1
|
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; 68:e91-e115. [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] [MESH Headings] [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.
Collapse
Affiliation(s)
- Andrea Rodríguez-Prat
- Faculty of Humanities, Universitat Internacional de Catalunya (A.R.-P.), Josep Trueta s/n, Barcelona, Spain
| | - Denise Pergolizzi
- School of Medicine and Health Sciences, Universitat Internacional de Catalunya (D.P., J.J.-T., A.B.), Josep Trueta s/n, Barcelona, Spain
| | - Iris Crespo
- Department of Psychology, School of Medicine and Health Sciences, Universitat Internacional de Catalunya (I.C.), Josep Trueta s/n, Barcelona, Spain
| | - Joaquim Julià-Torras
- School of Medicine and Health Sciences, Universitat Internacional de Catalunya (D.P., J.J.-T., A.B.), Josep Trueta s/n, Barcelona, Spain; Department of Palliative Care, Institut Català d'Oncologia Badalona (J.J.-T.), Badalona, Spain
| | - Albert Balaguer
- School of Medicine and Health Sciences, Universitat Internacional de Catalunya (D.P., J.J.-T., A.B.), Josep Trueta s/n, Barcelona, Spain
| | - Kerstin Kremeike
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne (K.K., R.V.), Cologne, Germany
| | - Raymond Voltz
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne (K.K., R.V.), Cologne, Germany
| | - Cristina Monforte-Royo
- Department of Nursing, School of Medicine and Health Sciences, Universitat Internacional de Catalunya (C.M.-R.),Sant Cugat del Vallès Barcelona, Spain.
| |
Collapse
|
2
|
Rodríguez-Mayoral O, Galindo-Vázquez O, Espinoza-Bello M, Allende-Pérez S, Pascual-Ramos V, Monforte-Royo C. Validation of the Mexican version of the Schedule of Attitudes Toward Hastened Death in patients undergoing palliative care in Mexico. Palliat Support Care 2023; 21:850-855. [PMID: 37198955 DOI: 10.1017/s147895152300055x] [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: 05/19/2023]
Abstract
OBJECTIVES The Schedule of Attitudes Toward Hastened Death (SAHD) has emerged as a valid and reliable tool to assess the wish to hasten death (WTHD) among patients diagnosed with advanced cancer; however, the instrument has never been culturally adapted and validated for patients in Mexico. This study sought to validate and abbreviate the SAHD tool for use among patients attending the Palliative Care Service of the Instituto Nacional de Cancerología in Mexico. METHODS The SAHD was culturally adapted from a previously published validation in patients from Spain. Eligible patients included Spanish literate subjects treated as outpatients in the Palliative Care Service, with an Eastern Cooperative Oncology Group (ECOG) performance status of 0-3. Patients were asked to answer the Mexican version of SAHD (SAHD-Mx) instrument and the Brief Edinburgh Depression Scale (BEDS). RESULTS A total of 225 patients were included in the study. Median positive response in the SAHD-Mx was 2 (range 0-18). Positive correlation was identified between the SAHD-Mx scale and ECOG performance status (r = 0.188, p = 0.005), as well as BEDS (r = 0.567, p < 0.001). SAHD-Mx displayed strong internal consistency (alpha = 0.85) and adequate reliability from test-retest phone interviews (r = 0.567, p < 0.001). Using the confirmatory factor analysis model, a factor was identified and the number of items was reduced to 6, including items 4, 5, 9, 10, 13, and 18. SIGNIFICANCE OF RESULTS The SAHD-Mx emerges as an adequate tool, with appropriate psychometric characteristics, for assessing WTHD among patients diagnosed with cancer undergoing palliative care in Mexico. .
Collapse
Affiliation(s)
- Oscar Rodríguez-Mayoral
- Palliative Care Service, Instituto Nacional de Cancerología, Mexico City, Mexico
- Interdisciplinary Center for Bioethics, Universidad Panamericana, Mexico City, Mexico
| | | | - Marcos Espinoza-Bello
- Psycho-Oncology Service, Instituto Nacional de Cancerología, Mexico City, Mexico
- Faculty of Psychology, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Silvia Allende-Pérez
- Palliative Care Service, Instituto Nacional de Cancerología, Mexico City, Mexico
- Interdisciplinary Center for Bioethics, Universidad Panamericana, Mexico City, Mexico
| | - Virginia Pascual-Ramos
- Interdisciplinary Center for Bioethics, Universidad Panamericana, Mexico City, Mexico
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, México
| | - Cristina Monforte-Royo
- Department of Nursing, School of Medicine and Health Science, Universitat Internacional de Catalunya, Barcelona, Spain
| |
Collapse
|
3
|
Shim EJ, Ha H, Kim BR, Kim SM, Moon JY, Hwang JH, Hahm BJ. The Multi-dimensional Assessment of Suicide Risk in Chronic illness-20 (MASC-20): Development and validation. Gen Hosp Psychiatry 2023; 83:140-147. [PMID: 37187033 DOI: 10.1016/j.genhosppsych.2023.03.016] [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: 02/01/2023] [Revised: 03/24/2023] [Accepted: 03/28/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND We developed and tested the psychometric properties of the Multi-dimensional assessment of suicide risk in chronic illness-20 (MASC-20), which assess suicidal behavior (SB), and its associated distress in chronic physical illness (CPI). METHODS Items were developed by incorporating inputs from patient interviews, a review of existing instruments, and expert consultations. Pilot testing with 109 patients and field testing with 367 patients with renal, cardiovascular, and cerebrovascular diseases were conducted. We analyzed Time (T) 1 data to select items and T2 data to examine psychometric properties. RESULTS Forty preliminary items were selected through pilot testing; 20 were finalized from field testing. Optimal internal consistency (α = 0.94) and test-retest reliability (Intra class correlation coefficient = 0.92) of the MASC-20 supported reliability. Good fit of the four-factor model (physical distress, psychological distress, social distress, and SB) from exploratory structural equation modeling demonstrated factorial validity. Its correlations with MINI suicidality (r = 0.59) and the Schedule of Attitudes Toward Hastened Death-abbreviated scores (r = 0.62) indicated convergent validity. Higher MASC-20 scores in patients with clinical levels of depression and anxiety and low health status demonstrated known-group validity. The MASC-20 distress score predicted SB beyond known SB risk factors, supporting incremental validity. A cutoff score of 16 was optimal for identifying suicide risk. The area under the curve was within a moderately accurate range. The sum of sensitivity and specificity (1.66) indicated diagnostic utility. LIMITATIONS MASC-20's applicability to other patient populations and its sensitivity to change requires testing. CONCLUSIONS The MASC-20 appears to be a reliable and valid tool for assessing SB in CPI.
Collapse
Affiliation(s)
- Eun-Jung Shim
- Department of Psychology, Pusan National University, Busan, Republic of Korea
| | - Hyeju Ha
- Department of Psychology, Pusan National University, Busan, Republic of Korea
| | - Bo-Ram Kim
- Department of Rehabilitation Medicine, Gyeongin Regional Rehabilitation Hospital, Incheon, Republic of Korea
| | - Sun Mi Kim
- Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Jung Yoon Moon
- Department of Psychiatry, Chamjoeun Hospital, Gwangju-si, Gyeongi-do, Republic of Korea
| | - Jin Ho Hwang
- Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Republic of Korea
| | - Bong-Jin Hahm
- Department of Psychiatry and Behavioral Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University, Seoul, Republic of Korea.
| |
Collapse
|
4
|
Shao J, Chang ES, Tsong Y, Chen C, Borelli JL. The mother-daughter Shared Agency in Weight Management Scale (SAWMS): development, validation, and implications for body dissatisfaction. J Eat Disord 2023; 11:27. [PMID: 36803452 PMCID: PMC9942406 DOI: 10.1186/s40337-023-00747-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 02/03/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Much research suggests that mothers play an important role in shaping daughters' body image, yet less is known about how mother-daughter relationship dynamics in weight management affect daughters' body dissatisfaction. The current paper described the development and validation of the mother-daughter Shared Agency in Weight Management Scale (SAWMS) and examined its associations with daughter's body dissatisfaction. METHODS In Study 1 (N = 676 college students), we explored the factor structure of the mother-daughter SAWMS and identified three processes (control, autonomy support, and collaboration) whereby mothers work with daughters in weight management. In Study 2 (N = 439 college students), we finalized the factor structure of the scale by conducting two CFAs and assessing the test-retest reliability of each subscale. In Study 3 (same sample as Study 2), we examined the psychometric properties of the subscales and their associations with daughters' body dissatisfaction. RESULTS Combining results from EFA and IRT, we identified three mother-daughter dynamics in weight management-maternal control, maternal autonomy support, and maternal collaboration. However, based on various empirical results indicating poor psychometric properties of the maternal collaboration subscale, we removed it from the mother-daughter SAWMS and only evaluated the psychometric properties of the remaining two subscales (i.e., control and autonomy support). They explained a significant amount of variance in daughters' body dissatisfaction over and above the effect of maternal pressure to be thin. Maternal control was a significant and positive predictor of daughters' body dissatisfaction; maternal autonomy support was a significant and negative predictor. CONCLUSIONS Results suggested that maternal control in weight management was associated with daughters' increased body dissatisfaction, whereas maternal autonomy support in weight management was associated with daughters' lower body dissatisfaction. These specific ways in which mother work with daughters in weight management provide nuances in understanding young women's body dissatisfaction. Our SAWMS offers new ways to examine body image among young women through the mother-daughter relationship dynamics in weight management.
Collapse
Affiliation(s)
- Jianmin Shao
- Department of Psychological Science, 4201 Social and Behavioral Sciences Gateway, University of California, Irvine, Irvine, CA, 92697-7085, USA.
| | - Esther S Chang
- Social and Behavioral Sciences Division, Soka University of America, Aliso Viejo, CA, USA
| | - Yuying Tsong
- Department of Human Services, California State University, Fullerton, Fullerton, CA, USA
| | - Chuansheng Chen
- Department of Psychological Science, 4201 Social and Behavioral Sciences Gateway, University of California, Irvine, Irvine, CA, 92697-7085, USA
| | - Jessica L Borelli
- Department of Psychological Science, 4201 Social and Behavioral Sciences Gateway, University of California, Irvine, Irvine, CA, 92697-7085, USA
| |
Collapse
|
5
|
Ghoshal A, O'Carroll RE, Ferguson E, Shepherd L, Doherty S, Mathew M, Morgan K, Doyle F. Assessing medical mistrust in organ donation across countries using item response theory. J Health Psychol 2021; 27:2806-2819. [PMID: 34963351 DOI: 10.1177/13591053211064985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Although medical mistrust (MM) may be an impediment to public health interventions, no MM scale has been validated across countries and the assessment of MM has not been explored using item response theory, which allows generalisation beyond the sampled data. We aimed to determine the dimensionality of a brief MM measure across four countries through Mokken analysis and Graded Response Modelling. Analysis of 1468 participants from UK (n = 1179), Ireland (n = 191), India (n = 49) and Malaysia (n = 49) demonstrated that MM items formed a hierarchical, unidimensional measure, which is very informative about high levels of MM. Possible item reduction and scoring changes were also demonstrated. This study demonstrates that this brief MM measure is suitable for international studies as it is unidimensional across countries, cross cultural, and shows that minor adjustments will not impact on the assessment of MM when using these items.
Collapse
Affiliation(s)
- Arunangshu Ghoshal
- Tata Memorial Centre, India.,Homi Bhaba National Institute (HBNI), India
| | | | | | | | | | | | - Karen Morgan
- Perdana University-Royal College of Surgeons in Ireland School of Medicine, Malaysia
| | - Frank Doyle
- Royal College of Surgeons in Ireland, Ireland
| |
Collapse
|
6
|
Li M, Shapiro GK, Klein R, Barbeau A, Rydall A, Bell JAH, Nissim R, Hales S, Zimmermann C, Wong RKS, Rodin G. Medical Assistance in Dying in patients with advanced cancer and their caregivers: a mixed methods longitudinal study protocol. BMC Palliat Care 2021; 20:117. [PMID: 34289838 PMCID: PMC8296526 DOI: 10.1186/s12904-021-00793-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 06/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The legal criteria for medical assistance in dying (MAiD) for adults with a grievous and irremediable medical condition were established in Canada in 2016. There has been concern that potentially reversible states of depression or demoralization may contribute to the desire for death (DD) and requests for MAiD. However, little is known about the emergence of the DD in patients, its impact on caregivers, and to what extent supportive care interventions affect the DD and requests for MAiD. The present observational study is designed to determine the prevalence, predictors, and experience of the DD, requests for MAiD and MAiD completion in patients with advanced or metastatic cancer and the impact of these outcomes on their primary caregivers. METHODS A cohort of patients with advanced or metastatic solid tumour cancers and their primary caregivers will be recruited from a large tertiary cancer centre in Toronto, Ontario, Canada, to a longitudinal, mixed methods study. Participants will be assessed at baseline for diagnostic information, sociodemographic characteristics, medical history, quality of life, physical and psychological distress, attitudes about the DD and MAiD, communication with physicians, advance care planning, and use of psychosocial and palliative care interventions. Measures will subsequently be completed every six months and at the time of MAiD requests. Quantitative assessments will be supplemented by qualitative interviews in a subset of participants, selected using quota sampling methods. DISCUSSION This study has the potential to add importantly to our understanding of the prevalence and determinants of the DD, MAiD requests and completions in patients with advanced or metastatic cancer and of the experience of both patients and caregivers in this circumstance. The findings from this study may also assist healthcare providers in their conversations about MAiD and the DD with patients and caregivers, inform healthcare providers to ensure appropriate access to MAiD, and guide modifications being considered to broaden MAiD legislation and policy.
Collapse
Affiliation(s)
- Madeline Li
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, 620 University Avenue, 12th Floor, Toronto, Ontario M5G 2C1 Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario Canada
| | - Gilla K. Shapiro
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, 620 University Avenue, 12th Floor, Toronto, Ontario M5G 2C1 Canada
- Global Institute of Psychosocial, Palliative and End-of-Life Care (GIPPEC), University of Toronto and Princess Margaret Cancer Centre, Toronto, Ontario Canada
| | - Roberta Klein
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, 620 University Avenue, 12th Floor, Toronto, Ontario M5G 2C1 Canada
| | - Anne Barbeau
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, 620 University Avenue, 12th Floor, Toronto, Ontario M5G 2C1 Canada
| | - Anne Rydall
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, 620 University Avenue, 12th Floor, Toronto, Ontario M5G 2C1 Canada
| | - Jennifer A. H. Bell
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, 620 University Avenue, 12th Floor, Toronto, Ontario M5G 2C1 Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario Canada
- Joint Centre for Bioethics, University of Toronto, Toronto, Ontario Canada
| | - Rinat Nissim
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, 620 University Avenue, 12th Floor, Toronto, Ontario M5G 2C1 Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario Canada
| | - Sarah Hales
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, 620 University Avenue, 12th Floor, Toronto, Ontario M5G 2C1 Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario Canada
- Global Institute of Psychosocial, Palliative and End-of-Life Care (GIPPEC), University of Toronto and Princess Margaret Cancer Centre, Toronto, Ontario Canada
| | - Camilla Zimmermann
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, 620 University Avenue, 12th Floor, Toronto, Ontario M5G 2C1 Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario Canada
- Global Institute of Psychosocial, Palliative and End-of-Life Care (GIPPEC), University of Toronto and Princess Margaret Cancer Centre, Toronto, Ontario Canada
- Department of Medicine, University of Toronto, Toronto, Ontario Canada
| | - Rebecca K. S. Wong
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, 620 University Avenue, 12th Floor, Toronto, Ontario M5G 2C1 Canada
- Department of Radiation Oncology, University of Toronto, Toronto, Ontario Canada
| | - Gary Rodin
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, 620 University Avenue, 12th Floor, Toronto, Ontario M5G 2C1 Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario Canada
- Global Institute of Psychosocial, Palliative and End-of-Life Care (GIPPEC), University of Toronto and Princess Margaret Cancer Centre, Toronto, Ontario Canada
| |
Collapse
|
7
|
Philipp R, Kalender A, Härter M, Bokemeyer C, Oechsle K, Koch U, Vehling S. Existential distress in patients with advanced cancer and their caregivers: study protocol of a longitudinal cohort study. BMJ Open 2021; 11:e046351. [PMID: 33895716 PMCID: PMC8074557 DOI: 10.1136/bmjopen-2020-046351] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION At the end of life, patients with advanced cancer and their informal caregivers may confront multiple existential concerns. Despite the strong potential to alleviate existential distress through psychosocial interventions, existential distress and its impact on healthcare outcomes have not yet been studied systematically. We aim to investigate the frequency, longitudinal trajectory and predictive impact of existential distress on end-of-life outcomes. We further aim to determine patients' and caregivers' specific need for and utilisation of psychosocial support for existential distress. METHODS This longitudinal cohort study will consecutively recruit 500 patients with advanced cancer and 500 caregivers from oncological outpatient and inpatient clinics. Participants will complete self-report questionnaires (sociodemographic and disease-related characteristics, existential distress, end-of-life outcomes, resources and support needs) at five points of assessment (at baseline and after 3, 6, 9 and 12 months). At baseline and 6-month follow-up, we will conduct structured diagnostic interviews to assess mental disorders. Statistical analyses will include descriptive statistics to determine the prevalence of existential distress, mental disorders and end-of-life outcomes; multiple linear and logistic regression analyses to calculate the predictive impact of existential distress on end-of-life outcomes; and growth mixture models to analyse longitudinal trajectories of existential distress. DISCUSSION This study will provide comprehensive knowledge about patients' and caregivers' existential concerns. The longitudinal empirical data will allow for conclusions concerning the frequency and course of existential distress throughout 1 year. This important extension of existing cross-sectional research will contribute to further develop targeted psychosocial interventions. Profiles of existential distress may be applied by clinicians from multiple professions and help to address existential concerns effectively. ETHICS AND DISSEMINATION The study was approved by the institutional research ethics committee (reference number LPEK-0177). Results will be presented at scientific conferences and published in peer-reviewed journals. Other forms of dissemination will include sharing results on the psychometric properties of the structured demoralisation interview with international research groups and communication with healthcare professionals providing psychosocial treatment for patients and caregivers. Following scientific standards, our progress will be regularly updated on ClinicalTrials.gov. TRIAL REGISTRATION NUMBER NCT04600206.
Collapse
Affiliation(s)
- Rebecca Philipp
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anna Kalender
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Oncology, Hematology, and Bone Marrow Transplantation with Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Härter
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carsten Bokemeyer
- Department of Oncology, Hematology, and Bone Marrow Transplantation with Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Karin Oechsle
- Department of Oncology, Hematology, and Bone Marrow Transplantation with Section of Pneumology, Palliative Care Unit, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Uwe Koch
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sigrun Vehling
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Oncology, Hematology, and Bone Marrow Transplantation with Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
8
|
Dürst A, Spencer B, Büla C, Fustinoni S, Mazzocato C, Rochat E, Rubli Truchard E, Monod S, Jox RJ. Wish to Die in Older Patients: Development and Validation of Two Assessment Instruments. J Am Geriatr Soc 2020; 68:1202-1209. [DOI: 10.1111/jgs.16392] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 01/27/2020] [Accepted: 02/06/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Anne‐Véronique Dürst
- Service of Geriatric Medicine & Geriatric Rehabilitation University of Lausanne Hospital (CHUV) Lausanne Switzerland
| | - Brenda Spencer
- Centre for Primary Care and Public Health (Unisanté) University of Lausanne Lausanne Switzerland
| | - Christophe Büla
- Service of Geriatric Medicine & Geriatric Rehabilitation University of Lausanne Hospital (CHUV) Lausanne Switzerland
| | - Sarah Fustinoni
- Centre for Primary Care and Public Health (Unisanté) University of Lausanne Lausanne Switzerland
| | - Claudia Mazzocato
- Service of Palliative and Supportive Care Lausanne University Hospital (CHUV) Lausanne Switzerland
| | - Etienne Rochat
- Institute of Humanities in Medicine Lausanne University Hospital (CHUV) and University of Lausanne Lausanne Switzerland
| | - Eve Rubli Truchard
- Service of Geriatric Medicine & Geriatric Rehabilitation University of Lausanne Hospital (CHUV) Lausanne Switzerland
- Chair in Geriatric Palliative Care Lausanne University Hospital (CHUV) and University of Lausanne Lausanne Switzerland
| | - Stéfanie Monod
- General Health Department Ministry of Health and Social Action Lausanne Switzerland
| | - Ralf J. Jox
- Service of Palliative and Supportive Care Lausanne University Hospital (CHUV) Lausanne Switzerland
- Institute of Humanities in Medicine Lausanne University Hospital (CHUV) and University of Lausanne Lausanne Switzerland
- Chair in Geriatric Palliative Care Lausanne University Hospital (CHUV) and University of Lausanne Lausanne Switzerland
| |
Collapse
|
9
|
Ohnsorge K, Rehmann-Sutter C, Streeck N, Gudat H. Wishes to die at the end of life and subjective experience of four different typical dying trajectories. A qualitative interview study. PLoS One 2019; 14:e0210784. [PMID: 30653575 PMCID: PMC6336242 DOI: 10.1371/journal.pone.0210784] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 12/21/2018] [Indexed: 12/11/2022] Open
Abstract
RESEARCH AIMS The motivations that lead to wishes to die (WTD) in palliative care patients with cancer are relatively well studied. But little is known about WTD in other pathologies and the relation between subjective understandings of dying trajectories and a WTD. We investigated the WTD of palliative patients in four different dying trajectories: neurological diseases, organ failure, frailty due to age, and cancer. STUDY POPULATION 62 palliative cancer (n = 30) and non-cancer (n = 32) patients (10 neurological disease; 11 organ failure; 11 frailty), their families and health professionals in different palliative care settings (248 interviews). STUDY DESIGN AND METHODS Qualitative semi-structured interviews. Data analysis through Interpretive Phenomenological Analysis and Grounded Theory. RESULTS In addition to personal motivations, we found that people dealing with similar trajectories were often confronted with similar questions and concerns due to similar challenges. For four trajectories we show typical patterns, similarities and differences that should be considered when talking with patients about their WTD. These illness-related considerations do not explain the WTD completely, but give important information on the challenges for particular patient groups that might experience a WTD. In all patient groups, there were clear moments that triggered a WTD: for neurological patients it was experiencing breathlessness, high-dependency care, or when considering tube feeding or respiratory support; for persons with organ failure it was an acute burdensome crisis; for patients with cancer after the initial diagnosis, it was the first relapse or the move into advanced palliative care; for elderly frail persons it was the move into care facilities, or the loss of important relationships or capabilities. The feeling of being a burden to others was reported in all patient groups. INTERPRETATION WTD can be triggered within disease trajectories by specific conditions and transitional points that affect agency and self-understanding. A better understanding of the concerns and challenges of a particular dying trajectory as well as its characteristic trigger points can facilitate early and comprehensive communication about patients' WTD, and the underlying motivations and protective factors.
Collapse
Affiliation(s)
- Kathrin Ohnsorge
- Hospiz im Park, Hospital for Palliative Care, Arlesheim, Switzerland
| | | | - Nina Streeck
- Institute of Biomedical Ethics and History of Medicine, University of Zurich, Zurich, Switzerland
| | - Heike Gudat
- Hospiz im Park, Hospital for Palliative Care, Arlesheim, Switzerland
| |
Collapse
|
10
|
Bellido-Pérez M, Crespo I, Wilson KG, Porta-Sales J, Balaguer A, Monforte-Royo C. Assessment of the wish to hasten death in patients with advanced cancer: A comparison of 2 different approaches. Psychooncology 2018; 27:1538-1544. [DOI: 10.1002/pon.4689] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 02/19/2018] [Accepted: 02/19/2018] [Indexed: 12/11/2022]
Affiliation(s)
- Mercedes Bellido-Pérez
- Department of Nursing; School of Medicine and Health Sciences; Universitat Internacional de Catalunya; Barcelona Spain
- Primary Health Care Center Esparreguera; Institut Català de la Salut; Barcelona Spain
| | - Iris Crespo
- School of Medicine and Health Sciences; Universitat Internacional de Catalunya; Barcelona Spain
| | - Keith G. Wilson
- Department of Psychology; Ottawa Hospital Rehabilitation Centre; Ottawa Ontario Canada
| | - Josep Porta-Sales
- School of Medicine and Health Sciences; Universitat Internacional de Catalunya; Barcelona Spain
- Palliative Care Service, Institut Català d'Oncologia; l'Hospitalet de Llobregat; Barcelona Spain
| | - Albert Balaguer
- School of Medicine and Health Sciences; Universitat Internacional de Catalunya; Barcelona Spain
| | - Cristina Monforte-Royo
- Department of Nursing, School of Medicine and Health Sciences; Universitat Internacional de Catalunya; Barcelona Spain
| |
Collapse
|
11
|
Monforte-Royo C, González-de Paz L, Tomás-Sábado J, Rosenfeld B, Strupp J, Voltz R, Balaguer A. Development of a short form of the Spanish schedule of attitudes toward hastened death in a palliative care population. Qual Life Res 2016; 26:235-239. [PMID: 27671489 PMCID: PMC5243867 DOI: 10.1007/s11136-016-1409-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2016] [Indexed: 11/25/2022]
Abstract
PURPOSE The schedule of attitudes toward hastened death (SAHD) is widely used to assess the wish to hasten death (WTHD) among patients with life-threatening conditions. A short form of the SAHD would increase its clinical applicability in this population. METHOD Rasch analysis of data from 101 Spanish palliative inpatients. Item reduction involved selecting items with a high discrimination index (point-biserials ≥0.70), removing items with inadequate fit statistics, and assessing unidimensionality and local dependency. We examined the test probability function to establish an empirical risk score for suffering a WTHD and tested convergence between the original and the reduced set of items. RESULTS A set of five items met all quality criteria. In this sample, 20.8 % of participants had a higher risk of a WTHD (p > 50 %) at a score of 3. Correlation analysis confirmed convergent validity between the original and reduced forms. Concurrent validity was confirmed by the similar correlations shown by both versions of the SAHD (5 and 20 items) with other measures. CONCLUSION This 5-item Spanish form of the SAHD could be a suitable alternative to the full instrument. The cut-off score derived from the Rasch analysis may be able to detect patients at risk of a WTHD.
Collapse
Affiliation(s)
- Cristina Monforte-Royo
- Department of Nursing, School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallés, Barcelona, Spain
| | - Luis González-de Paz
- Public Health Unit, School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallés, Barcelona, Spain
- Centre d'Atenció Primària Les Corts. Transverse Group for Research in Primary Care, IDIBAPS, Barcelona, Spain
| | - Joaquín Tomás-Sábado
- Escola Universitària d'Infermeria Gimbernat, Autonomous University of Barcelona, Barcelona, Spain
| | - Barry Rosenfeld
- Department of Psychology, Fordham University, Bronx, NY, USA
| | - Julia Strupp
- Department of Palliative Medicine, University Hospital of Cologne, Cologne, Germany
| | - Raymond Voltz
- Department of Palliative Medicine, University Hospital of Cologne, Cologne, Germany
| | - Albert Balaguer
- School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Josep Trueta s/n, 08195, Sant Cugat del Vallès, Barcelona, Spain.
| |
Collapse
|