Spiritual therapy's impact on death anxiety in Iran: A systematic review and meta-analysis

Recently, spirituality-based interventions for modulating death anxiety in both unhealthy and healthy individuals have increased. However, the effectiveness of this treatment approach in reducing death anxiety remains controversial. Thus, this systematic review and meta-analysis aimed to clarify the impact of spiritual therapy interventions on death anxiety in Iran. We searched for all randomised and controlled trials related to the research topic in national and international databases, including Web of Science, PubMed, Scopus, Wiley, Taylor & Francis, ScienceDirect, SID, Civilica, IranDoc and Noormags. Fifteen studies with 772 participants that were found relevant and fulfilled the defined exclusion and inclusion criteria were included in the analyses. Stata 17 software was used to analyse the data. The results showed a significant difference between the average death anxiety scores in the experimental and control groups after receiving spiritual therapy (standardised mean difference = -5.97, 95% confidence interval: -9.51, -2.44). In addition, the results of the Q and I2 tests indicated significant heterogeneity among the studies (p < 0.001; Q = 411.45; I2 = 99.50%). Thus, although the findings show that interventions based on spiritual therapy can reduce death anxiety, the high heterogeneity and publication bias of some trials limit the validity and generalisability of their effects. The findings of this meta-analysis will help in elucidating the effectiveness of spiritual therapy and open new horizons for this therapeutic approach for psychologists, counsellors and educational planners, thereby creating a relative consensus between advocates and critics of therapeutic spirituality.