The Mediating Role of Self-Compassion in the Relationship Between Perceived Stress and Death Anxiety in Patients with Multiple Sclerosis

TL;DR

This study shows that self-compassion helps reduce death anxiety caused by stress in multiple sclerosis patients.

Contribution

It identifies self-compassion as a mediator between stress and death anxiety in MS patients.

Findings

Self-compassion strongly reduces perceived stress in MS patients.

Higher self-compassion is linked to lower death anxiety.

Stress indirectly affects death anxiety through self-compassion.

Abstract

Background: Multiple sclerosis (MS) is a long-term and unpredictable condition that can cause considerable psychological distress, including perceived stress and death anxiety. Identifying psychological factors that may mitigate these effects is important for improving the psychosocial well-being of patients with MS. This study aimed to examine the mediating role of self-compassion in the relationship between perceived stress and death anxiety in patients with MS. Methods: This cross-sectional, descriptive, and correlational study included 169 Turkish patients diagnosed with MS between October 2024 and April 2025. A regression-based mediation analysis using the Hayes PROCESS macro with bootstrapping was conducted to assess the mediating role of self-compassion. Results: Death anxiety scores were positively but weakly correlated with perceived stress scores (r = 0.172, p = 0.026). Perceived stress scores were strongly and negatively correlated with self-compassion scores (r = −0.704, p < 0.001), whereas self-compassion scores showed a weak-to-moderate negative correlation with death anxiety scores (r = −0.287, p < 0.01). In the mediation model, perceived stress significantly predicted self-compassion (B = −0.087, p < 0.001), and self-compassion significantly predicted death anxiety (B = −1.758, p < 0.001). The direct effect of perceived stress on death anxiety was not statistically significant (B = −0.058; p = 0.344), whereas the indirect effect was significant (B = 0.153; 95% CI [0.079, 0.232]). The total effect was also significant (B = 0.095; p = 0.036). Conclusions: The findings indicate that self-compassion mediates the relationship between perceived stress and death anxiety in patients with MS. Higher levels of self-compassion were associated with lower levels of perceived stress and death anxiety, suggesting that self-compassion may function as an important psychological resource in coping with disease-related stress and death-related concerns. From a clinical and nursing perspective, integrating strategies that support self-compassion within holistic care may contribute to improving the psychosocial well-being of patients with MS.

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