00147 Anxiety Before Death

Domain 9: coping/stress tolerance
Class 2: coping responses
Diagnostic Code: 00147
Nanda label: anxiety against death
Diagnostic focus: anxiety to death
Approved 1998 • Revised 2006, 2017, 2020 • Level of evidence 2.1

NANDA Nursing Diagnosis Definition

The Nanda nursing diagnosis « anxiety against death ” is defined as: discomfort and emotional insecurity, generated by the anticipation of death and the process of dying own or of significant people, which affects significantly the quality of personal life.

Definite characteristics

  • dysphoria
  • Express concern about the tiredness of the caregiver (a)
  • Express concern about the impact of their own death on significant people
  • Express deep sadness
  • Express fear of the development of a terminal condition
  • Express fear of loneliness
  • Express fear of loss of mental skills during agony
  • Express fear of pain related to agony
  • Express fear of premature death
  • Express fear of a process of prolonged agony
  • Expresses fear of the separation of loved ones
  • Express fear of suffering related to agony
  • Express fear of the agony process
  • Express fear of the unknown
  • Express impotence
  • Informs negative thoughts related to death and agony

Related factors

  • Anticipation of the adverse consequences of anesthesia
  • Anticipation of the impact of death on others
  • Anticipation of pain
  • anticipation of suffering
  • Imminent death consciousness
  • Depressive symptoms
  • Discussions on the issue of death
  • Deterioration of religiosity
  • loneliness
  • Low self -esteem
  • No acceptance of mortality itself
  • Spiritual suffering
  • Uncertainty about the encounter with a higher power
  • Uncertainty about life after death
  • Uncertainty about the existence of a superior power
  • Uncertainty about prognosis
  • Unpleasant physical symptoms

Risk population

  • People who experience the terminal care of significant people
  • People who receive terminal care
  • People with a history of adverse experiences with the death of significant people
  • People with a history of experiences close to death
  • Older adults
  • Women
  • Young adults

Associated problems

  • Depression
  • Stigmatized conditions with high fear of death
  • Terminal condition

Suggestions of use

see Suggested alternative diagnostics

Other examples

The patient will be able to:

  • Maintain physical and psychological well -being during the death process
  • Express your feelings verbally (anger, sorrow or grief) and thoughts to the personnel who attend and/or loved ones
  • Refer that you feel less anxiety
  • Express your concern for the influence of their own death on the closest people
  • Identify personal control areas
  • Express positive feelings about relationships with the people who have affection
  • Accept limitations and seek help if necessary

NIC Interventions

  • Emotional support: provide comfort, acceptance and encouragement during moments of stress
  • Support in decision making: provide information and support to a patient who is making a decision regarding the care of their health
  • Spiritual support: help the patient feel in balance and communion with a superior power
  • Care in agony: foster physical well -being and psychological peace in the final stage of life
  • Decrease in anxiety: reduce apprehension, fear, in advance, or discomfort related to an anticipated danger of unknown origin
  • Facilitation of religious rites: facilitate participation in religious practices
  • Facilitation of spiritual growth: to facilitate the growth in the patient’s ability to identify, relate and resort to the source of meaning, purpose, comfort, strength and hope in their life
  • Infuse hope: to facilitate the development of an optimistic perspective in a certain situation
  • Pain management: eliminate pain or reduce it to an acceptable level of well -being for the patient
  • mood management: provide safety, stability, recovery and maintenance to a patient who has a depressed or hypertimic spirit.
  • Improve coping: help the patient adapt to stressful changes or perceived threats that interfere with the satisfaction of the demands and roles of life
  • Presence: Be next to the other, both physically and psychologically, during moments of necessity
  • Technique to reassure: reduce anxiety in a patient with Ansie- books.com

Nursing Activities


  • Monitor the appearance of signs and symptoms of anxiety (vital signs, appetite, sleep pattern, concentration capacity)
  • Assess the support provided by people close to the patient
  • Ask the patient about their preferences regarding care at the end of life (for example, who wants you to be by your side, if you want to die at home or at the hospital)
  • Be alert to expressions of hopelessness or impotence (as “I can’t”)
  • Determine possible causes of anxiety (fear of pain, alterations of body functioning, humiliation, abandonment, non -existence, negative influence on those who survive it)

Patient and family education

  • Inform about patient disease and prognosis
  • Give sincere and direct answers to the patient’s questions about the death process

Collaboration activities

  • Channel to domiciliary or institutionalized care, as appropriate
  • Concert contact between patients and priests or spiritual advisors, if that is their desire
  • Put the patient and the family in contact with the appropriate support groups
  • Channel to psychiatric home care services, if necessary


  • Support spiritual needs without imposing their own beliefs on the patient (such as encouraging him to pray)
  • Use therapeutic communication skills to establish a relationship of trust and facilitate the expression of needs by the patient
  • Listen closely
  • Offer support for those complicated feelings without offering false hopes or too many advice
  • Encourage the patient to express their feelings towards their loved ones
  • Help the patient identify personal control areas; Offer alternatives and options tailored to the patient’s ability
  • Spend time with the patient to avoid fear of being alone
  • Help the patient remember and review their lives in a positive way
  • Identify and support the usual coping strategies of the patient
  • Provide physical well -being and security (as measures to relieve pain and nausea, back massage)
  • Answer the questions about vital instructions and help you in this process if necessary
  • Encourage family members to be next to the patient as much as they want; Inform them, encourage them to have physical contact with the patient and be close to him (Pierce, 1999; Tarzian, 2000)