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Li Y, Zhang J, Hu J, Chen X, Yang X, Zhu Y, Fan Y, Zhang X, Xu X. Stigma and related influencing factors in brain cancer patients: a cross-sectional study and parallel mediation analysis. Support Care Cancer 2024; 32:522. [PMID: 39017733 DOI: 10.1007/s00520-024-08731-9] [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: 02/06/2024] [Accepted: 07/10/2024] [Indexed: 07/18/2024]
Abstract
PURPOSE Patients with brain cancer and painful symptoms of the disease experience heavy pressure and negative inner experiences, leading to a sense of stigma. Therefore, this study assessed the level of stigma in patients with brain cancer and analyzed the risk factors for stigma to analyze the underlying relationships among depression, social support, low self-esteem, and stigma. METHODS Patients completed the Social Impact Scale, Self-rating Depression Scale, Rosenberg Self-Esteem Scale, Herth Hope Index, Social Support Rating Scale, and Self-Perceived Burden Scale. Multiple linear regression analysis was used to identify factors independently associated with stigma. Parallel mediation analysis was used to evaluate the mediating role of the relationship between psychoemotional factors and stigma. RESULTS A multivariate linear regression analysis demonstrated significant associations between age (β = - 0.189, P = 0.002), treatment (β = 0.184, P = 0.003), self-esteem (β = - 0.128, P = 0.046), depression (β = 0.273, P < 0.001), hope (β = - 0.217, P = 0.003), and self-perceived burden (β = 0.260, P < 0.001) with brain cancer. It was observed that the social support received by brain cancer patients directly impacted their stigma (total effect, - 0.851, P = 0.001). Additionally, this relationship was influenced by depression and self-esteem through two distinct pathways. CONCLUSION Increased stigma among brain cancer patients was found to be associated with severe depression, feelings of inferiority, diminished hope, and a heavy perceived burden. The structural equation modeling (SEM) revealed that social support negatively influenced stigma through depression and self-esteem. It is imperative to grasp patients' inner needs, implement psychological interventions, and cultivate a cancer-friendly social environment to prevent stigmatization and discrimination based on their patient status.
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Affiliation(s)
- Yanqing Li
- Department of Nursing, Affiliated Hospital of Nantong University, 20th Xisi Road, Nantong, 226001, China
- Department of Neurosurgery, Affiliated Hospital of Nantong University, 20th Xisi Road, Nantong, 226001, China
| | - Jiajia Zhang
- Department of Nursing, Affiliated Hospital of Nantong University, 20th Xisi Road, Nantong, 226001, China
- Department of Neurosurgery, Affiliated Hospital of Nantong University, 20th Xisi Road, Nantong, 226001, China
| | - Jiali Hu
- Department of Nursing, Affiliated Hospital of Nantong University, 20th Xisi Road, Nantong, 226001, China
| | - Xing Chen
- Department of Nursing, Affiliated Hospital of Nantong University, 20th Xisi Road, Nantong, 226001, China
- Medical College, Nantong University, 19th Qixiu Road, Nantong, 226001, China
| | - Xueni Yang
- Department of Nursing, Affiliated Hospital of Nantong University, 20th Xisi Road, Nantong, 226001, China
- Medical College, Nantong University, 19th Qixiu Road, Nantong, 226001, China
| | - Yingqian Zhu
- Department of Nursing, Affiliated Hospital of Nantong University, 20th Xisi Road, Nantong, 226001, China
- Medical College, Nantong University, 19th Qixiu Road, Nantong, 226001, China
| | - Yinyin Fan
- Department of Nursing, Affiliated Hospital of Nantong University, 20th Xisi Road, Nantong, 226001, China
- Medical College, Nantong University, 19th Qixiu Road, Nantong, 226001, China
| | - Xiaomei Zhang
- Department of Nursing, Affiliated Hospital of Nantong University, 20th Xisi Road, Nantong, 226001, China.
- Department of Neurosurgery, Affiliated Hospital of Nantong University, 20th Xisi Road, Nantong, 226001, China.
| | - Xiuqun Xu
- Department of Nursing, Affiliated Hospital of Nantong University, 20th Xisi Road, Nantong, 226001, China.
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Ahmead M, Shehadah F, Abuiram I. Correlation of death anxiety with coping strategies among Palestinian women with breast cancer: a cross-sectional study. Front Public Health 2024; 12:1420306. [PMID: 38915747 PMCID: PMC11194404 DOI: 10.3389/fpubh.2024.1420306] [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: 04/19/2024] [Accepted: 05/27/2024] [Indexed: 06/26/2024] Open
Abstract
Background Death anxiety and maladaptive coping accompany breast cancer diagnoses. The coping mechanisms and death anxiety among Palestinian patients with breast cancer have not been studied. Aim To assess the prevalence of death anxiety and its relationship with coping strategies among Palestinian women with breast cancer who are treated in Beit Jala Governmental Hospital in Bethlehem. Method A cross-sectional design was used, and 214 breast cancer patients who visited the Beit Jala Governmental Hospital in Bethlehem were recruited. Templer's Death Anxiety Scale and the Brief COPE Scale were used. To investigate the relationship between coping strategies and death anxiety, frequency, percentages, chi-square tests, and Pearson's correlation tests were utilized. Results The results indicated that 58.40% of the patients experienced death anxiety. The participants who used positive reframing (adjusted odds ratio (AOR) = 1.487, p = < 0.026), self-blame (AOR = 1.309, p = < 0.023), and religion (AOR = 1.260, p = < 0.031) as coping mechanisms were more likely to experience death anxiety. Conversely, the participants who adopted substance use (AOR = 0.657, p < 0.005) and active coping (AOR = 0.629, p < 0.007) as coping strategies had a lower likelihood of experiencing death anxiety. Conclusion The study revealed that breast cancer patients tended to use a combination of functional and emotional coping strategies and that a significant proportion of these patients (58.4%) experienced symptoms of death anxiety. This study emphasizes the significance of screening for death anxiety and understanding the coping strategies utilized by the patients. Gaining this understanding will assist in identifying patients who need more guidance and support.
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Uslu-Sahan F, Terzioglu F, Dizdar EA, Kayademir N, Mutlu DK, Adıguzel G, Tozlu G, Baykal T. The Effect of Neonatal Intensive Care Nurses' Attitudes Towards Palliative Care on Death Anxiety and Burnout: An Analytic Cross-Sectional Study. OMEGA-JOURNAL OF DEATH AND DYING 2024:302228241252866. [PMID: 38758172 DOI: 10.1177/00302228241252866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
This study aimed to determined the effect of neonatal intensive care nurses' attitudes towards palliative care on death anxiety and burnout. This was an analytic cross-sectional study conducted with 215 neonatal intensive care nurses working a children's hospital with Turkey's largest NICU bed capacity. The mean Neonatal Palliative Care Attitude Scale total score was 3.04 ± 0.78, and the mean scores of the organization, resources, and clinician subscales were 3.16 ± 0.86, 2.87 ± 0.80, and 3.10 ± 0.97, respectively. The participants' mean Death Anxiety Scale score was 57.65 ± 21.46, and the mean Burnout Inventory score was 39.21 ± 17.61. The organization subscale explained 17% of the variance in death anxiety, and the organization and resources subscales explained 31% of the variance in burnout. Neonatal intensive care nurses' palliative care attitudes are moderate; they face obstacles in providing and improving their attitudes in this field. The high level of obstacles increases nurses' death anxiety and burnout.
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Affiliation(s)
- Fatma Uslu-Sahan
- Department of Obstetrics and Gynecologic Nursing, Faculty of Nursing, Hacettepe University, Ankara, Turkey
| | - Fusun Terzioglu
- Faculty of Health Sciences, Avrasya University, Trabzon, Turkey
| | - Evrim A Dizdar
- Neonatal Intensive Care Unit, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Neslihan Kayademir
- Children's Hospital, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Derya K Mutlu
- Neonatal Intensive Care Unit, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Garibe Adıguzel
- Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Gönül Tozlu
- Maternity Hospital Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Tugce Baykal
- Neonatal Intensive Care Unit, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
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Bahçecioğlu Turan G, Türkben Polat H. The effects of illness perception on death anxiety and satisfaction with life in patients with advanced gastrointestinal cancer. Palliat Support Care 2024; 22:360-366. [PMID: 37620999 DOI: 10.1017/s1478951523001244] [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] [Indexed: 08/26/2023]
Abstract
OBJECTIVES This study was conducted to determine the effects of illness perception on death anxiety and satisfaction with life in patients with advanced gastrointestinal cancer. METHODS This cross-sectional and correlational study was conducted with 125 patients with cancer who were admitted to the oncology clinic of a university hospital in the Central Anatolian Region of Turkey between March and December 2022 and who met the research criteria and accepted to participate in the study. The data were collected with "Patient descriptive information form," "Brief Illness Perception Questionnaire (BIPQ)," "Scale of Death Anxiety (SDA)," and "Satisfaction with Life Scale (SWLS)." RESULTS It was found that mean BIPQ score of the patients was 39.54 ± 12.82, the mean SDA score was 8.02 ± 3.16, and the mean SWLS score was 14.74 ± 5.19. BIPQ total score was found to affect SDA total score positively (β = .751) and SWLS total score negatively (β = - .591). SDA total score was found to affect SWLS total score negatively (β = -.216) (p < .05). SIGNIFICANCE OF RESULTS It was found that patients with advanced gastrointestinal cancer had moderate level of illness perception and life satisfaction, and high death anxiety. It was found that as illness perception of the patients increased, their death anxiety increased and satisfaction with life decreased. In addition, it was found that as the death anxiety of patients increased, their satisfaction with life decreased.
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Affiliation(s)
| | - Hilal Türkben Polat
- Department of Fundamentals of Nursing, Seydişehir Kamil Akkanat Faculty of Health Sciences, Necmettin Erbakan University, Konya, Turkey
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Scaria L, Devassy SM, Joubert L. Familial and Social Implications of Breast and Gynaecological cancer in Kerala, India. Curr Probl Cancer 2024; 49:101080. [PMID: 38490881 DOI: 10.1016/j.currproblcancer.2024.101080] [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: 08/01/2023] [Revised: 09/25/2023] [Accepted: 03/10/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND Due to the paucity of reliable data to determine the components of family-based comprehensive care for cancer in India, we explored the familial implications of gynaecological and breast cancer diagnosis and treatment through a mixed-method study. METHODS The mixed method study included 130 women aged above 18 with a confirmed diagnosis of gynaecological or breast cancer recruited from three selected tertiary hospitals in Kerala, India. Information on quality of life (36-Item Short Form Survey (SF-36)), psychological distress (distress thermometer), and the familial, interpersonal, social, and community impacts of cancer (semi-structured interview guide) were elicited. Linear regression was used to identify the factors associated with distress and the factors were explored further using thematic analysis. RESULTS Patients included in the study (n = 130; mean age 57.5 years) had moderate or mild (66.9%) to severe (25.4%) distress. Concerns about work (93%), difficulty in; home care and housing (82%), care for dependents (65%), unempathetic family (87.6%), isolation (70%), and body image (65%) were major reasons for their distress. Physiological, social, and family-related stressors among the respondents included challenges in physical functioning, intense physical symptoms like fatigue, loss of appetite and sleep, role restrictions, alterations in family responsibilities, functional dependency, inadequate family support, challenges in social and interpersonal interactions, and an unsupportive work environment. CONCLUSION Cancer is a health crisis that involves psychological, social, and economic distress, compelling professionals to design multifaceted individualized care packages rather than only concentrating on medical management to alleviate their distress.
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Affiliation(s)
- Lorane Scaria
- Department of Social Work, Rajagiri College of Social Sciences (Autonomous), Rajagiri PO, Kalamassery, Cochin 683104
| | - Saju Madavanakadu Devassy
- Department of Social Work, Rajagiri College of Social Sciences (Autonomous), Rajagiri PO, Kalamassery, Cochin 683104; Honorary Fellow, Department of Social Work, University of Edinburgh, Scotland.
| | - Lynette Joubert
- Department of Social Work, Melbourne School of Health Sciences, University of Melbourne, VIC 3010, Australia
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Heidari Gorji MA, Ghorbani Vajargah P, Salami Kohan K, Mollaei A, Falakdami A, Goudarzian AH, Takasi P, Emami Zeydi A, Osuji J, Jafaraghaee F, Taebi M, Karkhah S. The Relationship Between Spirituality and Religiosity with Death Anxiety Among Cancer Patients: A Systematic Review. JOURNAL OF RELIGION AND HEALTH 2024:10.1007/s10943-024-02016-5. [PMID: 38555537 DOI: 10.1007/s10943-024-02016-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/17/2024] [Indexed: 04/02/2024]
Abstract
This systematic review aimed to summarize the evidence regarding the relationship between spirituality and religiosity with death anxiety (DA) among cancer patients. This systematic review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) checklist. An extensive search was conducted on electronic databases such as Scopus, PubMed, Web of Science, Iranmedex, and Scientific Information Database (SID) via keywords extracted from Medical Subject Headings from the earliest to February 9, 2022. The quality of the included studies was assessed using the appraisal tool for cross-sectional studies (AXIS tool). Fifteen studies were selected for inclusion in this systematic review. Nine and six studies assessed the relationship between spirituality and religiosity with DA in cancer patients, respectively. Most studies had a negative relationship between spirituality (n = 8) and religiosity (n = 4) with DA. In sum, most studies showed that religion and spirituality are negatively related to DA in patients with cancer.
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Affiliation(s)
- Mohammad Ali Heidari Gorji
- Department of Medical-Surgical Nursing, Diabetes Research Center, Nasibeh Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Pooyan Ghorbani Vajargah
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Kobra Salami Kohan
- Department of Nursing, Faculty of Nursing and Midwifery, University of Medical Sciences, Tehran, Iran
| | - Amirabbas Mollaei
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Atefeh Falakdami
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Amir Hossein Goudarzian
- PhD Candidate of Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Poorya Takasi
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Amir Emami Zeydi
- Department of Medical-Surgical Nursing, Nasibeh School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Joseph Osuji
- Faculty of Health, Community, and Education, School of Nursing and Midwifery, Mount Royal University, Calgary, AB, Canada
| | - Fateme Jafaraghaee
- School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Mozhgan Taebi
- Department of Medical-Surgical Nursing, Faculty of Allied Medical Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Samad Karkhah
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran.
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Dadashi N, Pazokian M, Yadollahzade N, Taheri M, Kamian S. Predictors of death anxiety among Iranian cancer patients: Contribution of sense of Coherence. J Psychosoc Oncol 2024:1-14. [PMID: 38459951 DOI: 10.1080/07347332.2024.2319292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2024]
Abstract
BACKGROUND Death anxiety is a negative consequence of cancer that influences the quality of life of many patients. This study determined the predictors of death anxiety and the contribution of the sense of coherence to this disorder among Iranians with cancer. METHODS The present research was a descriptive-analytical study that examined cancer patients referring to one of the educational hospitals in Tehran, Iran. Two hundred eligible patients selected by purposeful sampling filled out a clinical and demographic questionnaire. The data were analyzed by the SPSS 20 software. RESULTS The correlational results revealed a negative and significant relationship between death anxiety and a sense of coherence (r = -0.610). Likewise, age, gender, marital status, occupational and economic circumstances, and cancer type were among the variables that correlated with death anxiety and predicted 85% of this psychological state. CONCLUSION The researchers recommend mental assessment in oncological care to identify psychological challenges to realize the ultimate goal of palliative care, i.e. improving patients' quality of life.
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Affiliation(s)
- Nasrin Dadashi
- Department of Medical Surgical, School of Nursing and Midwifery, Babol University of Medical Sciences, Babol, Iran
| | - Marzieh Pazokian
- School of Nursing and Midwifery, Clinical Research Development Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nima Yadollahzade
- School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahbobeh Taheri
- Clinical Research Development Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shaghayegh Kamian
- Department of Radiotherapy, School of Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Yang K, Ren Y, Peng W, Wang X, Du X, Wang J, Jiang J. Subjective well-being among Chinese breast cancer patients: The unique contributions of death anxiety, self-esteem, and social support. J Health Psychol 2024; 29:213-224. [PMID: 37688375 DOI: 10.1177/13591053231195391] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2023] Open
Abstract
Previous studies have indicated that cancer patients may have a lower level of subjective well-being (SWB); nevertheless, the underlying factors for this phenomenon remain insufficiently investigated. Based on the characteristics of Chinese breast cancer patients and the unique culture, this study explored the independent contributions of death anxiety, self-esteem, and social support to SWB from the protective and risk perspectives. A cross-sectional survey recruited 514 females with breast cancer and collected participants' demographic and the above variables. The results found that death anxiety independently predicted SWB in a negative direction (β = -0.36, p < 0.001). In addition, self-esteem (β = 0.38, p < 0.001) and social support (β = 0.14, p < 0.001) also had the unique positive effects on SWB. These findings offer new insights into strengthening breast cancer patients' SWB, for instance, using relevant interventions to reduce death anxiety and improve self-esteem and social support.
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Affiliation(s)
| | - Yinpeng Ren
- Chinese Academy of Medical Sciences and Peking Union Medical College, China
| | | | - Xiangyu Wang
- Chinese Academy of Medical Sciences and Peking Union Medical College, China
| | | | - Jing Wang
- Chinese Academy of Medical Sciences and Peking Union Medical College, China
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Zhang Y, Pang Y, He Y, You M, Tang L. Feasibility of online managing cancer and living meaningfully (CALM) in Chinese patients with metastatic breast cancer: a pilot randomized control trial. Sci Rep 2024; 14:4892. [PMID: 38418478 PMCID: PMC10902284 DOI: 10.1038/s41598-024-52574-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 01/20/2024] [Indexed: 03/01/2024] Open
Abstract
Metastatic breast cancer could cause various psychological symptoms. Managing Cancer and Living Meaningfully (CALM) is a brief, manualized psychotherapy that has been validated for advanced cancer patients. We conducted a pilot randomized control trial (RCT) to verify the feasibility and preliminary efficacy of CALM therapy in this population. Patients who met the inclusion criteria were randomly assigned into CALM or Wait-list Control (WLC) groups. Patients in the CALM group received CALM therapy and usual care; patients in WLC group first received usual care and then underwent CALM therapy after completing all assessments. All patients were asked to complete three assessments: T0(baseline), T1(3 months), and T2(6 months). The primary outcomes was death anxiety; other outcomes were depression, distress, suicide ideation, attachment security, spiritual well-being and quality of life at the end of life. Analysis of Covariance (ANCOVA) and t-test were used for statistics analysis. Thirty-six patients were randomly assigned to either of the two groups, with 34 patients completing the three assessments. At six months, we found significant between group differences in suicide ideation, distress, and life completion between the CALM and WLC groups. At T2, patients in CALM group reported lower levels of depression (F = 5.016, p = 0.033, partial η2 = 0.143), distress (F = 7.969, p = 0.010, partial η2 = 0.257), attachment avoidance (F = 4.407, p = 0.044, partial η2 = 0.128), and better sense of life completion (F = 5.493, p = 0.026, partial η2 = 0.155) than patients in the WLC group. Compared with results of the T0 assessments, we found significant differences in socres for depression (T2&T0, t = - 2.689, p = 0.011, Cohen's d = 0.940) and distress (T2&T0, t = - 2.453, p = 0.022, Cohen's d = 0.965) between the two groups. CALM therapy was well received by the study population, and CALM therapy can reduce depression, distress, attachment avoidance while improving quality of life in Chinese metastatic breast cancer patients. A Phase III RCT was recommended to verify the impact of CALM therapy on psychological burden and survival in this population.Trial registration: This study is part of the "Preliminary application study for Managing Cancer and Living Meaningfully (CALM) therapy in Chinese advanced cancer patients" clinical trial, with the Trial Registration Number of ChiCTR1900023129 (13/05/2019) in the Chinese Clinical Trial Registry (ChiCTR) website. ( https://www.chictr.org.cn/index.html ).
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Affiliation(s)
- Yening Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-Oncology, Peking University Cancer Hospital and Institute, Fu-Cheng Road 52, Hai-Dian District, Beijing, 100142, China
| | - Ying Pang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-Oncology, Peking University Cancer Hospital and Institute, Fu-Cheng Road 52, Hai-Dian District, Beijing, 100142, China
| | - Yi He
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-Oncology, Peking University Cancer Hospital and Institute, Fu-Cheng Road 52, Hai-Dian District, Beijing, 100142, China
| | - Miaoning You
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Bresat Oncology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Lili Tang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-Oncology, Peking University Cancer Hospital and Institute, Fu-Cheng Road 52, Hai-Dian District, Beijing, 100142, China.
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Zhao J, Ge H, Wang P, Zhang Z, Qin Q, Li S. Evaluation of the effectiveness of promoted psychological resilience intervention for oesophageal cancer patients in rural China: A randomized controlled study. Eur J Oncol Nurs 2024; 68:102501. [PMID: 38194901 DOI: 10.1016/j.ejon.2023.102501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 12/17/2023] [Accepted: 12/19/2023] [Indexed: 01/11/2024]
Abstract
PURPOSE The objective of this randomized controlled trial was to examine the effectiveness of promoted resilience intervention to facilitate resilience, self-efficacy, coping mode, and social support for oesophageal cancer patients in rural China. METHODS A two-arm, parallel design, single-blinded, randomized controlled trial was conducted in a comprehensive tertiary hospital in Anhui from August 2021 to September 2022. A total of 82 oesophageal cancer patients were assigned to two groups via blocked randomization. The intervention group (n = 41) received the Promoted Psychological Resilience Intervention based on survivors' experiences and the control group (n = 41) received routine care. Study data were collected using the sociodemographic information, Connor-Davidson Resilience Scale, Strategies Used by People to Promote Health, Medical Coping Modes Questionnaire, and Perceived Social Support Scale. RESULTS The groups were well-balanced at baseline. Post-intervention and three months after intervention, the resilience, self-efficacy, acceptance-resignation, and social support were all significantly different in the intervention and control groups (p < 0.05 for each). The main effect of group, time, and the interaction between group and time was statistically significant in the scores of resilience, self-efficacy, acceptance-resignation, and social support, except for the factor of self-determination and friends support (p < 0.05 for each). CONCLUSIONS This study demonstrated that an intervention program based on the experiences of long-term oesophageal cancer survivors can promote patients' resilience.
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Affiliation(s)
- Jinghan Zhao
- Anhui Medical University School of Nursing, Hefei, Anhui, China
| | - Hui Ge
- Peking University School of Nursing, Beijing, China; Anhui Medical University School of Nursing, Hefei, Anhui, China
| | - Pan Wang
- Anhui Medical University School of Nursing, Hefei, Anhui, China
| | - Zonghao Zhang
- Anhui Medical University School of Nursing, Hefei, Anhui, China
| | - Qiaoyun Qin
- Anhui Medical University School of Nursing, Hefei, Anhui, China
| | - Shuwen Li
- Anhui Medical University School of Nursing, Hefei, Anhui, China.
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Ji P, Zhang L, Gao Z, Ji Q, Xu J, Chen Y, Song M, Guo L. Relationship between self-esteem and quality of life in middle-aged and older patients with chronic diseases: mediating effects of death anxiety. BMC Psychiatry 2024; 24:7. [PMID: 38166844 PMCID: PMC10763298 DOI: 10.1186/s12888-023-05459-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Many studies have explored the relationship between self-esteem and quality of life. However, few studies have elucidated the mechanisms underlying the relationship between self-esteem and quality of life in middle-aged and older patients with chronic diseases. The present study aimed to explore the mediating role of death anxiety in this relationship. METHODS Middle-old-aged patients with chronic diseases were selected as the respondents by using a multi-stage sampling method, random number table method from October 2021 to February 2022 in the Second Affiliated Hospital of Zhejiang University School of Medicine. The Cumulative Disease Rating Scale, the Self-Esteem Scale (SES), the Chinese version of the Death Anxiety Scale (CT-DAS), and the Simplified version of the Quality of Life Scale (SF-12) were used as the researching tools to conduct the survey. SPSS26.0 was used to analysis data. AMOS 23.0 software was used to construct structural equation modeling. RESULTS 294 valid questionnaires were collected. There were significant differences in quality of life among middle-aged and elderly patients with chronic diseases who have different physical activities, socialization, and chronic pain (P < 0.01); Self-esteem was positively associated with quality of life (r = 0.330, P < 0.01), self-esteem was negatively associated with death anxiety (r = -0.222, P < 0.01), and death anxiety was negatively associated with quality of life (r = -0.263, P < 0.01); Death anxiety partially mediated the relationship between self-esteem and quality of life, with the mediating effect accounting for 18.40% of the total effect. CONCLUSION Death anxiety partially mediates the relationship between self-esteem and quality of life. Interventions to improve self-esteem and reduce death anxiety should be used to improve the quality of life of middle-aged and senior patients with chronic diseases.
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Affiliation(s)
- Pengjuan Ji
- School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, P.R. China
| | - Lin Zhang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P.R. China
| | - Ziyun Gao
- School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, P.R. China
| | - Qiqi Ji
- School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, P.R. China
| | - Jiashuang Xu
- School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, P.R. China
| | - Yian Chen
- School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, P.R. China
| | - Miaojing Song
- School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, P.R. China
| | - Leilei Guo
- School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, P.R. China.
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Arch JJ, Bright EE, Finkelstein LB, Fink RM, Mitchell JL, Andorsky DJ, Kutner JS. Anxiety and Depression in Metastatic Cancer: A Critical Review of Negative Impacts on Advance Care Planning and End-of-Life Decision Making With Practical Recommendations. JCO Oncol Pract 2023; 19:1097-1108. [PMID: 37831973 PMCID: PMC10732500 DOI: 10.1200/op.23.00287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 07/14/2023] [Accepted: 08/15/2023] [Indexed: 10/15/2023] Open
Abstract
PURPOSE Providers treating adults with advanced cancer increasingly seek to engage patients and surrogates in advance care planning (ACP) and end-of-life (EOL) decision making; however, anxiety and depression may interfere with engagement. The intersection of these two key phenomena is examined among patients with metastatic cancer and their surrogates: the need to prepare for and engage in ACP and EOL decision making and the high prevalence of anxiety and depression. METHODS Using a critical review framework, we examine the specific ways that anxiety and depression are likely to affect both ACP and EOL decision making. RESULTS The review indicates that depression is associated with reduced compliance with treatment recommendations, and high anxiety may result in avoidance of difficult discussions involved in ACP and EOL decision making. Depression and anxiety are associated with increased decisional regret in the context of cancer treatment decision making, as well as a preference for passive (not active) decision making in an intensive care unit setting. Anxiety about death in patients with advanced cancer is associated with lower rates of completion of an advance directive or discussion of EOL wishes with the oncologist. Patients with advanced cancer and elevated anxiety report higher discordance between wanted versus received life-sustaining treatments, less trust in their physicians, and less comprehension of the information communicated by their physicians. CONCLUSION Anxiety and depression are commonly elevated among adults with advanced cancer and health care surrogates, and can result in less engagement and satisfaction with ACP, cancer treatment, and EOL decisions. We offer practical strategies and sample scripts for oncology care providers to use to reduce the effects of anxiety and depression in these contexts.
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Affiliation(s)
- Joanna J. Arch
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO
- Division of Cancer Prevention and Control, University of Colorado Cancer Center, Aurora, CO
| | - Emma E. Bright
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO
| | - Lauren B. Finkelstein
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO
| | - Regina M. Fink
- Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO
- University of Colorado College of Nursing, Anschutz Medical Campus, Aurora, CO
| | | | | | - Jean S. Kutner
- Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO
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Dağcan Şahin N, Gürol Arslan G, Özbek D. Factors Affecting Death Anxiety in Patients Undergoing Open Heart Surgery: A Cross-Sectional Study. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231214128. [PMID: 37933629 DOI: 10.1177/00302228231214128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
After the operation, death anxiety of patients is affected by many factors. This study aims to investigate the factors affecting death anxiety of patients undergoing open heart surgery. A descriptive, cross-sectional study. Data were collected using the 'Introductory Information Form,' the 'Templer's Death Anxiety Scale,' and the 'Spiritual Well-being Scale.' This study was conducted with 313 intensive care patients. The mean scores of the patients on the "Death Anxiety Scale" were moderate (7.96 (4.28)). According to the study findings, age, gender, length of stay in the intensive care unit, and spiritual well-being were found to be important predictors of death anxiety (F (4,308) = 16.149, p < .001). Considering gender differences in nursing care, it is thought that the intensive care period will be shortened, the level of spiritual well-being will increase and death anxiety will decrease.
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Affiliation(s)
- Necibe Dağcan Şahin
- Fundamentals of Nursing Department, The Institute of Health Sciences, Dokuz Eylül University, Izmir, Turkey
| | - Gülşah Gürol Arslan
- Fundamentals of Nursing Department, Nursing Faculty, Dokuz Eylül University, Izmir, Turkey
| | - Dilara Özbek
- Akhisar Mustafa Kirazoglu State Hospital, Manisa, Turkey
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Wu B, Zhu P, Wang T, Tan JYB, Cao Z, Wan J, Wu S, Zhang L, Xing Y. Experiences of Chinese advanced cancer patients after attending a "four-stage" death education programme: A qualitative study. Eur J Oncol Nurs 2023; 66:102361. [PMID: 37499403 DOI: 10.1016/j.ejon.2023.102361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 05/14/2023] [Accepted: 06/05/2023] [Indexed: 07/29/2023]
Abstract
PURPOSE This study aimed to explore the experiences of cancer patients who participated in and completed a "four-stage" death education programme based on knowledge-attitude-practice theory. METHODS This study employed a qualitative descriptive design. Semistructured interviews with an interview guide were used to collect data. Fifteen cancer patients who participated in and completed the "four-stage" death education programme (from November 10, 2021, to December 29, 2021) were recruited via purposive sampling. The "four-stage" death education programme model was developed based on knowledge-attitude-practice theory and included eight death education modules. Each interview was audio-recorded and transcribed verbatim. Generic analysis was used to conduct data analysis by coding, classifying, and extracting themes. RESULTS Five themes were identified: the gradual shift of death cognition towards objective reality, a decrease in death anxiety, patients' early thoughts concerning issues related to death and preparation ahead of death, patients' improved ability to respond to death incidents, and patients' increased focus on cherishing the remainder of their lives and living in the moment. CONCLUSIONS Cancer patients accept and respond effectively to the implementation of a "four-stage" death education programme based on knowledge-attitude-practice theory. These findings can help cancer patients improve their reasonable perception of death and reduce their doubts and confusion concerning death.
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Affiliation(s)
- Bing Wu
- Department of Nursing, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, 210009, China
| | - Ping Zhu
- Department of Nursing, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, 210009, China
| | - Tao Wang
- College of Nursing and Midwifery, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Jing-Yu Benjamin Tan
- College of Nursing and Midwifery, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Zhenglan Cao
- Department of Oncology Surgery, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Jing Wan
- Department of Nursing, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, 210009, China
| | - Suya Wu
- Department of Nursing, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, 210009, China
| | - Liuliu Zhang
- Department of Nursing, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, 210009, China.
| | - Yihui Xing
- Department of Internal Medicine-Oncology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China.
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15
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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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16
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Mei Y, Yang X, Gui J, Li Y, Zhang X, Wang Y, Chen W, Chen M, Liu C, Zhang L. The relationship between psychological resilience and depression among the diabetes patients under the background of "dynamic zero COVID-19": the mediating role of stigma and the moderating role of medication burden. Front Public Health 2023; 11:1124570. [PMID: 37680269 PMCID: PMC10481163 DOI: 10.3389/fpubh.2023.1124570] [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: 12/15/2022] [Accepted: 08/11/2023] [Indexed: 09/09/2023] Open
Abstract
Objective Depression in diabetes patients is caused by their own disease or the surrounding social environment. How to cope with changes in mentality and adjust psychological stress responses, especially under China's dynamic zero COVID-19 policy, is worth further discussion. The researchers constructed a moderated mediation model to test the effect of psychological resilience during dynamic zero COVID-19 on depression in diabetes patients and the mediating role of stigma and the moderating effect of medication burden. Method From June to September, 2022, data were collected in Jinghu District, Wuhu City, Anhui Province, by multi-stage stratified sampling. Firstly, we selected a tertiary hospital randomly in Jinghu District. Secondly, departments are randomly chosen from the hospital. Finally, we set up survey points in each department and randomly select diabetes patients. In addition, we used the Connor-Davidson Elasticity Scale (CD-RISC) to measure psychological resilience of patients, and used the Stigma Scale for Chronic Illness (SSCI) to measure stigma, medication burden was measured by the Diabetes Treatment Burden Scale (DTBQ), and depression was assessed by the Patient Health Questionnaire-9 (PHQ-9). We used SPSS (version 23.0) and PROCESS (version 4.1) for data analysis. Results (1) Psychological resilience was negatively correlated with stigma, medication burden, and depression. Stigma was positively associated with medication burden and depression. Medication burden and depression are positively correlated, (2) The mediation analysis showed that psychological resilience had a direct predictive effect on depression, and stigma partially mediated the relationship, and (3) Medication burden moderates the direct pathway by which psychological resilience predicts depression; Medication burden moderates the first half of "psychological resilience → stigma → depression." Conclusion Under the mediating effect of stigma, psychological resilience can improve depression. Medication burden has a moderating effect on the relationship between psychological resilience and depression, and it also has a moderating effect on the relationship between psychological resilience and stigma. These results facilitate the understanding of the relationship mechanisms between psychological resilience and depression.
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Affiliation(s)
- Yujin Mei
- School of Nursing, Wannan Medical College, Higher Education Park, Wuhu City, Anhui Province, China
| | - Xue Yang
- School of Nursing, Wannan Medical College, Higher Education Park, Wuhu City, Anhui Province, China
| | - JiaoFeng Gui
- School of Nursing, Wannan Medical College, Higher Education Park, Wuhu City, Anhui Province, China
| | - YuQing Li
- School of Nursing, Wannan Medical College, Higher Education Park, Wuhu City, Anhui Province, China
| | - XiaoYun Zhang
- School of Nursing, Wannan Medical College, Higher Education Park, Wuhu City, Anhui Province, China
| | - Ying Wang
- School of Nursing, Wannan Medical College, Higher Education Park, Wuhu City, Anhui Province, China
| | - Wenyue Chen
- School of Nursing, Wannan Medical College, Higher Education Park, Wuhu City, Anhui Province, China
| | - Mingjia Chen
- School of Nursing, Wannan Medical College, Higher Education Park, Wuhu City, Anhui Province, China
| | - Changjun Liu
- School of Marxism, Jinzhou Medical University, Jinzhou City, Liaoning Province, China
| | - Lin Zhang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Higher Education Park, Wuhu City, Anhui Province, China
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Mei Y, Yang X, Liu C, Li Y, Gui J, Zhang L. The impact of psychological resilience on chronic patients' depression during the dynamic Zero-COVID policy: the mediating role of stigma and the moderating role of sleep quality. BMC Psychol 2023; 11:213. [PMID: 37480116 PMCID: PMC10362636 DOI: 10.1186/s40359-023-01248-6] [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: 09/10/2022] [Accepted: 07/12/2023] [Indexed: 07/23/2023] Open
Abstract
OBJECTIVE Chronic patients are experiencing depression caused by themselves or the surrounding environment, how to cope with the change of mentality and adjust the psychological stress response, especially under the background of the current dynamic Zero-COVID policy in China, is a problem worth further discussion. The researchers constructed a mediating regulation model to test the influence of psychological resilience on depression of chronic patients during dynamic Zero-COVID, as well as the mediating role of stigma and the moderating role of sleep. METHOD From October 2021 to February 2022, this study used a multi-stage sampling method and random number table method to collect data in the Shang Cheng District of Hangzhou City, Zhejiang Province. Firstly, the Second Affiliated Hospital of the Zhejiang University School of Medicine, a third-class hospital was randomly selected from the Shang Cheng District. Secondly, three departments were strategically selected from this hospital: endocrinology, dermatology, and traditional Chinese medicine. Thirdly, survey points were set up in each department, and chronic patients were strategically selected for questionnaire surveys. Finally, a face-to-face survey was conducted on 398 chronic patients who met the criteria for inclusion. In addition, chronic medical illness burden was assessed using the Cumulative Illness Rating Scale-Geriatrics (CIRS-G), psychological resilience was measured by the Conner-Davidson Resilience Scale (CD-RISC), stigma was measured by the Stigma Scale for Chronic Illness (SSCI), sleep was measured by the Pittsburgh Sleep Quality Index(PSQI) and depression was estimated by the Patient Health Questionaire-9(PHQ-9). SPSS (version 25.0) and PROCESS (version 4.0) were used for correlation analysis, mediation analysis, and mediated moderation analysis. RESULTS Psychological resilience was negatively correlated with depression, stigma, and sleep. Depression was positively correlated with stigma and sleep. Stigma and sleep were positively correlated; Stigma played a mediating role in the relationship between psychological resilience and depression; Sleep moderated the first half of the pathway "psychological resilience [Formula: see text] stigma [Formula: see text] depression". CONCLUSION Psychological resilience affected depression directly and indirectly through stigma. At the same time, sleep played a moderating role between psychological resilience and depression. The correlation between psychological resilience and stigma was stronger when levels of sleep levels were higher.
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Affiliation(s)
- Yujin Mei
- School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, Anhui Province, P.R. China
| | - Xue Yang
- School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, Anhui Province, P.R. China
| | - Changjun Liu
- School of Marxism, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, P.R. China
| | - Yuqing Li
- School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, Anhui Province, P.R. China
| | - Jiaofeng Gui
- School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, Anhui Province, P.R. China
| | - Lin Zhang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P.R. China.
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18
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Svet M, Portalupi LB, Pyszczynski T, Matlock DD, Allen LA. Applying terror management theory to patients with life-threatening illness: a systematic review. BMC Palliat Care 2023; 22:74. [PMID: 37330502 DOI: 10.1186/s12904-023-01193-6] [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: 05/07/2022] [Accepted: 06/06/2023] [Indexed: 06/19/2023] Open
Abstract
BACKGROUND Terror management theory (TMT) posits that people manage death-related anxiety through the meaning provided by their cultural world-views and the sense of personal value provided by self-esteem. While a large body of research has supported the core propositions of TMT, little research has focused on its application to individuals with terminal illness. If TMT can help healthcare providers better understand how belief systems adapt and change in life-threatening illness, and the role they play in managing death-related anxiety, it may provide guidance on how to improve communication around treatments near the end of life. As such, we set out to review the available research articles that focus on describing the relationship between TMT and life-threatening illness. METHODS We reviewed PubMed, PsycINFO, Google Scholar, and EMBASE through May 2022 for original research articles focused on TMT and life-threatening illness. Articles were only deemed appropriate for inclusion if direct incorporation of the principles of TMT were made in reference to a population of interest whom had life-threatening illness Results were screened by title and abstract, followed by full review of candidate articles. References were also scanned. Articles were assessed qualitatively. RESULTS Six relevant and original research articles were published which provide varied levels of support for TMT's application in critical illness, each article detailed evidence of ideological changes consistent with what TMT would predict. Building self-esteem, enhancing the experience of life as meaningful, incorporating spirituality, engaging family members, and caring for patients at home where meaning and self-esteem can be better maintained are strategies supported by the studies and serve as starting points for further research. CONCLUSION These articles suggest that applying TMT to life-threatening illness can help identify psychological changes that may effectively minimize the distress from dying. Limitations of this study include a heterogenous group of relevant studies and qualitative assessment.
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Affiliation(s)
- Mark Svet
- School of Medicine, University of Colorado, Academic Office 1, Room 7019 12631 E. 17th Avenue, Mail Stop B130, Aurora, CO, 80045, USA
| | - Laura B Portalupi
- School of Medicine, University of Colorado, Academic Office 1, Room 7019 12631 E. 17th Avenue, Mail Stop B130, Aurora, CO, 80045, USA
| | | | - Daniel D Matlock
- School of Medicine, University of Colorado, Academic Office 1, Room 7019 12631 E. 17th Avenue, Mail Stop B130, Aurora, CO, 80045, USA
| | - Larry A Allen
- School of Medicine, University of Colorado, Academic Office 1, Room 7019 12631 E. 17th Avenue, Mail Stop B130, Aurora, CO, 80045, USA.
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19
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Rodriguez GM, Kumar D, Patel MI. "I Have Constant Fear": A National Qualitative Study on the Impact of COVID-19 on Cancer Care and Potential Solutions to Improve the Cancer Care Experience During the COVID-19 Pandemic. JCO Oncol Pract 2023:OP2200550. [PMID: 37155941 DOI: 10.1200/op.22.00550] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
Abstract
PURPOSE The COVID-19 pandemic has greatly affected cancer care delivery for patients, including cancellation or delays in surveillance imaging, clinic visits, and treatments. Yet, gaps remain in understanding the extent of the impact of the COVID-19 pandemic on patients with cancer and potential ways to overcome these impacts. METHODS We conducted semistructured, in-depth, one-on-one qualitative interviews among adults with a past or current history of cancer in the United States. Participants from a parent quantitative survey were purposively sampled to participate in a qualitative interview. Interview questions addressed (1) experiences with cancer care delivery during the COVID-19 pandemic; (2) unmet concerns regarding care and other impacts; and (3) approaches to improve patient experiences. We conducted inductive thematic analysis. RESULTS Fifty-seven interviews were conducted. Four themes emerged: (1) concern regarding the risk of COVID-19 infection among patients with cancer and their families; (2) disruptions in care increased patients' anxiety about poor cancer outcomes and death from cancer; (3) significant social and economic impacts; and (4) increased social isolation and anxiety about the future. Suggestions for current clinical practice include (1) clear communication on patients' health risks; (2) increased attention to mental health needs and access to mental health services; and (3) routine use of telemedicine as frequently as possible when clinically appropriate. CONCLUSION These rich findings reveal the significant impact of the COVID-19 pandemic on patients with cancer and potential approaches to mitigate the impact from the patient perspective. The findings not only inform current cancer care delivery but also health system responses to future public health or environmental crises that may pose a unique health risk for patients with cancer or disrupt their care.
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Affiliation(s)
- Gladys M Rodriguez
- Division of Oncology, Stanford University School of Medicine, Stanford, CA
| | - Dhanya Kumar
- University of Massachusetts Medical School, Worcester, MA
| | - Manali I Patel
- Division of Oncology, Stanford University School of Medicine, Stanford, CA
- Medical Services, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
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20
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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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21
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Wong LP, Alias H, Tan SL, Sia TE, Saw A. An Exploration of Death Anxiety of Family Members of Silent Mentor Body Donation Program. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221132902. [PMID: 36217612 DOI: 10.1177/00302228221132902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: This study assesses the level of death anxiety among the family members of the Silent Mentor Programme (SMP) and determines whether their participation in various ceremonies during the training session impacted their death anxiety. Methods: The revised Collett-Lester Fear of Death Scale (CL-FODS) was administered to the study participants before the opening ceremony and after the sending-off ceremony of the programme. Results: All the four subscales that measure fear of one's own death, fear of the process of one's own dying, fear of the death of others and fear of the process of others dying in the CL-FODS showed significant reduction after the sending-off ceremony compared with before the opening ceremony. Younger family members reported significantly higher mean total death anxiety scores compared to the older members. Conclusion: The SMP not only nurtures doctors with humanity but also helps the family members to cope with grief and loss.
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Affiliation(s)
- Li Ping Wong
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
- Unit of Silent Mentor Program, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Haridah Alias
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
- Unit of Silent Mentor Program, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Sik-Loo Tan
- Unit of Silent Mentor Program, Universiti Malaya, Kuala Lumpur, Malaysia
- Department of Orthopedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Thiam Eng Sia
- Unit of Silent Mentor Program, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Aik Saw
- Unit of Silent Mentor Program, Universiti Malaya, Kuala Lumpur, Malaysia
- Department of Orthopedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning, Universiti Malaya, Kuala Lumpur, Malaysia
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22
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Liu H, Liu X, Liu Z, Wang Y, Feng R, Zheng R, Xie R, Tao H, Wu Y, Li X, Ying W, Wu X. Death anxiety and its relationship with family function and meaning in life in patients with advanced cancer-A cross-sectional survey in China. Asia Pac J Oncol Nurs 2022; 9:100134. [PMID: 36204085 PMCID: PMC9529665 DOI: 10.1016/j.apjon.2022.100134] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 08/21/2022] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE This study explores the factors influencing death anxiety in patients with advanced cancer, and to investigate the role of family function on death anxiety, and the correlation between meaning in life and death anxiety. METHODS Patients with advanced cancer who were hospitalized in three institutions from November 2020 to May 2021 were recruited in this cross-sectional study. The Chinese version of the Death and Dying Distress Scale, Meaning in Life Scale For Advanced Cancer Patients and Family APGAR Index were used to assess death anxiety, meaning in life and family function. Pain symptoms were evaluated by the Numeric Rating Scale. Karnofsky Performance Status, patients' socio-demographic and clinical variables were also recorded. Statistical analyses were performed using IBM SPSS Statistics for Windows (version 26.0). Multivariate regression analysis was performed to examine the correlations of social-demographic and clinical variables with family function and death anxiety. RESULTS Three hundred and twenty-eight patients with advanced cancer were included in this study. The results showed that 12.2% of patients experienced moderate to severe death anxiety. Meaning in Life Scale For Advanced Cancer Patients (acceptance of death, controlling one's life), types of institution (oncology department of tertiary hospitals), self-perceived economic burden (extreme), Karnofsky Performance Status score, age, and medical insurance status (self-paid, inter-provincial medical insurance) were identified as associated factors of death anxiety (R 2 = 0.335, F = 20.072, P < 0.001). Patients with good family function scores had significantly low level of death anxiety in univariate analysis (F = 5.892, P = 0.003). Multivariate analysis revealed no significant association between family function and death anxiety. CONCLUSIONS Our results demonstrated that the oncology department of a tertiary hospital, extremely high of self-perceived economic burden, self-pay, and inter-provincial medical insurance might be associated with higher death anxiety in patients with advanced cancer. Lower level death anxiety was associated with higher level acceptance of death, a greater sense of life control, better physical performance, and older age. Further confirmation about the association between family function and death anxiety in patients with advanced cancer is warranted in the future.
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Affiliation(s)
- Hui Liu
- Nursing Department, Cancer Hospital of Shantou University Medical College, Shantou, China
| | - Xiaocheng Liu
- Nursing Department, Shenzhen Longhua Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Zhili Liu
- Nursing Department, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Yao Wang
- Shantou University Medical College, Shantou, China
| | - Ruiling Feng
- Shantou University Medical College, Shantou, China
| | - Ruihua Zheng
- Nursing Department, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Rongzhi Xie
- Nursing Department, The Fifth Affiliated Hospital of Sun-Yat-Sen University, Zhuhai, China
| | - Hongmei Tao
- Nursing Department, The Fifth Affiliated Hospital of Sun-Yat-Sen University, Zhuhai, China
| | - Yanchun Wu
- Nursing Department, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Xiaomin Li
- Shantou University Medical College, Shantou, China
| | - Wenjuan Ying
- Nursing Department, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Xiaoying Wu
- Nursing Department, Shantou Central Hospital, Shantou, China
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23
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Turan GB, Dural G. Does Spiritual Well-Being Affect Death Anxiety and Psychological Resilience in Cancer Patients? OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221129948. [PMID: 36154332 DOI: 10.1177/00302228221129948] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
This study was conducted to research the effects of spiritual well-being on death anxiety and psychological resilience in cancer patients. This cross-sectional, descriptive and correlational study was carried out with 260 cancer patients who were admitted to oncology and haematology outpatient clinic of a university hospital in east of Turkey between October 2021 and April 2022. The data were collected by using "Personal Information Form", "Spiritual Well-being Scale (FACIT-sp), Death Anxiety Scale (DAS) and The Brief Resilience Scale (BRS). It was found that mean DAS total score of cancer patients was 12.51 ± 3.39, while their mean FACIT-sp total score was 26.10 ± 6.93 and their mean BRS total score was 16.1 ± 7.05. It was found that FACIT-sp total score affected DAS and BRS total score positively, while DAS total score affected BRS total score negatively (p < .001). It was found that cancer patients had moderate level of spiritual well-being and psychological resilience and high level of death anxiety. It was also found that death anxiety and psychological resilience of cancer patients increased as their spiritual well-being levels increased. Psychological resilience was found to decrease as death anxiety increased.
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Affiliation(s)
- Gülcan B Turan
- Faculty of Health Sciences, Department of Nursing, Fırat University, Elazığ, Turkey
| | - Gül Dural
- Faculty of Health Sciences, Department of Nursing, Fırat University, Elazığ, Turkey
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