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Rodríguez-Prat A, Pergolizzi D, Crespo I, Julià-Torras J, Balaguer A, Kremeike K, Voltz R, Monforte-Royo C. The wish to hasten death in patients with life-limiting conditions. A systematic overview. J Pain Symptom Manage 2024:S0885-3924(24)00743-7. [PMID: 38703862 DOI: 10.1016/j.jpainsymman.2024.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 03/07/2024] [Accepted: 04/21/2024] [Indexed: 05/06/2024]
Abstract
CONTEXT A systematic review of the wish to hasten death among people with life-limiting conditions was published in 2011. Since then, other reviews and primary studies have been published that have added to knowledge regarding the conceptual definition, aetiology and assessment of the wish to hasten death. OBJECTIVES To provide an updated synthesis of the literature on the wish to hasten death in people with life-limiting conditions. METHODS An overview of systematic reviews and primary studies was conducted, using an integrative review method. PubMed, CINAHL, Scopus and Web of Science databases were searched, from their inception until 2023. We included all systematic reviews published to date and all primary studies not included in these systematic reviews. RESULTS Eleven systematic reviews and 35 primary studies were included. We propose that the phenomenon may usefully be considered as existing along a continuum, defined by the extent to which thoughts of dying are linked to action. A total of nine assessment tools have been described. The reported prevalence of the wish to hasten death appears to be influenced by the wording used in assessment instruments, as well as by the cut-off used when applying a particular tool. Depression, pain, functional disability, decreased sense of meaning in life, the sense of being a burden and reduced quality of life are the most widely reported related factors. CONCLUSION This overview underscores the need for clinical strategies that can identify different manifestations of the wish to hasten death among people with life-limiting conditions.
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Affiliation(s)
- Andrea Rodríguez-Prat
- Faculty of Humanities, Universitat Internacional de Catalunya. Barcelona, Spain. Josep Trueta s/n, 08195 Sant Cugat del Vallès, Barcelona, Spain
| | - Denise Pergolizzi
- School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain. Josep Trueta s/n, 08195 Sant Cugat del Vallès, Barcelona. Spain
| | - Iris Crespo
- Department of Psychology, School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain. Josep Trueta s/n, 08195 Sant Cugat del Vallès, Barcelona, Spain
| | - Joaquim Julià-Torras
- School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain. Josep Trueta s/n, 08195 Sant Cugat del Vallès, Barcelona. Spain; Department of Palliative Care, Institut Català d'Oncologia Badalona, Badalona, Spain
| | - Albert Balaguer
- School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain. Josep Trueta s/n, 08195 Sant Cugat del Vallès, Barcelona. Spain
| | - Kerstin Kremeike
- Faculty of Medicine and University Hospital, Department of Palliative Medicine, University of Cologne, Cologne, Germany
| | - Raymond Voltz
- Faculty of Medicine and University Hospital, Department of Palliative Medicine, University of Cologne, Cologne, Germany
| | - Cristina Monforte-Royo
- Department of Nursing, School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain..
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Ernst M, Schwinn T, Hirschmiller J, Cleare S, Robb KA, Brähler E, Zwerenz R, Wiltink J, O'Connor RC, Beutel ME. To what extent are psychological variables considered in the study of risk and protective factors for suicidal thoughts and behaviours in individuals with cancer? A systematic review of 70 years of research. Clin Psychol Rev 2024; 109:102413. [PMID: 38518584 DOI: 10.1016/j.cpr.2024.102413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 11/29/2023] [Accepted: 03/08/2024] [Indexed: 03/24/2024]
Abstract
Psychological variables substantially shape the risk of suicidal thoughts and behaviours (STBs). However, it is unclear to what extent they are considered in individuals with cancer. We synthesized the quantitative research landscape concerning psychological risk/protective factors of STBs in the (psycho-) oncological context. This pre-registered review (PROSPERO-ID CRD42022331484) systematically searched the databases PubMed/Medline, CINAHL, PsycInfo, Cochrane Library, and Web of Science (as well as the grey literature and preprints). Risk of bias (RoB) was estimated using the ROBINS-I tool. Of 11,159 retrieved records, 319 studies were eligible for inclusion. Of those, 163 (51.1%) had investigated psychological factors (affective: n = 155; social: n = 65; cognitive: n = 63; personality/individual differences: n = 37; life events: n = 6), in a combined 3,561,741 participants. The most common STBs were suicidal ideation (n = 107) or death wishes (n = 20) rather than behaviour (suicide deaths: n = 26; attempts: n = 14). Most studies had a serious RoB. Thus, a large body of research investigated STBs in cancer patients/survivors, but it rarely aligned with the theoretical or clinical developments in suicide research. We propose a conceptual model of STBs in cancer delineating moderation and mediation effects to advance the integration of the fields, and to inform future research and practice.
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Affiliation(s)
- Mareike Ernst
- Department of Clinical Psychology, Psychotherapy and Psychoanalysis, Institute of Psychology, University of Klagenfurt, Klagenfurt am Wörthersee, Austria; Suicidal Behaviour Research Laboratory, School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom; Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
| | - Tamara Schwinn
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Judith Hirschmiller
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Seonaid Cleare
- Suicidal Behaviour Research Laboratory, School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Kathryn A Robb
- Cancer Behaviour Research Group, School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; Department of Medical Psychology and Medical Sociology, University Hospital Leipzig, Leipzig, Germany
| | - Rüdiger Zwerenz
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Jörg Wiltink
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Rory C O'Connor
- Suicidal Behaviour Research Laboratory, School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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Monforte-Royo C, Goni-Fuste B, Crespo I, Pergolizzi D, Martin-Delgado L, Fuster P, Bellido-Perez M, Tomás-Sábado J, Rodríguez-Prat A. Definition and validation of the nursing diagnosis label "wish to die": a research protocol. BMC Nurs 2024; 23:38. [PMID: 38212761 PMCID: PMC10785443 DOI: 10.1186/s12912-024-01707-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 01/03/2024] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Euthanasia has been incorporated into the health services of seven countries. The legalisation of these practices has important repercussions for the competences of nurses, and it raises questions about their role. When a patient with advanced disease expresses a wish to die, what is expected of nurses? What are the needs of these patients, and what kind of care plan do they require? What level of autonomy might nurses have when caring for these patients? The degree of autonomy that nurses might or should have when it comes to addressing such a wish and caring for these patients has yet to be defined. Recognising the wish to die as a nursing diagnosis would be an important step towards ensuring that these patients receive adequate nursing care. This study-protocol aims to define and validate the nursing diagnosis wish to die in patients with advanced disease, establishing its defining characteristics and related factors; to define nursing-specific interventions for this new diagnosis. METHODS A prospective three-phase study will be carried out. Phase-A) Foundational knowledge: an umbrella review of systematic reviews will be conducted; Phase-B) Definition and validation of the diagnostic nomenclature, defining characteristics and related factors by means of an expert panel, a Delphi study and application of Fehring's diagnostic content validation model; Phase-C) Definition of nursing-specific interventions for the new diagnosis. At least 200 academic and clinical nurses with expertise in the field of palliative care or primary health care will be recruited as participants across the three phases. DISCUSSION The definition of the wish to die as a nursing diagnosis would promote greater recognition and autonomy for nurses in the care of patients who express such a wish, providing an opportunity to alleviate underlying suffering through nursing-specific interventions and drawing attention to the needs of patients with advanced disease. The new diagnosis would be an addition to nursing science and would provide a framework for providing care to people with advanced disease who express such a wish. Nurses would gain professional autonomy about identifying, exploring and responding clinically to such a wish.
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Affiliation(s)
- Cristina Monforte-Royo
- Nursing Department, School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Josep Trueta s/n, Sant Cugat del Vallès, Barcelona, 08195, Spain.
| | - Blanca Goni-Fuste
- Nursing Department, School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Josep Trueta s/n, Sant Cugat del Vallès, Barcelona, 08195, Spain
| | - Iris Crespo
- Basic Science Department, School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Josep Trueta s/n, Sant Cugat del Vallès, Barcelona, 08195, Spain
| | - Denise Pergolizzi
- School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Josep Trueta s/n, Sant Cugat del Vallès, Barcelona, 08195, Spain
| | - Leandra Martin-Delgado
- Nursing Department, School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Josep Trueta s/n, Sant Cugat del Vallès, Barcelona, 08195, Spain
| | - Pilar Fuster
- Nursing Department, School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Josep Trueta s/n, Sant Cugat del Vallès, Barcelona, 08195, Spain
| | - Mercedes Bellido-Perez
- Nursing Department, School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Josep Trueta s/n, Sant Cugat del Vallès, Barcelona, 08195, Spain
| | | | - Andrea Rodríguez-Prat
- Faculty of Humanities, Universitat Internacional de Catalunya, Josep Trueta s/n, Sant Cugat del Vallès, Barcelona, 08195, Spain
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Wang M, Zhang L, Ma J, Sun H, Gao Z, Hu M, Liu H, Guo L. Mediating effect of successful aging on the relationship between psychological resilience and death anxiety among middle-aged and older adults with hypertension. Front Public Health 2023; 11:1116263. [PMID: 37808974 PMCID: PMC10552859 DOI: 10.3389/fpubh.2023.1116263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 04/06/2023] [Indexed: 10/10/2023] Open
Abstract
Objective The aging trend of China's population is severe and successful aging (SA) is imminent. Aging can lead to various chronic diseases, with hypertension being the most common. Due to this lifelong disease, patients suffer from many anxieties, as death anxiety (DA) can be the most prevalent. Studies have exhibited that middle-aged adults approaching the transition to an older state show more pronounced DA than the more senior. It has been suggested that psychological resilience (PR) can reduce DA. Therefore, this study aimed to analyze the mediating effect of SA between PR and DA in middle-aged and older adults with hypertension. Methods A cross-sectional survey was designed. From August to December 2021, 298 middle-aged and older adults with hypertension were selected by multistage cluster random sampling in three districts (Ling he District, Gu ta District, and Tai He District) of Jinzhou City, Liaoning Province. They were surveyed using the demographic questionnaires, the Conner-Davidson Resilience Scale, the Successful Aging Inventory, and the Chinese version of a Likert-type Templer-Death Anxiety Scale. Descriptive analyses, independent sample T-test, and one-way analysis of variance (ANOVA) were used to describe demographic characteristics among hypertensive patients with different characteristics, respectively. Statistics were considered significant when P < 0.05. Pearson correlation coefficients describe the relationship between PR, SA, and DA. The research model was shaped through Structural Equation Modeling (SEM). SPSS PROCESS macro was used to verify the mediation model. A binary logistic regression model was used with DA as the dependent variable. Results The scores for PR, SA, and DA in hypertensive patients are (49.52 ± 14.38) points, (51.22 ± 7.63) points, and (46.67 ± 9.03) points. PR was negatively correlated with DA (r = -0.307, P < 0.01). Moreover, incorporating SA as a mediating variable in PR and DA, SA was positively correlated with PR (r = 0.335, P < 0.01) and DA (r = 0.085, P > 0.05). The direct effect is opposite to the sign of the indirect effect. There is a suppression between PR and DA with a percentage of 20.7%. Good self-assessed health status [0.057 (0.018, 0.183)] may be a protective factor for DA. Conclusion Healthcare providers should improve the PR of middle-aged and older adults with hypertension through interventions that reduce DA and increase the likelihood of SA.
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Affiliation(s)
- Meiding Wang
- School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Lin Zhang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Jianing Ma
- School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Hong Sun
- School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Ziyun Gao
- School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Mengya Hu
- School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Haiyang Liu
- Student Health Center, Wannan Medical College, Wuhu, Anhui, China
| | - Leilei Guo
- School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, China
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Gong Y, Yan Y, Yang R, Cheng Q, Zheng H, Chen Y, Xu X. Factors influencing death anxiety among Chinese patients with cancer: a cross-sectional study. BMJ Open 2022; 12:e064104. [PMID: 36229154 PMCID: PMC9562313 DOI: 10.1136/bmjopen-2022-064104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The purpose of this study was to investigate death anxiety status among Chinese patients with cancer and identify factors that affect death anxiety. DESIGN Cross-sectional study. SETTING Changsha, Hunan Province, China. PARTICIPANTS A total of 286 inpatients diagnosed with cancer were randomly recruited from a tertiary cancer centre and completed the questionnaires between January and June 2021. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was the status of death anxiety. The secondary outcomes were the factors that affect death anxiety among Chinese patients with cancer. METHODS A total of 286 Chinese patients with cancer were recruited from a tertiary cancer hospital to complete the demographic and clinical characteristics questionnaire, Templer's Death Anxiety Scale, Acceptance and Action Questionnaire-second edition, and Meaning in Life Questionnaire from January to June 2021. Data were analysed using t-test, analysis of variance, Kruskal-Wallis H test, Pearson correlation analysis and multiple linear regression analysis. RESULTS On average, patients with cancer scored 7.72±4.17 for death anxiety, 25.71±9.69 for experiential avoidance and 45.19±8.22 for meaning in life. Ultimately, the statistically significant factors influencing death anxiety were education levels, insurance, pain scores, experiential avoidance and meaning in life. These factors explained 40.6% of the difference in death anxiety. CONCLUSIONS Patients with cancer in China experienced a high level of death anxiety. This study showed that experiential avoidance and meaning in life were important factors that affected death anxiety in patients with cancer. Further studies should be conducted to explore effective interventions to prevent experiential avoidance and increase meaning in life for patients with cancer. Attention should be paid to patients without insurance but with lower education levels and higher pain scores to ultimately relieve death anxiety and improve their quality of life.
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Affiliation(s)
- Youwen Gong
- School of Nursing, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Yixia Yan
- Department of Nursing, Hunan Cancer Hospital, Changsha, Hunan, China
| | - Renting Yang
- Department of Nursing, Hunan Cancer Hospital, Changsha, Hunan, China
| | - Qinqin Cheng
- Department of Nursing, Hunan Cancer Hospital, Changsha, Hunan, China
| | - Hongling Zheng
- Department of Nursing, Hunan Cancer Hospital, Changsha, Hunan, China
| | - Yongyi Chen
- Department of Nursing, Hunan Cancer Hospital, Changsha, Hunan, China
| | - Xianghua Xu
- Department of Health Service Center, Hunan Cancer Hospital, Changsha, Hunan, China
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Sauer C, Grapp M, Bugaj TJ, Maatouk I. Suicidal ideation in patients with cancer: Its prevalence and results of structural equation modelling. Eur J Cancer Care (Engl) 2022; 31:e13650. [PMID: 35801643 DOI: 10.1111/ecc.13650] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 06/03/2022] [Accepted: 06/21/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Patients with cancer have a higher risk of suicidal ideation (SI) and suicidality than the general population. This study was designed to investigate the prevalence of SI and its association with psychosocial and sociodemographic factors and tumour entity. METHODS In this observational cross-sectional study, 4372 adult patients with different cancer entities were enrolled. We assessed the outcome variables (i.e. SI, depressive and anxiety symptoms, mental and physical fatigue and sociodemographic data) using self-report questionnaires. Data were analysed via descriptive statistics, binomial logistic regression and structural equation modelling (SEM). RESULTS Among all patients, 627 (14.3%) reported SI, of whom 12.8% reported SI on several days, 0.9% on half of the days and 0.6% nearly every day. Age, anxiety, mental fatigue and the Patient Health Questionnaire-9 items 'feeling down, depressed and hopeless', 'feeling bad about oneself' and 'slowing or agitation' were significant predictors of SI. SEM, including all significant predictors with a latent depressiveness-demoralisation variable, explained 30.3% variance of SI, showing a good fit. CONCLUSIONS Our results showed that a significant number of patients with cancer show SI. Future long-term studies are needed to address the differential contribution of depression and demoralisation on SI in patients with cancer.
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Affiliation(s)
- Christina Sauer
- Department of General Internal and Psychosomatic Medicine, University Hospital Heidelberg, Heidelberg, Germany.,National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Germany
| | - Miriam Grapp
- Department of General Internal and Psychosomatic Medicine, University Hospital Heidelberg, Heidelberg, Germany.,National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Germany
| | - Till J Bugaj
- Department of General Internal and Psychosomatic Medicine, University Hospital Heidelberg, Heidelberg, Germany.,National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Germany
| | - Imad Maatouk
- Department of General Internal and Psychosomatic Medicine, University Hospital Heidelberg, Heidelberg, Germany.,Section of Psychosomatic Medicine, Psychotherapy and Psychooncology, Department of Internal Medicine II, Julius-Maximilian University Würzburg, Würzburg, Germany
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Predictive value of the Distress Thermometer score for risk of suicide in patients with cancer. Support Care Cancer 2022; 30:5047-5053. [PMID: 35201384 PMCID: PMC9046327 DOI: 10.1007/s00520-022-06801-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 12/31/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE This study aimed to assess the association between the Distress Thermometer (DT) score and risk of suicide in patients with cancer. In addition, we aimed to determine the best cutoff score to predict patients at risk of suicide. METHODS From 2015 to 2016, we retrospectively collected data on patients with cancer. DT scores were collected, and the association between DT score and risk of suicide (suicide ideation or death ideation) was analyzed. Furthermore, receiver operating characteristic (ROC) analysis was performed to identify the appropriate cutoff score for predicting risk of suicide. RESULTS A total of 260 patients with cancer were included, and suicidal ideation was identified in 33 cases referred for psychological intervention. The DT scores of the patients with suicidal ideation were significantly higher than those of patients without suicidal ideation (6.30±2.11 vs. 4.29±1.72, p<0.05). In addition, the area under the ROC curve for predicting risk for suicide was 0.758. The cutoff DT score of 3 had the highest sensitivity of 1.00 to rule out suicidal ideation, while 9 had the highest specificity of 1.00 to rule in suicidal ideation. Moreover, the appropriate cutoff DT score to predict patients with suicidal ideation was 5, with a sensitivity of 0.52, specificity of .84, positive likelihood ratio of 3.24, and negative likelihood ratio of 0.58. CONCLUSION The DT score may be a helpful clinical tool to evaluate emotional distress and risk of suicide in patients with cancer. Clinically, for DT scores greater than 5 in patients with cancer, the risk of suicide greatly increases. In view of the DT's widespread use internationally by non-mental health clinicians in cancer to guide the need for specialist mental health interventions, its potential utility in also predicting suicide risk is of great interest.
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Fadoir NA, Marie L, Basu N, Schuler K, Granato S, Smith PN. Exploring interpersonal theory of suicide typologies in patients with cancer: A latent profile analysis. DEATH STUDIES 2021; 47:1-10. [PMID: 34971345 DOI: 10.1080/07481187.2021.2021567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The current study examined patterns of endorsement of Interpersonal Theory of Suicide constructs in a group of patients with cancer (N = 133) via Latent Profile Analysis. Four profiles were identified: (1) Interpersonally Distressed (n = 7; 5.2%), (2) Burdened (n = 11; 8.3%), (3) Fearless About Death (n = 40; 30.1%), (4) Non-Distressed (n = 75; 56.4%). Profiles with higher levels of thwarted belongingness, perceived burdensomeness, and hopelessness were associated with greater suicide ideation. Results also suggest there may be characteristics of patients with cancer that require unique consideration about the potential meaning and relevance of such constructs.
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Affiliation(s)
- Nicholas A Fadoir
- Department of Psychology, University of South Alabama, Mobile, Alabama, USA
| | - Laura Marie
- Department of Psychology, University of South Alabama, Mobile, Alabama, USA
| | - Natasha Basu
- Department of Psychology, University of South Alabama, Mobile, Alabama, USA
| | - Kaitlyn Schuler
- Department of Psychology, University of South Alabama, Mobile, Alabama, USA
| | - Stephani Granato
- Oklahoma City VA Health Care System, Oklahoma City, Oklahoma, USA
| | - Phillip N Smith
- Department of Psychology, University of South Alabama, Mobile, Alabama, USA
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Grassi L, Riba MB. Disparities and inequalities in cancer care and outcomes in patients with severe mental illness: Call to action. Psychooncology 2021; 30:1997-2001. [PMID: 34874094 DOI: 10.1002/pon.5853] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVES People with severe mental illness (SMI) are at extreme risk of being stigmatized and to receive poor quality physical care. It has been demonstrated that they have higher morbidity and poorer prognosis of several medical diseases than the general population, with an at least 10-20-year reduction in life expectancy. METHODS A special issue of Psycho-Oncology focusing on cancer care among patients affected by SMI was called by the Editorial Board of the journal, with the aim to explore cancer health disparities and inequalities among people with SMI, mortality from cancer, problems of communication between multidisciplinary oncology and psychiatric teams and need for more structured intervention (i.e., screening, prevention, treatment). RESULTS Authors from eight countries contributed. The problem of stigma and barriers to cancer care provision for patients with SMI were studied (e.g., the complex nature of SMI and healthcare providers' misunderstanding of SMI). Key barriers were related to both patients, clinicians and institutional problems, such as fragmentation of care. A higher mortality from cancer and poor knowledge about cancer risk-factors was shown in patients with SMI. Models of intervention were also proposed. CONCLUSIONS Several conclusions have been recommended by the authors, such as the need for guidelines and clinical procedures specific for cancer care in mental health settings; large-scale studies to address the disparities of care in people with SMI; a larger vision of psychosocial oncology as the facilitator of the liaison between oncology and psychiatry.
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Affiliation(s)
- Luigi Grassi
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy.,University Hospital Psychiatric Unit, S. Anna Hospital, Ferrara, Italy.,Local Health Trust, Ferrara, Italy
| | - Michelle B Riba
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA.,Psychoncology Program, University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, USA
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