Does desire for hastened death change in terminally ill cancer patients?

被引:35
作者
Rosenfeld, Barry [1 ]
Pessin, Hayley [2 ]
Marziliano, Allison [2 ]
Jacobson, Colleen [3 ]
Sorger, Brooke
Abbey, Jennifer
Olden, Megan [4 ]
Brescia, Robert [5 ]
Breitbart, William [2 ]
机构
[1] Fordham Univ, Dept Psychol, Bronx, NY 10458 USA
[2] Mem Sloan Kettering Canc Ctr, New York, NY 10021 USA
[3] Iona Coll, New Rochelle, NY USA
[4] Weill Cornell Med Coll, New York, NY USA
[5] Calvary Hosp, Bronx, NY USA
关键词
US; Cancer; Desire for hastened death; End of life; Palliative care; ADVANCED AIDS; DEPRESSION; SCALE; HOPELESSNESS; ATTITUDES; SCHEDULE; SUICIDE;
D O I
10.1016/j.socscimed.2014.03.027
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Understanding why some terminally ill patients may seek a hastened death (a construct referred to as "desire for hastened death" or DHD) is critical to understanding how to optimize quality of life during an individual's final weeks, months or even years of life. Although a number of predictor variables have emerged in past DHD research, there is a dearth of longitudinal research on how DHD changes over time and what factors might explain such changes. This study examined DHD over time in a sample of terminally ill cancer patients admitted to a palliative care hospital. A random sample of 128 patients completed the Schedule of Attitudes toward Hastened Death (SAHD) at two time points approximately 2 4 weeks apart participated. Patients were categorized into one of four trajectories based on their SAHD scores at both time points: low (low DHD at TI and T2), rising (low DHD at T1 and high DHD at T2), falling (high DHD at T1 and low DHD at 12) and high (high DHD at T1 and 12). Among patients who were low at T1, several variables distinguished between those who developed DHD and those who did not: physical symptom distress, depression symptom severity, hopelessness, spiritual well-being, baseline DHD, and a history of mental health treatment. However, these same medical and clinical variables did not distinguish between the falling and high trajectories. Overall, there appears to be a relatively high frequency of change in DHD, even in the last weeks of life. Interventions designed to target patients who are exhibiting subthreshold DHD and feelings of hopelessness may reduce the occurrence of DHD emerging in this population. (C) 2014 Elsevier Ltd. All rights reserved.
引用
收藏
页码:35 / 40
页数:6
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