Death Anxiety and Correlates in Cancer Patients Receiving Palliative Care

被引:9
作者
Emanuel, Linda L. [1 ,2 ]
Solomon, Sheldon [3 ]
Chochinov, Harvey Max [4 ,5 ]
Guay, Marvin Omar Delgado [6 ]
Handzo, George [7 ]
Hauser, Joshua [8 ,9 ]
Kittelson, Sheri [10 ]
O'Mahony, Sean [12 ]
Quest, Tammie E. [14 ,15 ]
Rabow, Michael W. [16 ]
Schoppee, Tasha M. [11 ,17 ]
Wilkie, Diana J. [11 ]
Yao, Yingwei [11 ]
Fitchett, George [13 ]
机构
[1] Massachusetts Gen Hosp, Mongan Inst, Boston, MA 02114 USA
[2] Northwestern Med, Dept Med, Chicago, IL USA
[3] Skidmore Coll, Dept Psychol, Saratoga Springs, NY 12866 USA
[4] Univ Manitoba, Dept Psychiat, Winnipeg, MB, Canada
[5] CancerCare Manitoba, Winnipeg, MB, Canada
[6] Univ Texas MD Anderson Canc Ctr, Dept Palliat Rehabil & Integrat Med, Houston, TX 77030 USA
[7] HealthCare Chaplaincy Network, Hlth Serv Res & Qual, New York, NY USA
[8] Northwestern Feinberg Sch Med, Dept Med, Chicago, IL USA
[9] Jesse Brown VA Med Ctr, Chicago, IL USA
[10] Univ Florida, Dept Med, Div Palliat Care, Gainesville, FL USA
[11] Univ Florida, Ctr Palliat Care Res & Educ, Gainesville, FL USA
[12] Rush Univ, Dept Internal Med, Sect Palliat Med, Med Ctr, Chicago, IL 60612 USA
[13] Rush Univ, Med Ctr, Dept Relig Hlth & Human Values, 1653 West Congress Pkwy, Chicago, IL 60612 USA
[14] Emory Univ, Sch Med, Dept Family & Prevent Med, Atlanta, GA USA
[15] Emory Univ, Dept Emergency Med, Sch Med, Atlanta, GA USA
[16] Univ Calif San Francisco, Helen Diller Family Comprehens Canc Ctr, San Francisco, CA 94143 USA
[17] Community Hosp & Palliat Care, Jacksonville, FL USA
基金
美国国家卫生研究院;
关键词
death anxiety; Dignity Therapy; existential quality of life; prognostic awareness; PROGNOSTIC AWARENESS; DIGNITY THERAPY; DISTRESS; END; LIFE;
D O I
10.1089/jpm.2022.0052
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background: Death anxiety is powerful, potentially contributes to suffering, and yet has to date not been extensively studied in the context of palliative care. Availability of a validated Death Anxiety and Distress Scale (DADDS) opens the opportunity to better assess and redress death anxiety in serious illness.Objective: We explored death anxiety/distress for associations with physical and psychosocial factors.Design: Ancillary to a randomized clinical trial (RCT) of Dignity Therapy (DT), we enrolled a convenience sample of 167 older adults in the United States with cancer and receiving outpatient palliative care (mean age 65.9 [7.3] years, 62% female, 84% White, 62% stage 4 cancer). They completed the DADDS and several measures for the stepped-wedged RCT, including demographic factors, religious struggle, dignity-related distress, existential quality of life (QoL), and terminal illness awareness (TIA).Results: DADDS scores were generally unrelated to demographic factors (including religious affiliation, intrinsic religiousness, and frequency of prayer). DADDS scores were positively correlated with religious struggle (p < 0.001) and dignity-related distress (p < 0.001) and negatively correlated with existential QoL (p < 0.001). TIA was significantly nonlinearly associated with both the total DADDS (p = 0.007) and its Finitude subscale (p <= 0.001) scores. There was a statistically significant decrease in Finitude subscale scores for a subset of participants who completed a post-DT DADDS (p = 0.04).Conclusions: Findings, if replicable, suggest that further research on death anxiety and prognostic awareness in the context of palliative medicine is in order. Findings also raise questions about the optimal nature and timing of spiritual and psychosocial interventions, something that might entail evaluation or screening for death anxiety and prognostic awareness for maximizing the effectiveness of care.
引用
收藏
页码:235 / 243
页数:9
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