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چکیده
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Background: Death anxiety is a significant psychological issue among older adults, negatively affecting their mental health and quality of life. Meaning-centered therapy has emerged as a promising intervention to alleviate this anxiety, yet comprehensive evidence regarding its effectiveness in Iranian elderly populations is limited. Objective: This meta-analysis aimed to systematically evaluate the effectiveness of meaning-centered therapy in reducing death anxiety among Iranian elderly, considering the cultural and social context. Methods: Following the PRISMA 2020 guidelines, this study reviewed experimental research published between 2012 and 2024. Twenty-three studies, including randomized controlled trials and quasi-experimental designs with control groups, were selected from Iranian databases such as Irandoc, SID, Magiran, Noormags, and Google Scholar. Inclusion criteria required studies to report sufficient data for effect size calculation using Hedges’ g, focusing on group-based meaning therapy interventions. Quality assessment employed the Joanna Briggs Institute checklist, with only studies meeting a minimum threshold included. Data were analyzed using Comprehensive Meta-Analysis software (version 2), applying both fixed and random effects models. Due to significant heterogeneity (Q=26.741, p<0.001; I²=55.12%), the random effects model was adopted. Publication bias and sensitivity analyses were also conducted. Results: The combined effect size was large and statistically significant (Hedges’ g = -1.248, 95% CI [-1.573, -0.924], p < 0.001), indicating a strong effect of meaning therapy on reducing death anxiety in older adults. Subgroup analyses revealed greater effectiveness in women and mixed-gender groups compared to men, and slightly higher effects for elderly residing in nursing homes than those living with family. Despite some heterogeneity, all subgroups showed significant reductions. Conclusions: Meaning-centered therapy is a highly effective intervention to reduce death anxiety among Iranian elderly. These findings support its broader application in culturally sensitive psychological care for aging populations, emphasizing the importance of tailored interventions considering gender and living conditions.
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