale scores indicate a decrease in needs, while increasing mean scores indicate an increase in needs.\u003c/p\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003eTurkish Death Anxiety Scale (TDAS)\u003c/h2\u003e\u003cp\u003eThe Turkish Death Anxiety Scale was developed by Sarıkaya and Baloğlu (2016) with a total of 20 items on a 5-point Likert scale. Responses to the items are scored as \u0026ldquo;never\u0026thinsp;=\u0026thinsp;0,\u0026rdquo; \u0026ldquo;rarely\u0026thinsp;=\u0026thinsp;1,\u0026rdquo; \u0026ldquo;occasionally\u0026thinsp;=\u0026thinsp;2,\u0026rdquo; \u0026ldquo;often\u0026thinsp;=\u0026thinsp;3,\u0026rdquo; and \u0026ldquo;always\u0026thinsp;=\u0026thinsp;4.\u0026rdquo; The scores of the Turkish Death Anxiety Scale range from 0 to 80, with a high score indicating high death anxiety. There are no reverse-scored items in the Turkish Death Anxiety Scale. The Turkish Death Anxiety Scale consists of three sub-dimensions: uncertainty of death, suffering, and exposure. Exploratory factor analysis revealed that the 20-item scale has a three-factor structure that explains 67.27% of the total variance. This three-factor structure was tested with confirmatory factor analysis. The T-Test revealed a significant difference between the 27% lower and upper group means. The correlation between the Death Anxiety Scale and TP-DAS was .76, the correlation between the Death Anxiety Scale and trait anxiety was .43, the correlation between the Death Anxiety Scale and state anxiety was .28, and the correlation between the Death Anxiety Scale and BDI was .24 (p\u0026thinsp;\u0026lt;\u0026thinsp;.01).[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. The Cronbach\u0026rsquo;s alpha coefficient and the test-retest reliability over two weeks of the Death Anxiety Scale were .95 and .82, respectively. The Cronbach\u0026rsquo;s alpha internal consistency reliability coefficient of this study was .95.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eBeck Depression Inventory (BDI)\u003c/h3\u003e\n\u003cp\u003eThe Beck Depression Inventory (BDI) was developed by Beck in 1961 to identify individuals at risk for depression and to measure the level and severity of depressive symptoms. It was revised in 1978. It consists of 21 items and provides a 4-point Likert-type measurement. Each item receives a progressively increasing score between 0 and 3, with the maximum total score being 63. The scale included 21 categories of depressive symptoms: 1. Mood, 2. Pessimism, 3. Sense of failure, 4. Dissatisfaction, 5. Feelings of guilt, 6. Feelings of punishment, 7. Self-hatred, 8. Self-blame, 9. Desire to punish oneself, 10. Crying spells, 11. Irritability, 12. Social withdrawal, 13. Indecisiveness, 14. Body image, 15. Inhibition of workability, 16. Sleep disturbances, 17. Fatigue/weariness, 18. Decreased appetite, 19. Weight loss, 20. Somatic complaints, and 21. Loss of sex drive. Each of these categories consists of 4 self-report items. [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. The individual is asked to select and mark one of the four items in each group that best describes how they have felt during the past week, including the current day. The number next to each item (between 0 and 3) indicates the score to be given for that item. A depression score is obtained by summing these scores[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].\u003c/p\u003e\n\u003ch3\u003eWays of Coping with Stress Scale (WCSC)\u003c/h3\u003e\n\u003cp\u003eThe Ways of Coping with Stress Scale (WCSC) was developed by Folkman and Lazarus (1980) under the name Coping with Stress Inventory [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. The 4-point Likert-type scale consists of 66 items (0\u0026thinsp;=\u0026thinsp;never used, 3\u0026thinsp;=\u0026thinsp;frequently used). The scale was first used in Turkey by Siva (1988) [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Three separate studies were conducted to examine the factor structure of the shortened version of the Coping with Stress Inventory. As a result of these studies, it was determined that the scale consisted of five factors in total: \u003cb\u003e\u0026ldquo;\u003c/b\u003eself-confident approach \u0026ldquo; (items 8, 10, 14, 16, 20, 23, and 26), \u0026ldquo;desperate approach \u0026ldquo; (items 3, 7, 11, 19, 22, 25, 27, and 28), \u0026ldquo;submissive approach \u0026ldquo; (items 5, 13, 15, 17, 21, and 24), \u0026ldquo;optimistic approach\u0026rdquo; (items 2, 4, 6, 12, and 18), and \u0026ldquo;seeking social support\u003cb\u003e\u0026rdquo;\u003c/b\u003e (items 1, 9, 29, and 30). Among the effective methods (problem-focused), a self-confident approach indicates that the individual has the power and belief to cope with stress, the optimistic approach indicates that the individual can control stress by looking at events from a logical framework, and seeking social support indicates that the individual tries to cope with the stressful situation by getting help from others. The desperate approach, an ineffective (emotion-focused\u003cb\u003e)\u003c/b\u003e approach, refers to a situation in which an individual lacks faith and confidence in coping with stress, while the submissive approach refers to a situation in which stressful events are accepted, believing them to be fateful. In the scale\u0026rsquo;s scoring, items 1 and 9 in the seeking social support subfactor are reverse-scored, while all other items are straight-scored. High scores on each of these five subscales indicate the intensity of use of the coping style represented by that subscale. If a single total score is desired, a total score is obtained by reversing all items from the submissive and desperate approaches, as well as items 1 and 9. Reliability coefficients for the WCSC subscales obtained from three separate studies were detected to be between Cronbach\u0026rsquo;s alpha values for the self-confident approach, between .73 and .68 for the desperate approach, between .47 and .72 for the submissive approach, between .68 and .49 for the optimistic approach, and between .47 and .45 for seeking social support [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. In this study, Cronbach\u0026rsquo;s alpha value for the Ways of Coping with Stress Scale was detected to be .82. When examined in terms of factors, Cronbach\u0026rsquo;s alpha value was detected to be .77 for the self-confident approach, .74 for the desperate approach, .65 for the submissive approach, .75 for the optimistic approach, and .59 for seeking social support.\u003c/p\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003eEthical Dimensions of the Study\u003c/h2\u003e\u003cp\u003e It was approved by the Kastamonu University Training and Research Hospital Clinical Research Ethics Committee (September 22, 2021, 2020-KAEK-143-112).Written permission from the hospital chief physician, and institutional permission from the Kastamonu Provincial Health Directorate. Verbal and written information was provided to the participating first-degree relatives (mother, father, spouse, child), and their written permissions were obtained using the Informed Consent Form. The study was conducted in line with the Helsinki Declaration and informed consent was obtained from the participants.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003eStatistical Analysis of Data\u003c/h2\u003e\u003cp\u003eThe data obtained in the study were analyzed using the SPSS (Statistical Package for Social Sciences) for Windows 22.0 program. Descriptive statistical methods used in the evaluation of the data were number, percentage, mean, and standard deviation. Kurtosis (Kurtosis) and Skewness (Skewness) values were examined to determine whether the research variables showed a normal distribution. For total need, kurtosis is 0.548, and skewness is -1.027. The kurtosis values of the support, information, closeness, trust, and comfort sub-dimensions are 1.208, 2.135, 0.854, 1.415, and 0.841, respectively, and skewness values are \u0026minus;\u0026thinsp;0.962, -1.194, -1.056, -1.369, and \u0026minus;\u0026thinsp;1.036. The kurtosis values for total death anxiety and its sub-dimensions, uncertainty of death, thinking about death, witnessing death and suffering, are \u0026minus;\u0026thinsp;0.563; -0.565; -0.854; -0.699; and skewness values are \u0026minus;\u0026thinsp;0.343; -0.48; 0.257 and \u0026minus;\u0026thinsp;0.63. Depression total kurtosis is 0.745, and skewness is 1.319. For the sub-dimensions of coping with stress, confident approach, desperate approach, submissive approach, optimistic approach, and seeking social support, kurtosis values are 0.425, -0.448, 0.143, -0.359, -0.482, and skewness values are \u0026minus;\u0026thinsp;0.454, -0.104, -0.268, -0.035, and 0.046. In the relevant literature, a normal distribution is considered when the skewness and kurtosis values of the variables are between +\u0026thinsp;1.5 and \u0026minus;\u0026thinsp;1.5 [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e] and +\u0026thinsp;2.0 and \u0026minus;\u0026thinsp;2.0 [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e] It was determined that the variables exhibited a normal distribution. Pearson correlation and regression analysis were applied to the continuous variables of the study.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003eInclusion Criteria\u003c/h2\u003e\u003cp\u003eInclusion criteria were having first-degree relative (mother, father, sibling, spouse, child), or having second-degree relative (aunt, uncle, paternal uncle) for patients without first-degree relatives, family members over the age of 18 and under the age of 65, family members with good hearing and comprehension skills, at least literacy, and Turkish as a native language. Family members were selected if the patient's first 24 hours of intensive care unit admission had been completed, and those who agreed to participate in the study voluntarily were included. Furthermore, family members of patients who had been under intensive care monitoring for less than 24 hours or more than six months (the needs and expectations of family members who have been in the intensive care unit for more than six months vary as they adapt to the situation), and family members whose mental state (intense anxiety, stress, crying, etc.) made them unsuitable for communication were excluded from the study.\u003c/p\u003e\u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e shows the distribution of employees according to their descriptive characteristics. Among the patient relatives who participated in the study, 64.2% were female, 56.0% were primary school graduates, 78.1% were married, and 61.5% were unemployed. In terms of degree of relationship, 62.0% were first-degree relatives and 38.0% were second-degree relatives. Regarding losing a relative, 66.4% responded \u0026ldquo;yes\u0026rdquo; and 33.6% responded \u0026ldquo;no.\u0026rdquo; A total of 34.4% of patient relatives reported having serious health problems, and 65.6% reported not having serious health problems. The proportion of patient relatives who received information during the intensive care process was 73.8%, while the proportion of those who did not receive information was 26.2%. 60.0% reported receiving information from a physician, and 40.0% from a nurse. Among the individuals responsible for care, 15.0% were mothers, 7.4% were fathers, 4.1% were grandmothers, 7.7% were spouses, 5.2% were children, and 60.7% indicated this as \u0026ldquo;none.\u0026rdquo; The average age of the participants was detected to be 45.780\u0026thinsp;\u0026plusmn;\u0026thinsp;15.401 (min\u0026thinsp;=\u0026thinsp;18, max\u0026thinsp;=\u0026thinsp;88).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDistribution of Relatives According to Descriptive Characteristics\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGroups\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFrequency (n)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePercentage (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003eSex\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e235\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e64.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e131\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e35.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEducational Status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePrimary school\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e205\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e56.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHigh school\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e101\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e27.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCollege\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e16.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e286\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e78.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSingle\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e21.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eJob\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWorking\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e141\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e38.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNot working\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e225\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e61.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDegree of Closeness\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1st degree\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e227\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e62.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2nd degree\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e139\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e38.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eRelative of a Patient Previously Hospitalized in ICU\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e178\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e48.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e188\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e51.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDeath-Risk\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e16.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e304\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e83.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eLoss of a loved one\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e243\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e66.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e123\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e33.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSerious Health Problem\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e126\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e34.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e240\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e65.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDuration of Stay in YB\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2\u0026ndash;5 Days\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e181\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e49.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e6\u0026ndash;9 Days\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e87\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e23.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e10\u0026ndash;13 Days\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e21.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e13 and Above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5.7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eGetting Information During the ICU Process\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e270\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e73.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e96\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e26.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSource of information\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePhysician\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e162\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e60.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNurse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e108\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e40.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eType of ICU Where the Patient\u0026rsquo;s Relative was Admitted\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1st degree\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e114\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e31.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2nd degree\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e128\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e35.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGeneral Intensive Care\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e105\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e28.7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCardiovascular Surgery\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eMean\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003eSD\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e45.780\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e15.401\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e shows the descriptive statistics regarding the total mean scores of the scales used in the study. When the mean scores for needs, death anxiety, depression, and styles of coping with stress were examined, the participants\u0026rsquo; mean total needs score was detected to be 123.462\u0026thinsp;\u0026plusmn;\u0026thinsp;24.918 (min\u0026thinsp;=\u0026thinsp;40.00; max\u0026thinsp;=\u0026thinsp;160.00). The mean total death anxiety score was 42.653\u0026thinsp;\u0026plusmn;\u0026thinsp;19.881, and the means according to the sub-dimensions were: uncertainty of death 22.762\u0026thinsp;\u0026plusmn;\u0026thinsp;10.507, thinking about and witnessing death 12.434\u0026thinsp;\u0026plusmn;\u0026thinsp;7.645, and suffering 7.456\u0026thinsp;\u0026plusmn;\u0026thinsp;3.550. The total depression score was detected to be 10.500\u0026thinsp;\u0026plusmn;\u0026thinsp;8.270 (min\u0026thinsp;=\u0026thinsp;0.00; max\u0026thinsp;=\u0026thinsp;46.00). In terms of styles of coping with stress, the means were as follows: self-confident approach 18.954\u0026thinsp;\u0026plusmn;\u0026thinsp;4.389, desperate approach 20.820\u0026thinsp;\u0026plusmn;\u0026thinsp;4.306, submissive approach 15.863\u0026thinsp;\u0026plusmn;\u0026thinsp;3.162, optimistic approach 15.093\u0026thinsp;\u0026plusmn;\u0026thinsp;2.788, and seeking social support 9.396\u0026thinsp;\u0026plusmn;\u0026thinsp;2.251.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eMean scores of Needs. Death Anxiety, Depression, and Styles of Coping with Stress\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eN\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMean\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSD\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eMin.\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eMax.\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eNeeds Scale Total Score\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e366\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e123.462\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e24.918\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e40.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e160.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cem\u003eSupport\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e366\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e36.533\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e8.356\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e13.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e52.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cem\u003eInformation\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e366\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e26.511\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5.793\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e9.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e36.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cem\u003eRelationship\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e366\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e23.186\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4.993\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e7.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e28.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cem\u003eTrust\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e366\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e16.355\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e3.859\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e5.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e20.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cem\u003eComfort\u003c/em\u003e​\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e366\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e20.877\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4.578\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e6.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e24.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDeath Anxiety Total Score\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e366\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e42.653\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e19.881\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e80.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cem\u003eUncertainty of Death\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e366\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e22.762\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e10.507\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e40.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cem\u003eThinking of Death Witnessing\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e366\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e12.434\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e7.645\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e28.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cem\u003eSuffering\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e366\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e7.456\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e3.550\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e12.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDepression Scale Total Score\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e366\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e10.500\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e8.270\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e46.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSelf-Confident Approach\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e366\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e18.954\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4.389\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e7.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e28.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDesperate Approach\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e366\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e20.820\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4.306\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e11.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e32.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSubmissive Approach\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e366\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e15.863\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e3.162\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e7.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e24.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eOptimistic Approach\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e366\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e15.093\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2.788\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e8.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e20.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSeeking Social Support\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e366\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e9.396\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2.251\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e5.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e14.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e shows the correlation analysis between the scores of Needs, Death Anxiety, Depression and Coping Styles. A significant positive correlation was detected between the total death anxiety score and the total needs score (r\u0026thinsp;=\u0026thinsp;0.393, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01). Similarly, significant positive correlations were detected between the sub-dimensions of uncertainty of death (r\u0026thinsp;=\u0026thinsp;0.374, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01), thinking about and witnessing death (r\u0026thinsp;=\u0026thinsp;0.359, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01), and suffering (r\u0026thinsp;=\u0026thinsp;0.320, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01) and the total needs score. Statistically significant and positive correlations were also detected between all of the needs sub-dimensions and death anxiety and its sub-dimensions.\u003c/p\u003e\u003cp\u003eAlthough there was no significant relationship between depression and the total needs score (r=-0.092, p\u0026thinsp;\u0026gt;\u0026thinsp;0.05), only weak but significant negative relationships were observed with the closeness (r=-0.123, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) and trust (r=-0.115, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) sub-dimensions.\u003c/p\u003e\u003cp\u003eSignificant negative correlations were detected between the self-confident approach and the total needs score (r=-0.326, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01) and all sub-dimensions of coping styles. Similarly, strong and significant negative correlations were found between the optimistic approach and the total needs score (r=-0.359, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01) and all sub-dimensions. However, no significant relationship was found between the helpless approach and the submissive approach and the total needs score, and only a weakly significant relationship was found with the support sub-dimension (r=-0.109, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 for the helpless approach; r\u0026thinsp;=\u0026thinsp;0.105, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 for the submissive approach). No significant relationship was detected between seeking social support and needs scores (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05). In general, it can be said that as death anxiety increases, the needs levels of patients' relatives also increase, whereas needs levels are lower in individuals who use positive coping strategies (e.g., self-confident and optimistic approaches).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eCorrelation Analysis Between Need, Death Anxiety, Depression, and Stress Coping Styles Scores\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"8\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eRequirement Total\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSupport\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eInformation\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eRelationship\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eTrust\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003eComfort\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eDeath Anxiety Total\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003er\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.393**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.451**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.407**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.273**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.379**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.186**\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eThe Uncertainty of Death\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003er\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.374**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.434**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.367**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.263**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.368**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.185**\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eThinking of Death Witnessing\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003er\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.359**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.416**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.391**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.239**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.330**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.163**\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.002\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eSuffering\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003er\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.320**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.344**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.349**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.235**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.325**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.141**\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.007\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eDepression Total\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003er\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e-0.092\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-0.030\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e-0.097\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e-0.123*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e-0.115*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e-0.092\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.079\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.566\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.063\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.018\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.028\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.080\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eSelf-Confident Approach\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003er\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e-0.326**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-0.352**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e-0.298**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e-0.283**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e-0.285**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e-0.210**\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eDesperate Approach\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003er\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e-0.051\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-0.109*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e-0.042\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.018\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e-0.012\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e-0.033\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.334\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.038\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.420\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.731\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.812\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.531\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eSubmissive Approach\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003er\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.037\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.105*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.070\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e-0.017\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.034\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e-0.087\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.476\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.045\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.180\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.744\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.513\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.096\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eOptimistic Approach\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003er\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e-0.359**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-0.340**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e-0.379**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e-0.304**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e-0.311**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e-0.259**\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eSeeking Social Support\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003er\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.045\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.040\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e-0.022\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.081\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.038\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.078\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.394\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.449\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.674\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.121\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.469\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.136\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"8\"\u003e**\u0026lt;0.01; Pearson Correlation Analysis\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e shows the variables affecting the needs of patient relatives. In the regression analysis, the total need score was detected to have a significant and positive effect on death anxiety (β\u0026thinsp;=\u0026thinsp;0.393; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The explanatory power of the model was 15.2% (R\u0026sup2; = 0.152), and the model was generally significant (F\u0026thinsp;=\u0026thinsp;66.571; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The increase in death anxiety increased with the increase in need scores.\u003c/p\u003e\u003cp\u003eSimilarly, when the effect of the total need score on the self-confident coping style was examined, a negative and significant relationship was detected between them (β = -0.326; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The explanatory power of the model was 10.4% (R\u0026sup2; = 0.104), and a significant model was obtained (F\u0026thinsp;=\u0026thinsp;43.425; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), which suggests that as the need level increases, individuals\u0026rsquo; tendency to use the self-confident coping style decreases.\u003c/p\u003e\u003cp\u003eAlso, the effect of the total need score on optimism was detected to be negative and significant (β = -0.359; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The model\u0026rsquo;s explanatory power was 12.6% (R\u0026sup2; = 0.126), and the model was statistically significant (F\u0026thinsp;=\u0026thinsp;53.787; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), which suggests that individuals with higher need levels tend to use optimistic coping less.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eVariables Affecting the Needs of Patient Relatives\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"8\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eDependent Variable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eUnstandardized Coefficients\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eStandardized Coefficients\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003et\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u003cp\u003e95% Confidence Interval\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eB\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eSE\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eβ\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eMin\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003eMax\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDeath Anxiety Total\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.314\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.038\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.393\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e8,159\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003e0,000\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.238\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.389\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e\u003cp\u003e*Dependent Variable\u0026thinsp;=\u0026thinsp;Death Anxiety Total, \u003cem\u003eR\u0026thinsp;=\u0026thinsp;0.393; R\u003c/em\u003e \u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e \u003cem\u003e=0.152; F\u0026thinsp;=\u0026thinsp;66.571; p\u0026thinsp;=\u0026thinsp;0.000; Durbin Watson Value\u0026thinsp;=\u0026thinsp;0.139\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSelf-Confident Approach\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.058\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.009\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.326\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-6,590\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003e0,000\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e-0.075\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e-0.040\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e\u003cp\u003e*Dependent Variable\u0026thinsp;=\u0026thinsp;Self-Confident Approach, \u003cem\u003eR\u0026thinsp;=\u0026thinsp;0.326; R\u003c/em\u003e \u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e \u003cem\u003e=0.104; F\u0026thinsp;=\u0026thinsp;43.425; p\u0026thinsp;=\u0026thinsp;0.000; Durbin Watson Value\u0026thinsp;=\u0026thinsp;0.591\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eOptimistic Approach\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.040\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.005\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.359\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-7,334\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003e0,000\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e-0.051\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e-0.029\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e\u003cp\u003e*Dependent Variable\u0026thinsp;=\u0026thinsp;Optimistic Approach, \u003cem\u003eR\u0026thinsp;=\u0026thinsp;0.359; R\u003c/em\u003e \u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e \u003cem\u003e=0.126; F\u0026thinsp;=\u0026thinsp;53.787; p\u0026thinsp;=\u0026thinsp;0.000; Durbin Watson Value\u0026thinsp;=\u0026thinsp;0.275\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eSignificant and positive relationships were detected between the need levels of relatives of patients in Intensive Care Units (ICU) and death anxiety (β\u0026thinsp;=\u0026thinsp;0.393; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The analysis results show that need scores significantly predict death anxiety, and the explanatory level of the model was 15.2% (R\u0026sup2; = 0.152). This result shows that death anxiety increases when the needs of relatives of patients are not met or are not met adequately. This can directly affect the psychological states of family members, especially in environments such as ICUs where uncertainty, isolation, and life-threatening situations prevail. This result is parallel to those of many studies in the literature. For example, the study by G\u0026ouml;r\u0026uuml;c\u0026uuml; (2024) reported that the death anxiety of individuals with relatives of patients in intensive care is significantly related to their spiritual well-being[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Family members experience more anxiety when thinking about the death of their patients, and their need for spiritual support during this process also increases. Likewise, Chiang et al. (2016) emphasized that relatives of patients in the ICU experienced high levels of stress and anxiety, and that this was related to unmet needs such as information, support, and comfort[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. The same study also reported that a short-term cognitive-behavioral psychoeducation program offered to family members reduced anxiety, stress, and depression levels, indicating that meeting the needs of relatives reduced psychological burden. Another study by Naef et al. (2021) revealed that symptoms of depression, anxiety, and post-traumatic stress experienced by family members after ICU were negatively correlated with their satisfaction with the intensive care process[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. In other words, as the perception that needs were adequately met increased, psychological distress decreased. The results also show that the death anxiety levels of patients\u0026rsquo; relatives are generally moderate. The highest mean score in the \u0026ldquo;uncertainty of death\u0026rdquo; subscale, in particular, suggests that uncertainty has a strong psychological impact on individuals. The scores in the \u0026ldquo;thinking about and witnessing death\u0026rdquo; and \u0026ldquo;suffering\u0026rdquo; subscales are also notable, demonstrating that witnessing the death process and related mental images have the potential to create anxiety in individuals. Furthermore, the significantly high mean depression score suggests that the intensive care process triggers not only death anxiety but also depressive symptoms in patients\u0026rsquo; relatives. These results highlight the necessity of psychosocial support interventions for patients\u0026rsquo; relatives and the importance of informative and supportive approaches, particularly for coping with uncertainty. Kynoch et al. (2018) similarly detected that family members\u0026rsquo; anxiety and depression levels are significantly linked to unmet needs and inadequate support[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Leske (2002) supported the positive effects of meeting families\u0026rsquo; needs on stress, anxiety, and depression in his study[\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. This is consistent with our study results. Studies show that failure to meet basic needs, particularly those related to information, emotional support, and close contact with the patient, can further increase families\u0026rsquo; death anxiety.\u003c/p\u003e\u003cp\u003eThe regression analysis yielded a negative and significant relationship was detected between the need levels of individuals who are relatives of patients in the intensive care unit (ICU) and their assertive coping style (β = -0.326; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), consistent with various results in the literature, which suggests that as individuals\u0026rsquo; needs increase, they become under psychological pressure and for this reason move away from active and assertive coping strategies. While the model\u0026rsquo;s explanatory power of 10.4% suggests that need levels have a certain but limited impact on coping styles, it does reveal a significant psychosocial relationship. These results directly align with the study conducted by \u0026Ouml;z\u0026ccedil;elik and Erdoğan (2020) with relatives of patients in ICUs in Turkey. The study detected that when basic needs such as information, support, and reassurance were not met, relatives used more desperate and submissive coping styles, whereas when these needs were met, they used more self-assured and problem-focused coping styles. This suggests that unmet needs weaken an individual\u0026rsquo;s reliance on internal resources and lead to passivity[\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. Similarly, in a study conducted in Nigeria by Olabisi et al. (2020), they reported that task-focused coping styles were negatively correlated with depression, anxiety, and stress levels. When individuals used task-focused and self-confident coping styles more, a decrease in psychological symptoms was observed. However, it was found that individuals with high needs were more likely to employ emotion-based or avoidance-based methods instead of these coping styles [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].In a review study by R\u0026uuml;ckholdt et al. (2019), it was shown that avoidant and submissive coping styles were associated with intense psychological stress, whereas active coping methods were positively associated with psychological resilience. This study suggests that factors such as social support, previous ICU experience, and individual awareness also shape coping skills [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. Also, Butler et al. (2016) demonstrated that the coping styles of relatives of ICU patients are closely related to personality traits, level of social support, and psychological history (history of anxiety, depression). This study also detected that individuals with \u0026ldquo;maladaptive\u0026rdquo; or \u0026ldquo;avoidant\u0026rdquo; coping profiles were less likely to use confident and task-oriented strategies[\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIn the study, the need total score had a negative and significant effect on optimistic coping style (β = -0.359; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), suggesting that as an individual's need level increases, their tendency to approach events with an optimistic perspective decreases. The explanatory power was significant at 12.6% (R\u0026sup2; = 0.126). This finding suggests that individuals receiving treatment in high-stress environments, such as intensive care, may experience a decline in their hopes for the future and positive coping tendencies if their needs are not adequately met. This result differs from some studies in the literature but is consistent with others. For example, a study by Nadig et al. (2016) reported that optimism in family members of patients recovering from mechanical ventilation in intensive care units is a protective factor against psychological distress. However, the important point emphasized here is that high optimism is already associated with low stress levels; in other words, as need levels rise and remain unmet, this protective optimistic effect diminishes [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. Similarly, Tokem et al. (2015) conducted a study with families of oncology patients, finding that optimistic coping decreased in individuals with increased levels of hopelessness, while emotional and negative coping styles, such as helplessness, increased [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. Also, a study by Shao (2016) found a significant relationship between illness uncertainty and coping styles among families of sepsis patients in intensive care. This study found a negative correlation between positive coping styles and low uncertainty, suggesting that meeting needs and reducing uncertainty may increase optimistic coping tendencies[\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e].\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eBased on a holistic perspective, the needs of individuals who are relatives of patients in the intensive care unit (ICU) can be said to play a significant role in their stress coping processes. When these needs are not adequately met, the resulting anxiety and depressive symptoms reduce individuals\u0026rsquo; self-esteem, leading to a shift in coping styles to more passive, avoidant, and emotion-based styles. For this reason, healthcare professionals must identify the needs of family members early and develop supportive approaches to address these needs to increase individuals\u0026rsquo; psychological resilience and encourage more active coping strategies. Holistic assessments and necessary measures must be conducted to meet the physical, psychological, and psychosocial needs of relatives of patients receiving intensive care. This approach aligns with the family-centered approach and forms a fundamental cornerstone in providing quality healthcare. The results of the present study highlights the importance of addressing not only the treatment and care needs of patients but also the holistic approach of patients, including their families and social environments. In this context, it is recommended to increase similar studies focusing on the needs of patient relatives and to develop institutional or individual interventions for these problems detected in clinical settings.\u003c/p\u003e\u003cp\u003eIn conclusion, identifying the needs of patient relatives in intensive care units at an early stage and developing supportive approaches to these needs strengthens the psychological resilience of individuals, enables them to cope with stress more healthily, and forms the basis of a quality, family-centered care approach. It is important for nurses and healthcare professionals to support the psychological health of family members with an empathic approach during the intensive care process (Velasco Bueno et al., 2018). Multi-center, qualitative studies are needed in this field, and effective social support systems for family caregivers need to be established in T\u0026uuml;rkiye.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors thank all the volunteers who participated in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eHK and ŞYB conceived the study and contributed to the interpretation of the results. HK did statistical analyses and drafted the first manuscript. ŞYB and HK provided oversight and managed the research activity. HK, ŞYB contributed to the review and revision of the manuscript. All authors contributed to the design of the study protocol and reviewed the manuscript. The authors have read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e: This paper did not receive any funding from public, com-mercial, or not-for profit sectors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data that supports the findings of this study is available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was approved by the Kastamonu University Training and Research Hospital Clinical Research Ethics Committee. Ethical permission (22.09.2021, 2020/143\u0026ndash; 112) and institutional permission was obtained from Kastamonu University Rectorate. All study procedures were performed following relevant guidelines. Institutional permission was obtained for the study. All study procedures were performed in accordance with relevant guidelines. All participants were given an oral explanation of the purpose and content of the study and informed consent was obtained from all participants. The study was conducted in line with the Helsinki Declaration and informed consent was obtained from the participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eDeclaration of Conflicting Interests\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eKoukouli, S., Lambraki, M., Sigala, E., Alevizaki, A., \u0026amp; Stavropoulou, A.(2018). The experience of Greek families of critically ill patients: Exploring their needs and coping strategies. Intensive \u0026amp; Critical Care Nursing, 45, 44\u0026ndash;51.\u003c/li\u003e\n\u003cli\u003e\u0026Ouml;zg\u0026uuml;rsoy, B.N., \u0026amp; Durmaz, A.A.(2008). Yogun bakim \u0026uuml;nitesinde yatan hastalarin ailelerinin gereksinimleri. Yogun Bakim Hemsireligi Dergisi, 12(1-2),33-38.\u003c/li\u003e\n\u003cli\u003eKarahan, E., Akin, N., \u0026amp; \u0026Ccedil;elik, S.(2020). Yogun bakimda yatan hastalarin deneyimleri ve aile gereksinimlerinin incelenmesi, Adiyaman \u0026Uuml;niversitesi Saglik Bilimleri Dergisi. 6(2):140-149. doi:10.30569.adiyamansaglik.710495.\u003c/li\u003e\n\u003cli\u003eFrivold, G., Sletteb\u0026oslash;, A.,\u0026amp; Dale, B.(2016). Family members\u0026rsquo; lived experiences of everyday life after intensive care treatment of a love done: A phenomenological hermeneutical study. Journal of Clinical Nursing, 25: 392-402. 14.\u003c/li\u003e\n\u003cli\u003eGaeeni M, A. (2015). Farahani M, Seyedfatemi N, Mohammadi N. 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Yogun bakim \u0026uuml;nitesinde yatan hastalarin yakinlarinin gereksinimleri ve stresle bas etme tarzlarinin belirlenmesi, Nevsehir Haci Bektas Veli \u0026Uuml;niversitesi Fen Bilimleri Enstit\u0026uuml;s\u0026uuml;, Hemsirelik Anabilim Dali Y\u0026uuml;ksek Lisans Tezi.\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e-\u003c/strong\u003e G\u0026ouml;r\u0026uuml;c\u0026uuml;, S., \u0026amp; G\u0026uuml;rol Arslan, G. (2024). The investigation of death anxiety and spiritual well-being levels of family members of patients admitted to intensive care unit. Journal of Caring Sciences, 13(1), 20\u0026ndash;26. https://doi.org/10.34172/jcs.2024.33069\u003c/li\u003e\n\u003cli\u003eOlabisi, O., Olorunfemi, O., Bolaji, A., Azeez, F. O., Olabisi, T. E., \u0026amp; Azeez, O. (2020). Depression, anxiety, stress and coping strategies among family members of patients admitted in intensive care unit in Nigeria. International Journal of Africa Nursing Sciences, 13,100223. https://doi.org/10.1016/j.ijans.2020.100223\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e-\u003c/strong\u003e Ak\u0026ccedil;a Ay, F. (2018). Saglik Uygulamalarinda Temel Kavramlar ve Beceriler (1. Baski). Istanbul: Nobel Tip Kitabevi\u003c/li\u003e\n\u003cli\u003eB\u0026uuml;y\u0026uuml;k\u0026ccedil;oban, S., \u0026Ccedil;i\u0026ccedil;eklioglu, M., Yilmaz Demiral, N. \u0026amp; Civaner, M. M. (2016). Yogun Bakim \u0026Uuml;nitesindeki Hastalarin Yakinlari i\u0026ccedil;in Gereksinim \u0026Ouml;l\u0026ccedil;egi\u0026rsquo;nin T\u0026uuml;rk\u0026ccedil;eye uyarlanmasi ve psikometrik \u0026ouml;zellikleri. Toplum ve Hekim Dergisi, 31(1), 31\u0026ndash;41\u003c/li\u003e\n\u003cli\u003eSarikaya, Y., \u0026amp; Baloglu, M. (2016). The development and psychometric properties of the Turkish Death Anxiety Scale (TDAS). Death Studies, 40(7), 419\u0026ndash;431.\u003c/li\u003e\n\u003cli\u003eBeck, A. T., Ward, C. H., Mendelson, M., Mock, J., \u0026amp; Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561\u0026ndash;571.\u003c/li\u003e\n\u003cli\u003eHisli, N. (1989). Beck Depresyon Envanterinin \u0026uuml;niversite \u0026ouml;grencileri i\u0026ccedil;in ge\u0026ccedil;erligi ve g\u0026uuml;venirligi. Psikoloji Dergisi, 7(23), 3\u0026ndash;13.\u003c/li\u003e\n\u003cli\u003eFolkman, S., \u0026amp; R. S. Lazarus. (1980). \u0026ldquo;An Analysis of Coping in a Middleaged Community Sample.\u0026rdquo; Journal of Health and Social Behavior 21: 219\u0026ndash;239.\u003c/li\u003e\n\u003cli\u003eSiva, A. (1988). \u003cem\u003eStresle basa \u0026ccedil;ikma yollari \u0026ouml;l\u0026ccedil;eginin T\u0026uuml;rk toplumuna uyarlanmasi\u003c/em\u003e. (Yayimlanmamis y\u0026uuml;ksek lisans tezi). Hacettepe \u0026Uuml;niversitesi, Ankara.\u003c/li\u003e\n\u003cli\u003eSahin, N. H., \u0026amp;A. Durak. (1995). Stresle Basa Cikma Tarzlari Olcegi: Universite Ogrencileri Icin Uyarlanmasi. Turk Psikoloji Dergisi, 10, 56\u0026ndash;73.\u003c/li\u003e\n\u003cli\u003eTabachnick, B. G., \u0026amp; Fidell, L. S. (2013). Using Multivariate Statistics (6. baski). Boston: Pearson. s. 79.\u003c/li\u003e\n\u003cli\u003eGeorge, D., \u0026amp; Mallery, P. (2010). SPSS for Windows Step by Step: A Simple Guide and Reference, 17.0 Update (10. baski). Boston: Pearson. s. 41.\u003c/li\u003e\n\u003cli\u003eChiang, V. C. L., Chien, W. T., Wong, H. T., Lee, R. L. T., Ha, J. Y., Leung, S. S. Y., \u0026amp; Wong, D. F. K. (2016). A brief cognitive-behavioral psychoeducation (B-CBE) program for managing stress and anxiety of main family caregivers of patients in the intensive care unit. International Journal of Environmental Research and Public Health, 13(10), 962. https://doi.org/10.3390/ijerph13100962.\u003c/li\u003e\n\u003cli\u003eNaef, R., von Felten, S., \u0026amp; Ernst, J. (2021). Factors influencing post-ICU psychological distress in family members of critically ill patients: A linear mixed-effects model. BioPsychoSocial Medicine, 15, Article 6. https://doi.org/10.1186/s13030-021-00206-1\u003c/li\u003e\n\u003cli\u003eKynoch, K., Chang, A. M., Coyer, F., \u0026amp; McArdle, A. (2018). Developing a model of factors that influence meeting the needs of family with a relative in ICU. International Journal of Nursing Practice, 25(1). https://doi.org/10.1111/ijn.12693\u003c/li\u003e\n\u003cli\u003eLeske, J. S. (2002). Interventions to decrease family anxiety. Critical Care Nurse, 22(6), 61\u0026ndash;65.\u003c/li\u003e\n\u003cli\u003e\u0026Ouml;z\u0026ccedil;elik, H., \u0026amp; Erdogan, N. (2020). Relationship between the needs of Turkish relatives of patients admitted to an intensive care unit and their coping styles. OMEGA\u0026ndash;Journal of Death and Dying, 85(4), 990\u0026ndash;1006. https://doi.org/10.1177/0030222820960963\u003c/li\u003e\n\u003cli\u003eR\u0026uuml;ckholdt, M., Tofler, G., Randall, S., \u0026amp; Buckley, T. (2019). Coping by family members of critically ill hospitalised patients: An integrative review. International Journal of Nursing Studies, 97, 40\u0026ndash;54. https://doi.org/10.1016/J.IJNURSTU.2019.04.016\u003c/li\u003e\n\u003cli\u003eButler, J. M., Hirshberg, E., Hopkins, R., Wilson, E., Orme, J., Beesley, S., Kuttler, K., \u0026amp; Brown, S. M. (2016). Preliminary identification of coping profiles relevant to surrogate decision making in the ICU. PLoS ONE, 11(11),e0166542. https://doi.org/10.1371/journal.pone.0166542\u003c/li\u003e\n\u003cli\u003eNadig, N., Huff, N. G., Cox, C. E., \u0026amp; Ford, D. W. (2016). Coping as a multifaceted construct: Associations with psychological outcomes among family members of mechanical ventilation survivors. Critical Care Medicine, 44(9), 1710\u0026ndash;1717. https://doi.org/10.1097/CCM.0000000000001761\u003c/li\u003e\n\u003cli\u003eTokem, Y., \u0026Ouml;z\u0026ccedil;elik, H., \u0026amp; Cicik, A. (2015). Examination of the relationship between hopelessness levels and coping strategies among the family caregivers of patients with cancer. Cancer Nursing, 38(2),E28\u0026ndash;E34. https://doi.org/10.1097/NCC.0000000000000189\u003c/li\u003e\n\u003cli\u003eShao, X. (2016). Associations between uncertainty in illness and coping style about family members of patients with severe sepsis in intensive care unit. Chinese Journal of Modern Nursing, 18(3), 358\u0026ndash;361. https://doi.org/10.3760/CMA.J.ISSN.1008-1372.2016.03.010\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Intensive care, Patient relatives, Death anxiety, Depression","lastPublishedDoi":"10.21203/rs.3.rs-7820598/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7820598/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eThe study aimed to examine the effects of coping with stress in predicting the needs, death anxiety, and depression of relatives of patients hospitalized in Intensive Care Units.\u003c/p\u003e\u003ch2\u003eMaterials and Methods\u003c/h2\u003e\u003cp\u003eA sample of 367 relatives of patients hospitalized in intensive care units was formed, and data were collected face-to-face using a General Information Form, the Needs Scale for Patient Relatives in Intensive Care Units, Turkish Death Anxiety Scale, the Beck Depression Inventory and the Ways of Coping with Stress Scale. The data were analyzed using numbers, percentages, means, standard deviations, Pearson Correlation, and regression analysis\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eThe mean total needs score of the patient relatives was found to be 123.462\u0026thinsp;\u0026plusmn;\u0026thinsp;24.918, the mean death anxiety score was 42.653\u0026thinsp;\u0026plusmn;\u0026thinsp;19.881, and the mean depression score was 10.500\u0026thinsp;\u0026plusmn;\u0026thinsp;8.270. In the dimension of coping styles, the means were as follows: self-confident approach 18.954\u0026thinsp;\u0026plusmn;\u0026thinsp;4.389, desperate approach 20.820\u0026thinsp;\u0026plusmn;\u0026thinsp;4.306, submissive approach 15.863\u0026thinsp;\u0026plusmn;\u0026thinsp;3.162, optimistic approach 15.093\u0026thinsp;\u0026plusmn;\u0026thinsp;2.788, and seeking social support 9.396\u0026thinsp;\u0026plusmn;\u0026thinsp;2.251. A positive and significant relationship was detected between death anxiety and the need score (r\u0026thinsp;=\u0026thinsp;0.393, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01), and a negative and strong and significant relationship was detected between the self-confident approach and the need total score (r=-0.326, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01), and the optimistic approach and the need total score (r=-0.359, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01) and the sub-dimensions\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003ePatients\u0026rsquo; families have several needs. Increasing the level of needs of patients\u0026rsquo; families leads to increased death anxiety, while decreasing self-confidence and optimistic coping strategies. This demonstrates that a holistic approach, focusing not only on the patients but also on the needs of their families, is crucial for preventing potential psychological symptoms.\u003c/p\u003e","manuscriptTitle":"The Effect of Coping With Stress in Predicting the Needs, Death Anxiety, and Depression of Patients’ Relatives in Intensive Care Units","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-04 13:33:26","doi":"10.21203/rs.3.rs-7820598/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-12-19T13:33:48+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-12T13:22:01+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"50870431754157994787840198972194417699","date":"2025-12-12T07:29:19+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-18T13:25:21+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"281732302538509060701122106815361468583","date":"2025-11-18T05:12:16+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"238457812804570050851613520917331151361","date":"2025-11-15T18:50:08+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"141103068564409778793195140432034718562","date":"2025-10-24T12:02:12+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-10-23T11:40:09+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-10-20T06:26:20+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-10-17T14:09:17+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-10-16T19:16:41+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Public Health","date":"2025-10-16T19:12:05+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"16d4250d-22e1-45c2-9247-5ef4dd718d05","owner":[],"postedDate":"November 4th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-02-02T16:00:39+00:00","versionOfRecord":{"articleIdentity":"rs-7820598","link":"https://doi.org/10.1186/s12889-026-26407-3","journal":{"identity":"bmc-public-health","isVorOnly":false,"title":"BMC Public Health"},"publishedOn":"2026-01-28 15:58:08","publishedOnDateReadable":"January 28th, 2026"},"versionCreatedAt":"2025-11-04 13:33:26","video":"","vorDoi":"10.1186/s12889-026-26407-3","vorDoiUrl":"https://doi.org/10.1186/s12889-026-26407-3","workflowStages":[]},"version":"v1","identity":"rs-7820598","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7820598","identity":"rs-7820598","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}