The Nursing Diagnosis of “Death Anxiety”: Content Validation by Experts Lidia Fernández-Donaire, MScN, RN, José Manuel Romero-Sánchez, PhD, RN , Olga Paloma-Castro, PhD, RN , Francesc Boixader-Estévez, PhD, and Ana María Porcel-Gálvez, PhD, RN Lidia Fernández-Donaire, MScN, RN, is a PhD student at the University of Seville, Seville, Spain, as well as a Professor at the Gimbernat University School, Autonomous University of Barcelona, Barcelona, Spain, José Manuel Romero-Sánchez, RN, PhD, is a Research Nurse at the Research Group under the Andalusian Research, Development, and Innovation Scheme CTS-1019, University of Cádiz, Cádiz, Spain, Olga Paloma-Castro, RN, PhD is a Professor and Research Nurse at University of Cádiz, Cádiz, Spain, Francesc Boixader-Estévez, PhD, is a Professor and Researcher at the Gimbernat University School, Autonomous University of Barcelona, Barcelona, Spain, and Ana María Porcel-Gálvez, RN, PhD is a Professor and Research Nurse at the University of Seville, Seville, Spain PURPOSE: To validate the content of the NANDA-I diagnosis “death anxiety” (00147). METHODS: Descriptive study using the Fehring model with 202 Spanish nurses who were expert in end-of-life care to explore the adequacy of the components of the NANDA-I diagnosis “death anxiety” (00147) in the Spanish edition. FINDINGS: None of the diagnosis definitions were considered as representative. Furthermore, 5 of the 56 defining characteristics and 5 of the 26 related factors were validated as major. CONCLUSIONS: In general, the components of the diagnosis “death anxiety” (00147) in the Spanish edition are not representative according to experts. IMPLICATIONS FOR NURSING PRACTICE: The results support the need to either exclude the diagnosis from the taxonomy or adjust its content. Search terms: Content validation, death anxiety, defining characteristics, fear, nursing diagnoses Author contact: jose.romerosanchez@mail.uca.es, with a copy to the Editor: journal@nanda.org Background The concept of death anxiety was defined by Templer (1970) as an emotional reaction caused by the perception of real or imaginary signals of danger or threats to one’s exis- tence which can be triggered by environmental, situational, or dispositional stimuli related to the idea of one’s own death or that of another individual. The concepts of anxiety and fear in relation to death are usually used interchangeably, since both have similar man- ifestations that vary only in intensity and duration between them (Bay & Algase, 1999). However, the main difference be- tween anxiety and fear lies in the stimulus that generates them. Thus, the fear of death would be caused by clearly identifiable dangerous stimuli that make one fear for one’s own life, to which the individual reacts involuntarily in an at- tempt to survive. In contrast, anxiety would be triggered by a cause which is difficult to identify but which is perceived as a threat, even though it is not actually life-threatening (Perna, 2013). In this sense, death represents a threat to one’s own exis- tence, since it implies the possibility of ceasing to exist, and therefore it is conceived as a stimulus capable of generating emotions of fear or anxiety (Sacks, 2013). However, it is a dif- ferent matter to think of death as the idea of something that will happen at some point in our lives than to think of death as the experience of dying in agony and suffering. In the nursing context, the NANDA-I diagnosis of “death anxiety” (00147) (Herdman, Kamitsuru, & North American Nursing Diagnosis Association, 2014) is primarily used in care plans that target individuals at the end of their lives (Renz et al., 2018; Vehling et al., 2017). However, the definition of death anxiety and some of its Defining Char- acteristics (DCs) and Related Factors (RFs) are worth study- ing due to the ambiguity present between the terms anxiety and fear when referring to death (Tomás-Sábado, Fernández- Narváez, Fernández-Donaire, & Aradilla-Herrero, 2007). Purpose The aim of the present study is to validate the contents of the nursing diagnosis “death anxiety” (00147) on the ba- sis of its definition, DCs, and RFs present in the Spanish edition of the 2015–2017 NANDA-I classification (Herdman, Kamitsuru, & NANDA-International, 2015) while also explor- ing the degree of adequacy of other definitions found in the last Spanish editions of the NANDA-I classification. In addition, another aim of this study is to assess the repre- sentativeness of other manifestations and causes proposed C  2018 NANDA International, Inc. 1 International Journal of Nursing Knowledge Volume 00, No. 0, October 2018