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Walbaum C, Philipp R, Bokemeyer C, Härter M, Junghans J, Koch U, Oechsle K, Schilling G, Vehling S. Death Anxiety in Patients With Advanced Cancer and Their Family Caregivers. J Pain Symptom Manage 2024:S0885-3924(24)00957-6. [PMID: 39182590 DOI: 10.1016/j.jpainsymman.2024.08.027] [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: 06/07/2024] [Revised: 08/09/2024] [Accepted: 08/12/2024] [Indexed: 08/27/2024]
Abstract
CONTEXT Death anxiety is associated with fears of suffering and uncertainty at the end of life. It is also relevant to patients' family caregivers, who can experience fears about the patients' death and dying. OBJECTIVES This study investigates the prevalence of death anxiety in advanced cancer patients and their family caregivers and its association with sociodemographic and medical characteristics. METHODS We recruited patients with UICC stage IV solid tumors from in- and outpatient oncology and palliative care settings. We administered the Death and Dying Distress Scale to assess clinically significant death anxiety. We analyzed its association with sociodemographic and medical characteristics using simultaneous multiple linear regression analyses. RESULTS Death anxiety was prevalent in 37% of patients (N = 481) and 75% of family caregivers (N = 140). Most frequent death anxiety concerns were "feeling distressed about the impact of one's own death on loved ones" (52% of patients) and "feeling distressed about running out of time with their loved one" (69% of family caregivers). Patients who experienced high death anxiety were more likely to be younger (standardized β = -0.1; P=0.005) and have known about their diagnosis for less time (standardized β = -0.1; P=0.046). Being female predicted higher death anxiety in patients (β = 0.12; P=0.041) and family caregivers (β = 0.32; P=0.002). CONCLUSION The results indicate that death anxiety is a common, clinically significant problem in patients with advanced cancer and their family caregivers, emphasizing the need for targeted psychological support.
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Affiliation(s)
- Charlotte Walbaum
- Department of Medical Psychology (C.W., R.P., M.H., J.J., U.K., S.V.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Oncology, Hematology and Bone Marrow Transplantation with Section of Pneumology (C.W., C.B., K.O., S.V.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Rebecca Philipp
- Department of Medical Psychology (C.W., R.P., M.H., J.J., U.K., S.V.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carsten Bokemeyer
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section of Pneumology (C.W., C.B., K.O., S.V.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Härter
- Department of Medical Psychology (C.W., R.P., M.H., J.J., U.K., S.V.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Johanna Junghans
- Department of Medical Psychology (C.W., R.P., M.H., J.J., U.K., S.V.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Uwe Koch
- Department of Medical Psychology (C.W., R.P., M.H., J.J., U.K., S.V.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Karin Oechsle
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section of Pneumology (C.W., C.B., K.O., S.V.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Georgia Schilling
- Department of Oncology, Asklepios Tumor Center Hamburg (G.S.), Hamburg, Germany
| | - Sigrun Vehling
- Department of Medical Psychology (C.W., R.P., M.H., J.J., U.K., S.V.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Oncology, Hematology and Bone Marrow Transplantation with Section of Pneumology (C.W., C.B., K.O., S.V.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Brechbiel JK, Willis KD, Reid MP, Lanoye A, Aslanzadeh FJ, Fox AM, Braun SE, Loughan AR. Primary brain tumor representation in the post-traumatic growth literature: A scoping review. Neurooncol Pract 2024; 11:26-35. [PMID: 38222049 PMCID: PMC10785581 DOI: 10.1093/nop/npad058] [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: 01/16/2024] Open
Abstract
Background Post-traumatic growth (PTG) has been extensively explored within general oncology, yet little is known about the experience of PTG in neuro-oncology. This study aimed to determine the representation of patients with primary brain tumors (PBT) in the PTG literature. Methods PsycINFO, PubMed, and CINAHL were systematically searched from inception to December 2022. Search terms were related to personal growth and positive reactions to cancer. Articles were first screened by titles and abstracts, then full texts were reviewed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method. Results A total of 382 articles met the inclusion criteria. Of those, 13 included patients with PBT. Over 100 000 cancer patients were represented, with 0.79% having a PBT. Most research focused on low-grade gliomas. PTG negatively correlated with post-traumatic stress symptoms and avoidant coping. In the sole longitudinal study, patients with PBT demonstrated improved PTG after 1 year. Three quasi-experimental studies investigated the effect of mindfulness-based interventions with mixed-cancer samples and demonstrated improvement in PTG. Conclusions The inclusion rate of patients with PBT in the PTG literature was significantly lower than the population prevalence rate (1.3% of cancer diagnoses). Relatively few studies focused exclusively on how patients with PBT experience PTG (k = 5), and those that did only included low-grade glioma. The experience of PTG in those with high-grade glioma remains unknown. Patients with PBT are scarcely included in research on PTG interventions. Few studies examined the relationship between PTG and medical, cognitive, or psychological characteristics. Our understanding of the PTG experience in neuro-oncology remains extremely limited.
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Affiliation(s)
- Julia K Brechbiel
- Department of Psychiatry and Behavioral Science, University of Washington, Seattle, Washington, USA
| | - Kelcie D Willis
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Morgan P Reid
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Autumn Lanoye
- School of Medicine, Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia, USA
- Massey Cancer Center, Richmond, Virginia, USA
| | - Farah J Aslanzadeh
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Amber M Fox
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Sarah Ellen Braun
- Massey Cancer Center, Richmond, Virginia, USA
- Department of Neurology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Ashlee R Loughan
- Massey Cancer Center, Richmond, Virginia, USA
- Department of Neurology, Virginia Commonwealth University, Richmond, Virginia, USA
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Willis K, Ravyts SG, Lanoye A, Reid MP, Aslanzadeh FJ, Braun SE, Svikis D, Rodin G, Loughan AR. Measuring and understanding death anxiety in caregivers of patients with primary brain tumor. Palliat Support Care 2023; 21:812-819. [PMID: 35975283 PMCID: PMC9935750 DOI: 10.1017/s1478951522001110] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Caregivers of patients with primary brain tumor (PBT) describe feeling preoccupied with the inevitability of their loved one's death. However, there are currently no validated instruments to assess death anxiety in caregivers. This study sought to examine (1) the psychometric properties of the Death and Dying Distress Scale (DADDS), adapted for caregivers (DADDS-CG), and (2) the prevalence and correlates of death anxiety in caregivers of patients with PBT. METHODS Caregivers (N = 67) of patients with PBT completed the DADDS-CG, Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder (GAD-7), Fear of Cancer Recurrence (FCR-7), and God Locus of Health Control (GLHC). Caregivers' sociodemographic information and patients' medical characteristics were also collected. Preliminary examination of the psychometric properties of the DADDS-CG was conducted using exploratory factor analysis, Cronbach's alpha, and correlations. The prevalence and risk factors of death anxiety were assessed using frequencies, pair-wise comparisons, and correlations. RESULTS Factor analysis of the DADDS-CG revealed a two-factor structure consistent with the original DADDS. The DADDS-CG demonstrated excellent internal consistency, convergent validity with the PHQ-9, GAD-7, and FCR-7, and discriminant validity with the GLHC. Over two-thirds of caregivers reported moderate-to-severe symptoms of death anxiety. Death anxiety was highest in women and caregivers of patients with high-grade PBT. SIGNIFICANCE OF RESULTS The DADDS-CG demonstrates sound psychometric properties in caregivers of patients with PBT, who report high levels of death anxiety. Further research is needed to support the measure's value in clinical care and research - both in this population and other caregivers - in order to address this unmet, psychosocial need.
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Affiliation(s)
- Kelcie Willis
- Department of Psychology, Virginia Commonwealth University, Richmond, VA
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA
| | - Scott G. Ravyts
- Department of Psychology, Virginia Commonwealth University, Richmond, VA
| | - Autumn Lanoye
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA
- Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, VA
| | - Morgan P. Reid
- Department of Psychology, Virginia Commonwealth University, Richmond, VA
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA
| | | | - Sarah Ellen Braun
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA
- Department of Neurology, Virginia Commonwealth University, Richmond, VA
| | - Dace Svikis
- Department of Psychology, Virginia Commonwealth University, Richmond, VA
| | - Gary Rodin
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Ashlee R. Loughan
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA
- Department of Neurology, Virginia Commonwealth University, Richmond, VA
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Andrei AM, Webb R, Enea V. Health anxiety, death anxiety and coronaphobia: Predictors of postpartum depression symptomatology during the COVID-19 pandemic. Midwifery 2023; 124:103747. [PMID: 37276749 PMCID: PMC10229209 DOI: 10.1016/j.midw.2023.103747] [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: 02/02/2022] [Revised: 03/07/2023] [Accepted: 05/26/2023] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To determine levels of postpartum depression symptoms and possible relevant predictors, such as death anxiety, health anxiety, and coronavirus-related anxiety. DESIGN Cross-sectional web-based survey using quantitative methods. SETTING Exclusively online recruiting via social media and unpaid cross-posting conducted during the third wave of the COVID-19 pandemic in Romania. PARTICIPANTS Women were eligible to take part in the study if they were mothers over the age of 18 and had a baby aged between 4 weeks - 12 months of age; 1024 women were included in the final sample. MEASUREMENTS AND FINDINGS Health anxiety, death anxiety, coronavirus-related anxiety, and postpartum depression symptoms were measured using validated instruments. Current depression symptomatology was 67.6%, 26.7% scored above the cut-off for high health anxiety, 1% for coronavirus-related anxiety, and 62.7% for death anxiety. Significant predictors for depressive symptomatology were breastfeeding, history of depression, family income, number of children, health anxiety, death anxiety, and coronavirus anxiety. Further, hierarchical multiple regression analysis indicated that death anxiety, health anxiety, and coronavirus anxiety predicted postpartum depression symptoms over and above socio-demographic factors. KEY CONCLUSIONS Supported by previous studies, our results suggest that postpartum depression symptomatology levels during the COVID-19 pandemic are high and that they are predicted by health and death anxiety, which are also increased during the pandemic. IMPLICATION FOR PRACTICE The findings provide information to identify the risk for depression symptoms in postpartum mothers during acute public health situations.
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Affiliation(s)
- Ana-Maria Andrei
- Department of Psychology, Alexandru Ioan Cuza University, Iaşi, Romania
| | | | - Violeta Enea
- Department of Psychology, Alexandru Ioan Cuza University, Iaşi, Romania.
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Letzner RD. Death anxiety in connection to anxiety and depressive disorders: A meta-analysis on emotional distress in clinical and community samples. DEATH STUDIES 2023; 48:393-406. [PMID: 37416947 DOI: 10.1080/07481187.2023.2230556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
Awareness of one's mortality bears noteworthy implications on psychological functioning, proposing death anxiety as a transdiagnostic construct, with connections to psychopathology. The present meta-analysis investigates the relationship between death anxiety, depression, and anxiety disorders, as well as in symptomatology labeled as emotional distress. A random-effects model was used for extracting the effect size from 105 selected studies, comprising both clinical and community samples (N = 11,803). Results revealed a large overall effect size, g = 1.47 (95% CI [1.27; 1.67]), and a higher effect size favoring anxiety disorders. The instruments evaluating death anxiety and the presence of chronic conditions moderated the relationship. A higher effect size was observed for instruments other than Templer's Death Anxiety Scale, and for participants with chronic/terminal illness compared to healthy samples. Overall, the results highlight the need for a transdiagnostic perspective on death anxiety, as well as for reaching a consensus regarding its conceptualization and measurement.
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Affiliation(s)
- Ramona D Letzner
- Department of Psychology and Cognitive Sciences, University of Bucharest, Bucharest, Romania
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Patra I, Muda I, Ketut Acwin Dwijendra N, Najm MAA, Hamoud Alshahrani S, Sajad Kadhim S, Hameed NM, Alnassar YS, Mohammed NM, Mustafa YF, Shojaeimotlagh V. A Systematic Review and Meta-Analysis on Death Anxiety During COVID-19 Pandemic. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228221144791. [PMID: 37384902 PMCID: PMC10311374 DOI: 10.1177/00302228221144791] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
This systematic review was conducted to estimate the pooled score of death anxiety during the COVID-19 pandemic. All eligible articles from January 2020 to May 2022 reporting the death anxiety score were included in the analysis b.y searching the Scopus, PubMed, Embase, and ISI databases. The standard score of death anxiety in the COVID-19 pandemic was 50%. The highest score of death anxiety was related to patients with COVID-19 (59.4%), other chronic patients (58.9%), and the elderly (56.4%). The lowest death anxiety score was related to the general population (42.9%) and health care workers (48.2%). The death anxiety score in the studies whose data was collected in 2020 and 2021 was 51% and 62%, respectively. During the COVID-19 pandemic, people experienced high death anxiety, which had terrible effects on their lives. Therefore, it seems necessary to provide training courses to deal with death anxiety for other possible pandemics.
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Affiliation(s)
- Indrajit Patra
- An Independent Researcher, PhD from NIT Durgapur, Durgapur, West Bengal, India
| | - Iskandar Muda
- Faculty Economic and Business, Department of Doctoral Program, Universitas Sumatera Utara, Medan, Indonesia
| | | | - Mazin AA. Najm
- Pharmaceutical Chemistry Department, College of Pharmacy, Al-Ayen University, Thi-Qar, Iraq
| | | | - Samah Sajad Kadhim
- Medical Laboratory Techniques Department, Al-Mustaqbal University College, Babylon, Iraq
| | | | | | | | - Yasser Fakri Mustafa
- Department of Pharmaceutical Chemistry, College of Pharmacy, University of Mosul, Mosul, Iraq
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Lobb EA, Halkett GKB, McDougall E, Campbell R, Dhillon HM, Phillips JL, Nowak AK. Bereavement outcomes of carers of patients with high grade glioma: Experiences of support before and after the death. DEATH STUDIES 2023:1-10. [PMID: 36786747 DOI: 10.1080/07481187.2023.2167888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Carers of people with High Grade Glioma (HGG) completed a survey assessing their anxiety, depression, and grief in addition to open-ended questions exploring their experiences of support pre- and post-death (N = 25). One-third reported borderline or clinical levels of anxiety, depression, and grief related distress. Given the poor prognosis and rapid deterioration of patients with HGG, the findings highlight the importance of sensitive communication about prognosis early in the disease trajectory, information tailored to disease stage, the initiation of a referral to psychological support services, and timely discussions about the preferred place of care and death.
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Affiliation(s)
- Elizabeth A Lobb
- Calvary Health Care Kogarah, Sydney, Australia
- School of Medicine, The University of Notre Dame, Sydney, Australia
- Faculty of Health, University of Technology Sydney, Ultimo, Australia
| | - Georgia K B Halkett
- Faculty of Health Sciences, Curtin School of Nursing/Curtin Health Innovation Research Institute, Curtin University, Bentley, Australia
| | - Emma McDougall
- Faculty of Health Sciences, Curtin School of Nursing/Curtin Health Innovation Research Institute, Curtin University, Bentley, Australia
| | - Rachel Campbell
- Psycho-Oncology Cooperative Research Group, Faculty of Science, School of Psychology, University of Sydney, Sydney, Australia
| | - Haryana M Dhillon
- Psycho-Oncology Cooperative Research Group, Faculty of Science, School of Psychology, University of Sydney, Sydney, Australia
- Centre for Medical Psychology & Evidence-Based Decision-Making, University of Sydney, Sydney, Australia
| | - Jane L Phillips
- Faculty of Health, University of Technology Sydney, Ultimo, Australia
- Faculty of Health, School of Nursing, Queensland University of Technology, Brisbane, Australia
| | - Anna K Nowak
- Medical School, University of Western Australia, Nedlands, Australia
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, Australia
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Forst DA, Kaslow-Zieve ER, Hansen A, Mesa M, Landay SL, Quain KM, Sereno I, El-Jawahri A, Greer JA, Temel JS, Jacobs JM. Characterizing Distress and Identifying Modifiable Intervention Targets for Family Caregivers of Patients with Malignant Gliomas. J Palliat Med 2023; 26:17-27. [PMID: 35708587 DOI: 10.1089/jpm.2021.0534] [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: 01/11/2023] Open
Abstract
Background: Individuals caring for patients with malignant gliomas experience high rates of anxiety; however, an in-depth understanding of their distress and evidence-based interventions to target their needs are lacking. Objective: We conducted semistructured interviews with caregivers with elevated anxiety to characterize their drivers of anxiety, identify modifiable intervention targets, and capture their preferences for a psychosocial intervention. Design: From 9/2017 to 3/2019, we conducted semistructured interviews with 21 caregivers of patients with malignant gliomas, at time points following the patient's diagnosis or within one to three months after the patient's death. Setting/Subjects: Eligible caregivers in the United States had clinically significant anxiety as measured by a Hospital Anxiety and Depression Scale-Anxiety score >7. Measurements: Three independent coders employed thematic content analysis to analyze the qualitative data with NVivo 12, achieving high intercoder agreement (Kappa = 0.98). Results: On average, caregivers were 54.81 years old (SD = 10.85) with elevated anxiety (M = 10.90, SD = 3.25). We identified six themes in which caregivers described (1) coping through reassurance seeking or avoidance, (2) changes in their relationship with the patient, (3) challenges with social support, (4) vacillation between certainty and uncertainty regarding the future, (5) devaluation of self-care for the patients' needs, and (6) challenges communicating with the health care team. Caregivers were interested in an intervention soon after the patient's diagnosis, yet expressed concern about finding the time to participate. Conclusions: Emergent themes characterized the distress experienced by caregivers of patients with malignant gliomas and provided insight into their psychosocial intervention preferences. We identified evidence-based intervention components based on the modifiable factors arising from these themes.
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Affiliation(s)
- Deborah A Forst
- Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | | | - Andrea Hansen
- Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Michelle Mesa
- Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Kit M Quain
- Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Areej El-Jawahri
- Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Joseph A Greer
- Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Jennifer S Temel
- Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Jamie M Jacobs
- Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
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9
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Ku YL, Ha LTH, Kuo SM, Chen SM. Spiritual distress of patients living with cancer in Northern Vietnam. Int J Palliat Nurs 2022; 28:114-122. [PMID: 35452267 DOI: 10.12968/ijpn.2022.28.3.114] [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: 11/11/2022]
Abstract
BACKGROUND Literature on the spirituality of cancer patients has been mainly focused on the experiences of western patients. Few studies explore the experience of Asian cancer patients, while no spiritual study on cancer patients has been conducted in Vietnam. PURPOSE The purpose of this study was to survey the spiritual distress of cancer patients at two general hospitals in northern Vietnam. METHODS This was a quantitative survey with a cross-sectional design. This study used purposive sampling with a fitting the inclusion criteria, alongside the Spiritual Distress Scale-Vietnam version (SDS-V). The data was collected by an investigator in two general hospitals in northern Vietnam. The study received approval from two research councils. RESULTS The results demonstrated that the demographics of cancer patients in the study reflected the national data of Vietnam. Regarding the four exploratory dimensions, more than 50% of cancer patients expressed feeling hardship and sorrow, most did not feel loneliness, most patients reported a good relationship with others and God, while the majority of were afraid to discuss death. CONCLUSIONS Due to impact of aging and poverty on the sample patients, further studies into the interconnectivity between economics and the spiritual health status of patients is recommended. Additionally, since the 132 Vietnamese cancer patients reported a positive relationship with others and God, healthcare professionals should study effective strategies to apply the above strengths in easing hardships for future cancer patients.
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Affiliation(s)
- Ya-Lie Ku
- Associate Professor, College of Nursing, Fooyin University, Taiwan
| | | | - Shih-Ming Kuo
- Assistant Professor, Department of Nursing, Fooyin University, Taiwan
| | - Shu-Ming Chen
- Associate Professor, College of Nursing, Fooyin University, Taiwan
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10
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Loughan AR, Husain M, Ravyts SG, Willis KD, Braun SE, Brechbiel JK, Aslanzadeh FJ, Rodin G, Svikis DS, Thacker L. Death anxiety in patients with primary brain tumor: Measurement, prevalence, and determinants. Palliat Support Care 2021; 19:672-680. [PMID: 36942577 DOI: 10.1017/s1478951521000808] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study investigated death anxiety in patients with primary brain tumor (PBT). We examined the psychometric properties of two validated death anxiety measures and determined the prevalence and possible determinants of death anxiety in this often-overlooked population. METHODS Two cross-sectional studies in neuro-oncology were conducted. In Study 1, 81 patients with PBT completed psychological questionnaires, including the Templer Death Anxiety Scale (DAS). In Study 2, 109 patients with PBT completed similar questionnaires, including the Death and Dying Distress Scale (DADDS). Medical and disease-specific variables were collected across participants in both studies. Psychometric properties, including construct validity, internal consistency, and concurrent validity, were investigated. Levels of distress were analyzed using frequencies, and determinants of death anxiety were identified using logistic regression. RESULTS The DADDS was more psychometrically sound than the DAS in patients with PBT. Overall, 66% of PBT patients endorsed at least one symptom of distress about death and dying, with 48% experiencing moderate-severe death anxiety. Generalized anxiety symptoms and the fear of recurrence significantly predicted death anxiety. SIGNIFICANCE OF RESULTS The DADDS is a more appropriate instrument than the DAS to assess death anxiety in neuro-oncology. The proportion of patients with PBT who experience death anxiety appears to be higher than in other advanced cancer populations. Death anxiety is a highly distressing symptom, especially when coupled with generalized anxiety and fears of disease progression, which appears to be the case in patients with PBT. Our findings call for routine monitoring and the treatment of death anxiety in neuro-oncology.
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Affiliation(s)
- Ashlee R Loughan
- School of Medicine, Virginia Commonwealth University, Richmond, VA
- Massey Cancer Center, Richmond, VA
| | - Mariya Husain
- School of Medicine, Virginia Commonwealth University, Richmond, VA
| | - Scott G Ravyts
- Department of Psychology, Virginia Commonwealth University, Richmond, VA
| | - Kelcie D Willis
- Department of Psychology, Virginia Commonwealth University, Richmond, VA
| | - Sarah Ellen Braun
- School of Medicine, Virginia Commonwealth University, Richmond, VA
- Massey Cancer Center, Richmond, VA
| | - Julia K Brechbiel
- Department of Psychology, Virginia Commonwealth University, Richmond, VA
| | - Farah J Aslanzadeh
- Department of Psychology, Virginia Commonwealth University, Richmond, VA
| | - Gary Rodin
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Dace S Svikis
- Department of Psychology, Virginia Commonwealth University, Richmond, VA
| | - Leroy Thacker
- Massey Cancer Center, Richmond, VA
- Department of Biostatistics, Virginia Commonwealth University, Richmond, VA
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11
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Ueland V, Dysvik E, Hemberg J, Furnes B. Cancer survivorship: existential suffering. Int J Qual Stud Health Well-being 2021; 16:2001897. [PMID: 34775931 PMCID: PMC8592584 DOI: 10.1080/17482631.2021.2001897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose This study aimed to explore and describe existential experiences after cancer treatment. Method An exploratory phenomenological hermeneutical design was used following in-depth interviews with 21 people. Results The study revealed experiences of multifaceted suffering in the form of limitations in everyday life, inner struggles, and bearing the burden alone. Conclusions Existential suffering after cancer treatment was revealed as like being in a process of transition, in an intermediate state, as moving between suffering and enduring, and alternating between alienworld and homeworld. A new and broader professional perspective is needed to establish rehabilitation services based on multifaceted experiences of suffering. This means a shift in focus from biomedical symptoms towards understanding of existential meaning for the person.
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Affiliation(s)
- Venke Ueland
- Faculty of Health Sciences, University of Stavanger, University of Stavanger, Stavanger, Norway
| | - Elin Dysvik
- Emerita Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Jessica Hemberg
- Faculty of Education and Welfare Studies, Åbo Akademi University, Vaasa, Finland
| | - Bodil Furnes
- Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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12
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Viftrup DT, Prinds C, Nissen RD, Steenfeldt VØ, Søndergaard J, Hvidt NC. Older Adults' Experience of Meaning at the End of Life in Two Danish Hospices: A Qualitative Interview Study. Front Psychol 2021; 12:700285. [PMID: 34603128 PMCID: PMC8484531 DOI: 10.3389/fpsyg.2021.700285] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 08/23/2021] [Indexed: 11/13/2022] Open
Abstract
The aim of this study was to explore how older adults (aged > 65) confronted with imminent death express their thoughts and feelings about death and dying and verbalize meaning. Furthermore, the aim was to investigate how health professionals could better address the needs of this patient group to experience meaning at the end of life. The study applied a qualitative method, involving semi-structured interviews with 10 participants at two hospices. The method of analysis was interpretative phenomenological analysis. We found three chronological time-based themes: (1) Approaching Death, (2) The time before dying, and (3) The afterlife. The participants displayed scarce existential vernacular for pursuing meaning with approaching death. They primarily applied understanding and vocabulary from a medical paradigm. The participants' descriptions of how they experienced and pursued meaning in the time before dying were also predominantly characterized by medical vernacular, but these descriptions did include a few existential words and understandings. When expressing thoughts and meaning about the afterlife, participants initiated a two-way dialogue with the interviewer and primarily used existential vernacular. This indicates that the participants' scarce existential vernacular to talk about meaning might be because people are not used to talking with healthcare professionals about meaning or their thoughts and feelings about death. They are mostly "trained" in medical vernacular. We found that participants' use of, respectively, medical or existential vernacular affected how they experienced meaning and hope at the end of life. We encourage healthcare professionals to enter into existential dialogues with people to support and strengthen their experiences of meaning and hope at the end of life.
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Affiliation(s)
- Dorte Toudal Viftrup
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Christina Prinds
- Research Unit of Gynecology and Obstetrics, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department for Research and Development, University College South Denmark, Haderslev, Denmark
| | - Ricko Damberg Nissen
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | | | - Jens Søndergaard
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Niels Christian Hvidt
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Odense, Denmark
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13
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Fear of Cancer Recurrence and Death Anxiety: Unaddressed Concerns for Adult Neuro-oncology Patients. J Clin Psychol Med Settings 2021; 28:16-30. [PMID: 31848927 DOI: 10.1007/s10880-019-09690-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Primary brain tumor (PBT) patients may experience existential distress; however, few studies have examined this issue. The objectives of this study were to (1) systematically review PBT representation in psycho-oncology literature regarding fear/anxiety related to progression, recurrence, and death and (2) preliminarily assess the prevalence of fear of dying in a sample of PBT patients. Systematic searching of three databases yielded 1555 articles for review. Of these, 327 studies met inclusion criteria (patient sample N = 132,951). Only eight studies (0.18% of the participants) included patients with a PBT diagnosis, potentially due to exclusion criteria such as cognitive impairment or specific treatment parameters which may prohibit PBT patient participation. Review of the results from the eight included studies revealed mixed methods and limited demographic analyses; existential distress was correlated with heightened depression and anxiety, and overall worsened quality of life. From the original data collection, approximately one-third of PBT patients endorsed fear of dying, which was positively related to depression severity. Taken together, results suggest that PBT patients are considerably underrepresented in existential psycho-oncology literature, despite preliminary findings suggesting prevalence of these concerns. Future research on existential distress in neuro-oncology is warranted.
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14
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Crooms RC, Lin HM, Neifert S, Deiner SG, Brallier JW, Goldstein NE, Gal JS, Gelfman LP. Palliative Care Consultation for Hospitalized Patients with Primary and Secondary Brain Tumors at a Single Academic Center. J Palliat Med 2021; 24:1550-1554. [PMID: 34166114 DOI: 10.1089/jpm.2021.0088] [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: 11/13/2022] Open
Abstract
Introduction: Studies addressing palliative care delivery in neuro-oncology are limited. Objectives: To compare inpatients with brain tumors who received palliative care (through referral or trigger) with those receiving usual care. Design: Retrospective cohort study. Setting/Subjects: Inpatients with primary or secondary brain tumors who did or did not receive palliative care at a U.S. medical center. Measurements: Sociodemographic, clinical, and utilization characteristics were compared. Results: Of 1669 brain tumor patients, 386 (23.1%) received palliative care [nontrigger: 246 (14.7%); trigger: 140 (8.4%)] and 1283 (76.9%) received usual care. Nontrigger patients were oldest (mean age 65.0 years; trigger: 61.1 years; usual care: 55.5 years; p < 0.001); sickest at baseline (mean Elixhauser comorbidity index 3.76; trigger: 3.49; usual care: 1.84; p < 0.001); and had highest in-hospital death [34 (13.8%), trigger: 10 (7.1%), usual care: 7 (0.5%); p < 0.001] and hospice discharge [54 (22.0%), trigger: 18 (12.9%), usual care: 14 (1.1%); p < 0.001]. Conclusions: Trigger criteria may promote earlier palliative care referral, yet criteria tailored for neuro-oncology are undeveloped.
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Affiliation(s)
- Rita C Crooms
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Hung-Mo Lin
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Sean Neifert
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Stacie G Deiner
- Dartmouth Hitchcock and Geisel School of Medicine, Lebanon, New Hampshire, USA
| | - Jess W Brallier
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Nathan E Goldstein
- Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Geriatric Research Education and Clinical Center, James J. Peters VA Medical Center, Bronx, New York, USA
| | - Jonathan S Gal
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Laura P Gelfman
- Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Geriatric Research Education and Clinical Center, James J. Peters VA Medical Center, Bronx, New York, USA
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15
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Jarvis CA, Lin M, Ding L, Julian A, Giannotta SL, Zada G, Mack WJ, Attenello FJ. Comorbid depression associated with non-routine discharge following craniotomy for low-grade gliomas and benign tumors - a nationwide readmission database analysis. Acta Neurochir (Wien) 2020; 162:2671-2681. [PMID: 32876766 DOI: 10.1007/s00701-020-04559-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 08/27/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE Prior studies have demonstrated elevated rates of depression in patients with malignant brain tumor; however, the prevalence and effect on surgical outcomes in patients with low-grade gliomas (LGG) and benign brain tumors (BBT) remain unknown. Readmission and non-routine discharge, which includes discharge to skilled nursing, rehabilitative, and other inpatient facilities, are well-established quality of care indicators. We sought to analyze the association between comorbid depression and non-routine discharge, readmission, and other post-operative inpatient outcomes in patients with LGG and BBT. METHODS The Nationwide Readmissions Database from 2010 to 2014 was retrospectively queried to select for surgically treated patients with LGG and BBT. Multivariable logistic regression models adjusting for patient and hospital characteristics were used to determine the effects of comorbid depression on post-operative outcomes. Interaction of gender and depression on non-routine disposition was analyzed. RESULTS We identified 31,654 craniotomies for resection of BBT and LGG (2010-2014). The majority of patients (64.1%) were female. The rate of depression comorbid with BBT and LGG was 11.9%. Depression was associated with non-routine discharge after surgery (OR 1.19, p 0.0002*), but was not associated with increased morbidity, mortality, or readmission at 30 or 90 days. The rate of comorbid depression was higher among female than male patients (14.0 vs. 8.0%). Depression in males was associated with a 38% increased likelihood of non-routine disposition (p = 0.0002*), while depression in females was associated with a 13% increased likelihood of non-routine disposition (p = 0.03*). CONCLUSION Depression is prevalent in patients with LGG and BBT and is associated with increased risk of non-routine discharge following surgical intervention. The increased likelihood of non-routine disposition is greater for males than that for females. Awareness of the risk factors for depression may aid in early screening and intervention and improve overall patient outcomes.
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Affiliation(s)
- Casey A Jarvis
- Keck School of Medicine, University of Southern California, 1200 North State St. Suite 3300, Los Angeles, CA, 90033, USA.
| | - Michelle Lin
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Li Ding
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Alex Julian
- Keck School of Medicine, University of Southern California, 1200 North State St. Suite 3300, Los Angeles, CA, 90033, USA
| | - Steven L Giannotta
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Gabriel Zada
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - William J Mack
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Frank J Attenello
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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16
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Eggen AC, Reyners AKL, Shen G, Bosma I, Jalving M, Leighl NB, Liu G, Richard NM, Mah K, Shultz DB, Edelstein K, Rodin G. Death Anxiety in Patients With Metastatic Non-Small Cell Lung Cancer With and Without Brain Metastases. J Pain Symptom Manage 2020; 60:422-429.e1. [PMID: 32145337 DOI: 10.1016/j.jpainsymman.2020.02.023] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 02/20/2020] [Accepted: 02/23/2020] [Indexed: 12/16/2022]
Abstract
CONTEXT Death anxiety is common in patients with metastatic cancer, but its relationship to brain metastases and cognitive decline is unknown. Early identification of death anxiety and its determinants allows proactive interventions to be offered to those in need. OBJECTIVES To identify psychological, physical, and disease-related (including brain metastases and cognitive impairment) factors associated with death anxiety in metastatic non-small cell lung cancer (mNSCLC) patients. METHODS A cross-sectional pilot study with mNSCLC outpatients completing standardized neuropsychological tests and validated questionnaires measuring death anxiety, cognitive concerns, illness intrusiveness, depression, demoralization, self-esteem, and common cancer symptoms. We constructed a composite for objective cognitive function (mean neuropsychological tests z-scores). RESULTS Study measures were completed by 78 patients (50% females; median age 62 years [range 37-82]). Median time since mNSCLC diagnosis was 11 months (range 0-89); 53% had brain metastases. At least moderate death anxiety was reported by 43% (n = 33). Objective cognitive impairment was present in 41% (n = 32) and perceived cognitive impairment in 27% (n = 21). Death anxiety, objective, and perceived cognitive impairment did not significantly differ between patients with and without brain metastases. In univariate analysis, death anxiety was associated with demoralization, depression, self-esteem, illness intrusiveness, common physical cancer symptoms, and perceived cognitive impairment. In multivariate analysis, demoralization (P < 0.001) and illness intrusiveness (P = 0.001) were associated with death anxiety. CONCLUSION Death anxiety and brain metastases are common in patients with mNSCLC but not necessarily linked. The association of death anxiety with both demoralization and illness intrusiveness highlights the importance of integrated psychological and symptom management. Further research is needed on the psychological impact of brain metastases.
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Affiliation(s)
- Annemarie C Eggen
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Anna K L Reyners
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Gerald Shen
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Ingeborg Bosma
- Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Mathilde Jalving
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Natasha B Leighl
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Geoffrey Liu
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Nadine M Richard
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Kenneth Mah
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - David B Shultz
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Kim Edelstein
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Gary Rodin
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.
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17
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Latifi Z, Soltani M, Mousavi S. Evaluation of the effectiveness of self-healing training on self-compassion, body image concern, and recovery process in patients with skin cancer. Complement Ther Clin Pract 2020; 40:101180. [DOI: 10.1016/j.ctcp.2020.101180] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 04/13/2020] [Accepted: 04/16/2020] [Indexed: 11/28/2022]
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18
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Loughan AR, Aslanzadeh FJ, Brechbiel J, Rodin G, Husain M, Braun SE, Willis KD, Lanoye A. Death-related distress in adult primary brain tumor patients. Neurooncol Pract 2020; 7:498-506. [PMID: 33014390 DOI: 10.1093/nop/npaa015] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Background A diagnosis of cancer may increase mortality salience and provoke death-related distress. Primary brain tumor (PBT) patients may be at particular risk for such distress given the certainty of tumor progression, lack of curative treatments, and poor survival rates. This study is the first to examine the prevalence of death-related distress and its correlates in PBT patients. Methods Adult PBT patients (N = 105) enrolled in this cross-sectional study and completed the Death Distress Scale (subscales: Death Depression, Death Anxiety, Death Obsession), Generalized Anxiety Disorder-7, and Patient Health Questionnaire-9. Prevalence and predictors of death-related distress, and the relationships of demographic variables to clusters of distress, were explored. Results The majority of PBT patients endorsed clinically significant death-related distress in at least one domain. Death anxiety was endorsed by 81%, death depression by 12.5%, and death obsession by 10.5%. Generalized anxiety was the only factor associated with global death-related distress. Cluster analysis yielded 4 profiles: global distress, emotional distress, resilience, and existential distress. Participants in the resilience cluster were significantly further out from diagnosis than those in the existential distress cluster. There were no differences in cluster membership based on age, sex, or tumor grade. Conclusions PBT patients appear to have a high prevalence of death-related distress, particularly death anxiety. Further, 4 distinct profiles of distress were identified, supporting the need for tailored approaches to addressing death-related distress. A shift in clusters of distress based on time since diagnosis also suggest the need for future longitudinal assessment.
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Affiliation(s)
- Ashlee R Loughan
- Virginia Commonwealth University, Department of Neurology, Division of Neuro-Oncology, Richmond, Virginia.,Massey Cancer Center, Richmond, Virginia.,Virginia Commonwealth University, School of Medicine, Richmond, Virginia
| | - Farah J Aslanzadeh
- Virginia Commonwealth University, Department of Psychology, Richmond, Virginia
| | - Julia Brechbiel
- Virginia Commonwealth University, Department of Psychology, Richmond, Virginia
| | - Gary Rodin
- Princess Margaret Cancer Centre, University Health Network, Department of Supportive Care, Toronto, Ontario, Canada.,University of Toronto, Department of Psychiatry, Toronto, Ontario, Canada
| | - Mariya Husain
- Virginia Commonwealth University, School of Medicine, Richmond, Virginia
| | - Sarah E Braun
- Virginia Commonwealth University, Department of Psychology, Richmond, Virginia.,Medical University of South Carolina, Department of Psychiatry & Behavioral Sciences, Charleston, South Carolina
| | - Kelcie D Willis
- Virginia Commonwealth University, Department of Psychology, Richmond, Virginia
| | - Autumn Lanoye
- Virginia Commonwealth University, School of Medicine Department of Health Behavior and Policy, Richmond, Virginia
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19
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Trejnowska A, Goodall K, Rush R, Ellison M, McVittie C. The relationship between adult attachment and coping with brain tumour: the mediating role of social support. Psychooncology 2020; 29:729-736. [PMID: 31876067 DOI: 10.1002/pon.5325] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 12/17/2019] [Accepted: 12/23/2019] [Indexed: 01/01/2023]
Abstract
OBJECTIVE A primary brain tumour diagnosis is known to elicit higher distress than other forms of cancer and is related to high depressive symptomatology. Using a cross-sectional design, the present study explored how individuals cope with this diagnosis using an attachment theory framework. Attachment anxiety and attachment avoidance were hypothesised to be positively related to helplessness/hopelessness, anxious preoccupation, and cognitive avoidance; and negatively related to fighting spirit and fatalism coping. We proposed perceived social support to play a mediating role in those associations. METHODS Four hundred and eighty participants diagnosed with primary brain tumours completed the Mini-Mental Adjustment to Cancer Scale (Mini-MAC), the Experiences in Close Relationships Questionnaire-Revised (ECR-R), and the modified Medical Outcomes Study-Social Support Scale (mMOS-SSS) online. RESULTS Lower perceived social support mediated the positive associations between both higher attachment anxiety and avoidance and higher helpless/hopeless coping. Attachment anxiety was also positively associated with anxious preoccupation. This relationship was not mediated by perceived social support. Cognitive avoidance was unrelated to both attachment dimensions and social support. CONCLUSIONS The findings highlight that the differences in coping repertoire are associated with social relatedness factors, specifically attachment security and its relationship to perceived social support. Implications of the findings are discussed.
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Affiliation(s)
- Anna Trejnowska
- Division of Psychology, Sociology and Education, Queen Margaret University, Edinburgh, UK
| | - Karen Goodall
- Department of Clinical Psychology, University of Edinburgh, Edinburgh, UK
| | - Robert Rush
- Division of Psychology, Sociology and Education, Queen Margaret University, Edinburgh, UK
| | - Marion Ellison
- Division of Psychology, Sociology and Education, Queen Margaret University, Edinburgh, UK
| | - Chris McVittie
- Division of Psychology, Sociology and Education, Queen Margaret University, Edinburgh, UK
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20
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Ebenau A, Groot M, Visser A, van Laarhoven HWM, van Leeuwen R, Garssen B. Spiritual care by nurses in curative oncology: a mixed-method study on patients' perspectives and experiences. Scand J Caring Sci 2020; 34:96-107. [PMID: 31095760 PMCID: PMC7074061 DOI: 10.1111/scs.12710] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 04/12/2019] [Indexed: 11/26/2022]
Abstract
AIMS Spirituality can be important in adjusting to the experience of cancer and its medical treatment. Since nurses have frequent contact with patients, they seem to have a unique role in providing spiritual care. Nurses consider spiritual care important; however, little is known about how patients in a curative setting experience and value spiritual care. Therefore, this study aimed to give insight into patients' experiences with and opinions about spiritual care as provided by nurses in curative cancer care. METHODS This is a national, multicentre mixed-methods study, combining a quantitative approach using questionnaires (n = 62) and a qualitative analysis of semi-structured interviews (n = 61). Nonparametric tests were used for quantitative data, and qualitative data were analysed inductively. FINDINGS Most patients rarely received spiritual care by nurses. If spiritual care was provided, it mainly consisted of noticing problems and referring to other professionals. This appeared to be dependent on certain 'triggers', such as age. Structural discussions on spirituality with a nurse were experienced rarely. This was explained by, among other factors, the hospital setting. Yet, the majority (79%) of patients found the attention to spirituality sufficient or very good. Furthermore, a majority (58%) viewed spiritual care as a nursing task: nurses should notice spiritual problems and refer to other professionals, though extensively discussing patients' spirituality was neither considered nurses' task nor capability. CONCLUSIONS Attention to spiritual care in a curative setting, though not so much desired by most patients, should be pursued, because of its importance in performing person-centred nursing care and its positive impact on patients' health. By training nurses in offering spiritual care in proactive and 'nonactive' (accepting) ways, spiritual care could be structurally offered in clinical practice in personalised forms. Since younger and less spiritual patients are not much satisfied with spiritual care by nurses, they need special attention.
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Affiliation(s)
- Anne Ebenau
- Helen Dowling Institute for Psycho‐oncological CareBilthovenThe Netherlands
- Department of Anesthesiology, Pain and Palliative CareRadboud University Medical CenterNijmegenThe Netherlands
| | - Marieke Groot
- Helen Dowling Institute for Psycho‐oncological CareBilthovenThe Netherlands
- Department of Anesthesiology, Pain and Palliative CareRadboud University Medical CenterNijmegenThe Netherlands
| | - Anja Visser
- Helen Dowling Institute for Psycho‐oncological CareBilthovenThe Netherlands
- Faculty of Theology and Religious Studies, Comparative Study of ReligionUniversity of GroningenGroningenThe Netherlands
| | | | - René van Leeuwen
- Faculty of Health CareChristian University of Applied Sciences ViaaZwolleThe Netherlands
| | - Bert Garssen
- Helen Dowling Institute for Psycho‐oncological CareBilthovenThe Netherlands
- Department Health PsychologyRijksuniversiteit GroningenGroningenThe Netherlands
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21
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Gullick J, West S. Heideggerian hermeneutic phenomenology as method: modelling analysis through a meta-synthesis of articles on Being-towards-death. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2020; 23:87-105. [PMID: 31264089 DOI: 10.1007/s11019-019-09911-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
While the richness of Heideggerian philosophy is attractive as a healthcare research framework, its density means authors rarely utilise its fullest possibilities as an hermeneutic analytic structure. This article aims to clarify Heideggerian hermeneutic analysis by taking one discrete element of Heideggerian philosophy (Being-towards-death), and using it's clearly defined structure to conduct a meta-synthesis of Heideggerian phenomenological studies on the experience of living with a potentially life-limiting illness. The findings richly illustrate Heidegger's philosophy that there is either an inauthentic positioning towards death, or an authentic positioning towards death with a proposition that (1) death is certain; (2) death is indefinite; (3) death is non-relational; and (4) death is not-to-be-outstripped. None of the 29 included studies on the experience of a confrontation with death fully utilised this framework, despite claiming a grounding in Heideggerian thought. This demonstrates the value in modelling how Heideggerian existential structures can be used proactively as analytical 'hooks' for data in research claiming a basis in this philosophy and/or method. By modelling the potential application of an important Heideggerian philosophical construct to published qualitative data, this meta-synthesis has revealed new domains and more nuanced understandings of the temporal structure of Being-towards-death. Such an approach helps to more fully unveil the existential concerns of people at the core of interpretative phenomenological enquiry and may provide a blueprint to map either primary or synthesised data to other key ontological existentials.
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Affiliation(s)
- Janice Gullick
- A4:32, MO2, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
- International Institute of Qualitative Methods, University of Alberta, Edmonton, AB, Canada.
| | - Sandra West
- A5:11, MO2, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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22
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Mercês CAMF, Souto JDSS, Zaccaro KRL, Souza JF, Primo CC, Brandão MAG. Death Anxiety: Concept Analysis and Clarification of Nursing Diagnosis. Int J Nurs Knowl 2019; 31:218-227. [DOI: 10.1111/2047-3095.12260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 08/10/2019] [Accepted: 08/26/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Claudia Angélica Mainenti Ferreira Mercês
- Graduate Program in Nursing School Anna Nery Federal University of Rio de Janeiro (UFRJ) Rio de Janeiro Rio de Janeiro Brazil
- National Institute of Cancer José Alencar Gomes da Silva Rio de Janeiro Brazi
| | | | - Kênia Rocha Leite Zaccaro
- Graduate Program in Nursing School Anna NeryUFRJ Rio de Janeiro Rio de Janeiro Brazil
- National Institute of Traumatology and Orthopedics Rio de Janeiro Brazil
| | - Jackeline Felix Souza
- Graduate Program in Nursing School Anna NeryUFRJ Rio de Janeiro Rio de Janeiro Brazil
- Federal University of Rondônia Porto Velho Rondônia Brazil
| | - Cândida Caniçali Primo
- Departament of Nursing of Federal University of Espírito Santo Vitória Espírito Santo Brazil
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McInnerney D, Kupeli N, Stone P, Anantapong K, Chan J, Candy B. Emotional disclosure as a therapeutic intervention in palliative care: a scoping review protocol. BMJ Open 2019; 9:e031046. [PMID: 31455716 PMCID: PMC6720334 DOI: 10.1136/bmjopen-2019-031046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 07/03/2019] [Accepted: 07/26/2019] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION Emotional disclosure (ED) is a term used to describe the therapeutic expression of emotion. ED underlies a variety of therapies aimed at improving well-being for various populations, including people with palliative-stage disease and their family carers. Systematic reviews of ED-based psychotherapy have largely focused on expressive writing as a way of generating ED. However, heterogeneity in intervention format and outcome measures has made it difficult to analyse efficacy. There is also debate about the mechanisms proposed to explain the potential effects of ED.We present a scoping review protocol to develop a taxonomy of ED-based interventions to identify and categorise the spectrum of interventions that could be classified under the umbrella term of 'emotional disclosure' in the palliative care setting. By mapping these to associated treatment objectives, outcome measures and explanatory frameworks, the review will inform future efforts to design and evaluate ED-based therapies in this population. METHODS AND ANALYSIS The review will be guided by Arksey and O'Malley's five-stage scoping review framework and Levac's extension. The following electronic databases will be searched from database inception: CENTRAL, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Scopus, Web of Science and MEDLINE. We will include peer-reviewed studies and reviews. We will also check grey literature, including clinical trial registers, conference proceedings and reference lists, as well as contacting researchers. Articles will be screened by at least two independent reviewers and data charted using an extraction form developed for this review. Results will be analysed thematically to create a taxonomy of interventions, outcome measures and theoretical frameworks. ETHICS AND DISSEMINATION This review does not require ethical approval as it is a secondary analysis of pre-existing, published data. The results will inform future research in the development of ED-based interventions and evaluation of their efficacy in the palliative care setting. We will disseminate findings through peer-reviewed journals.
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Affiliation(s)
- Daisy McInnerney
- Marie Curie Palliative Care Research Department, University College London, London, UK
| | - Nuriye Kupeli
- Marie Curie Palliative Care Research Department, University College London, London, UK
| | - Patrick Stone
- Marie Curie Palliative Care Research Department, University College London, London, UK
| | - Kanthee Anantapong
- Marie Curie Palliative Care Research Department, University College London, London, UK
- Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
| | - Justin Chan
- Marie Curie Palliative Care Research Department, University College London, London, UK
| | - Bridget Candy
- Marie Curie Palliative Care Research Department, University College London, London, UK
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Death anxiety, exposure to death, mortuary preferences, and religiosity in five countries. Sci Data 2019; 6:154. [PMID: 31434905 PMCID: PMC6704076 DOI: 10.1038/s41597-019-0163-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 07/25/2019] [Indexed: 11/09/2022] Open
Abstract
We present three datasets from a project about the relationship between death anxiety and religiosity. These include data from 1,838 individuals in the United States (n = 813), Brazil (n = 800), Russia (n = 800), the Philippines (n = 200), South Korea (n = 200), and Japan (n = 219). Measures were largely consistent across samples: they include measures of death anxiety, experience of and exposure to death, religious belief, religious behaviour, religious experience, and demographic information. Responses have also been back-translated into English where necessary, though original untranslated data are also included. Design Type(s) | crowd-sourcing design • data integration objective • subject-based data analysis objective | Measurement Type(s) | anxiety | Technology Type(s) | survey method | Factor Type(s) | sex • geographic location • Marital Status • Ethnic Group • age | Sample Characteristic(s) | Homo sapiens • United States of America • Brazil • Russia • The Philippines • South Korea • Japan |
Machine-accessible metadata file describing the reported data (ISA-Tab format)
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Frid M, Strang P, Friedrichsen MJ, Johansson K. Lower Limb Lymphedema: Experiences and Perceptions of Cancer Patients in the Late Palliative Stage. J Palliat Care 2019. [DOI: 10.1177/082585970602200102] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Lower limb lymphedema (LLL) is a common but neglected problem in palliative cancer patients. No studies have focused on these patients’ experiences of lymphedema. The aims of this study were to explore patients’ experiences regarding LLL and how they manage to deal with this in the late palliative stage. Methods: Thirteen patients with cancer-related LLL were included to satisfy a maximum variation sampling strategy. Interviews were analyzed using a qualitative phenomenographic method. Results: LLL influenced the patients’ thoughts about the future. Body image was often strongly influenced. Interactions with other persons were perceived as both positive and negative, and a range of coping strategies were expressed. Conclusion: LLL can exert a considerable influence on the physical experiences and the psychosocial situation of cancer patients in palliative care. Areas in need of increased education, attention, and further research are highlighted.
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Affiliation(s)
- Marianne Frid
- Physiotherapy Unit, Karolinska University Hospital, and Research Unit, Stockholms Sjukhem Foundation, Stockholm
| | - Peter Strang
- Research Unit, Stockholms Sjukhem Foundation, and Karolinska Institute, SSH, Stockholm
| | - Maria J. Friedrichsen
- Research Unit, Stockholms Sjukhem Foundation, Stockholm, and Department of Welfare and Care, Palliative Care, Faculty of Health Sciences, Campus Norrköping, Norrköping
| | - Karin Johansson
- Department of Health Science, Lund University, and Lymphedema Unit, Lund University Hospital, Lund, Sweden
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Waldrop DP, Milch RA, Skretny JA. Understanding Family Responses to Life-Limiting Illness: In-depth Interviews with Hospice Patients and Their Family Members. J Palliat Care 2019. [DOI: 10.1177/082585970502100204] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Understanding family dynamics is a key component in providing comprehensive care for persons with progressive illnesses and their caregivers. The purpose of this study was to investigate what families experience during an advancing illness and to describe their patterns of response. In-depth interviews (n=108) were conducted with families two weeks after hospice admission. Interviews were tape recorded, transcribed, and analyzed using qualitative methods. Six modes were distilled: reactive (illness generates intense responses), advocacy (vulnerability ignites assertive actions), fused (illness and decline are shared experiences), dissonant (diametrically opposed viewpoints cause struggle), resigned (decline and death are anticipated), and closed (outward responses are impassive). Three events triggered movement from one mode to another: (1) functional changes, (2) crisis events, and (3) provider communication. Providers who understand varied family reactions can ease the patient's suffering, assist relatives in providing effective care, and prepare them for the approaching death.
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Affiliation(s)
| | - Robert A. Milch
- The Center for Hospice and Palliative Care, Cheektowaga, New York, USA
| | - Judith A. Skretny
- The Center for Hospice and Palliative Care, Cheektowaga, New York, USA
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Derakhshani N, Azami-Aghdash S, Ghojazadeh M, Naghavi-Behzad M, Asl V, Samei B. A pilot study of fear of disease consequences and its relationship with quality of life, depression and anxiety in patients with multiple sclerosis. INTERNATIONAL ARCHIVES OF HEALTH SCIENCES 2019. [DOI: 10.4103/iahs.iahs_9_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Affiliation(s)
- Peter Strang
- Karolinska Institutet and Stockholms Sjukhem Foundation, Stockholm, Sweden
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Dadfar M, Lester D. The Farsi translation, reliability and validity of the Death Concern Scale. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2018; 40:114-125. [PMID: 29995157 DOI: 10.1590/2237-6089-2017-0078] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 08/23/2017] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Death concern is a conscious contemplation of the reality of death combined with a negative evaluation of that reality. The Death Concern Scale (DCS) is related to thinking, and death fear or anxiety about death. The aim of the present study was to develop a Farsi version of the DCS and to explore its psychometric properties in a sample of Iranian nurses. METHODS A cross-sectional study was conducted to investigate the reliability, validity, and factorial structure of the Farsi version of the DCS in a convenience sample of 106 Iranian nurses in two hospitals in Tehran, Iran. The nurses completed the DCS, the Collett-Lester Fear of Death Scale (CLFDS), the Death Anxiety Scale (DAS), the Reasons for Death Fear Scale (RDFS), the Death Depression Scale (DDS), and the Death Obsession Scale (DOS). RESULTS For the DCS, Cronbach's α was 0.77, the Spearman-Brown coefficient 0.63, the Guttman split-half coefficient 0.62, and two-week test-retest reliability 0.77. The DCS correlated at 0.51 with the CLFDS, 0.52 with the DAS, 0.34 with the RDFS, 0.40 with the DDS, and 0.48 with the DOS, indicating good construct and criterion-related validity. The results of an exploratory factor analysis for the DCS identified seven factors, accounting for 64.30% of the variance and indicating considerable heterogeneity in the content of the items. CONCLUSIONS The Farsi version of the DCS has good validity and reliability, and it can be used in clinical, educational, and research settings to assess death concerns in the Iranian society.
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Affiliation(s)
- Mahboubeh Dadfar
- School of Behavioral Sciences and Mental Health, Tehran Institute of Psychiatry, International Campus, School of Public Health, Iran University of Medical Sciences, Iran
| | - David Lester
- Psychology Program, Stockton University, Galloway, NJ, USA
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Sjöberg M, Beck I, Rasmussen BH, Edberg AK. Being disconnected from life: meanings of existential loneliness as narrated by frail older people. Aging Ment Health 2018; 22:1357-1364. [PMID: 28714734 DOI: 10.1080/13607863.2017.1348481] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES This study illuminated the meanings of existential loneliness (EL) as narrated by frail older people. METHOD Data were collected through individual narrative interviews with 23 people 76-101 years old receiving long-term care and services. A phenomenological hermeneutical analysis was performed, including a naïve reading and two structural analyses as a basis for a comprehensive understanding of EL. RESULT Four themes were identified related to meanings of EL: (1) being trapped in a frail and deteriorating body; (2) being met with indifference; (3) having nobody to share life with; and (4) lacking purpose and meaning. These intertwined themes were synthesized into a comprehensive understanding of EL as 'being disconnected from life'. CONCLUSION Illness and physical limitation affects access to the world. When being met with indifference and being unable to share one's thoughts and experiences of life with others, a sense of worthlessness is reinforced, triggering an experience of meaninglessness and EL, i.e. disconnection from life. It is urgent to develop support strategies that can be used by health care professionals to address older people in vulnerable situations, thereby facilitating connectedness.
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Affiliation(s)
- Marina Sjöberg
- a Department of Care Science, Faculty of Health and Society , Malmö University , Malmö , Sweden.,b Department of Health and Society, The Research Platform for Collaboration for Health , Kristianstad University , Kristianstad , Sweden
| | - Ingela Beck
- b Department of Health and Society, The Research Platform for Collaboration for Health , Kristianstad University , Kristianstad , Sweden.,c The Institute For Palliative Care , Region Skåne and Lund University , Lund , Sweden.,d Department of Clinical Sciences Lund, Division of Oncology, Faculty of Medicine , Lund University , Lund , Sweden
| | - Birgit H Rasmussen
- c The Institute For Palliative Care , Region Skåne and Lund University , Lund , Sweden.,e Department for Health Sciences, Faculty of Medicine, Unit of Older People's Health and Person Centred Care , Lund University , Lund , Sweden
| | - Anna-Karin Edberg
- b Department of Health and Society, The Research Platform for Collaboration for Health , Kristianstad University , Kristianstad , Sweden
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Goebel S, Mehdorn HM. Breaking Bad News to Patients with Intracranial Tumors: The Patients' Perspective. World Neurosurg 2018; 118:e254-e262. [DOI: 10.1016/j.wneu.2018.06.168] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 06/19/2018] [Accepted: 06/20/2018] [Indexed: 10/28/2022]
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Sacher M, Meixensberger J, Krupp W. Interaction of quality of life, mood and depression of patients and their informal caregivers after surgical treatment of high-grade glioma: a prospective study. J Neurooncol 2018; 140:367-375. [DOI: 10.1007/s11060-018-2962-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 07/30/2018] [Indexed: 01/06/2023]
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Goebel S, Mederer D, Mehdorn HM. Surgery-Related Coping in Surgery Patients with Intracranial Tumors. World Neurosurg 2018; 116:e775-e782. [DOI: 10.1016/j.wneu.2018.05.091] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 05/13/2018] [Accepted: 05/14/2018] [Indexed: 01/10/2023]
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Clayton MF, Hulett J, Kaur K, Reblin M, Wilson A, Ellington L. Nursing Support of Home Hospice Caregivers on the Day of Patient Death. Oncol Nurs Forum 2018. [PMID: 28632241 DOI: 10.1188/17.onf.457-464] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To describe nurse-caregiver communication on the day of patient death.
. DESIGN A descriptive secondary analysis of 44 audio-recorded home hospice nursing visits on day of death.
. SETTING Nine hospices in Utah, Oregon, and Massachusetts.
. SAMPLE 42 caregiver-patient dyads, 27 hospice nurses.
. METHODS Transcripts of audio recordings were coded for supportive nursing communication and relative time spent in physical, psychosocial, and spiritual discussion.
. MAIN RESEARCH VARIABLES Tangible, emotional, informational, esteem, and networking supportive communication; nurses' self-reported communication effectiveness; caregiver religious affiliation.
. FINDINGS Nurses reported that their communication skills were less effective when discussing difficult topics as compared to their overall communication effectiveness. Eleven patients died before the nursing visit, 3 died during the visit, and 30 died post-visit. Nurses primarily engaged in discussions facilitating caregiver emotional, tangible, and informational support. More informational support was observed when patient death occurred during the nursing visit. Time spent in general conversation showed that physical care conversations predominated (80% of the average overall amount of conversation time), compared to lifestyle/psychosocial discussions (14%) and spiritual discussions (6%). Spiritual discussions were observed in only 7 of 44 hospice visits. Spiritual discussions, although short and infrequent, were significantly longer, on average, for caregivers without a religious affiliation.
. CONCLUSIONS Nurses support caregivers on the day of patient death using multiple supportive communication strategies. Spiritual discussions are minimal.
. IMPLICATIONS FOR NURSING Communication skills programs can potentially increase self-reported communication effectiveness. Emerging acute spiritual concerns, particularly for caregivers without a previous religious affiliation, should be anticipated. Spiritual support is included in the hospice model of holistic care.
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Affiliation(s)
| | | | | | - Maija Reblin
- H. Lee Moffitt Cancer Center and Research Institute
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Postolică R, Enea V, Dafinoiu I, Petrov I, Azoicăi D. Association of sense of coherence and supernatural beliefs with death anxiety and death depression among Romanian cancer patients. DEATH STUDIES 2018; 43:9-19. [PMID: 29393825 DOI: 10.1080/07481187.2018.1430083] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The aim of this cross-sectional study was to examine the association of supernatural beliefs and sense of coherence with death anxiety and death depression in a Romanian sample of cancer patients. We found support for the terror management theory worldview defence hypothesis postulating the presence of a curvilinear relation between death anxiety and supernatural beliefs among cancer patients. Results conformed to an inverted U-shape quadratic regression, indicating that cancer patients who scored moderately on supernatural beliefs were afraid of death the most, while death anxiety was lowest for the extreme atheists and extreme believers in supernatural entities.
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Affiliation(s)
- Roxana Postolică
- a Regional Institute of Oncology , Iasi , Romania
- b Faculty of Medicine, Department of Oncogenetics , "Grigore T. Popa" University of Medicine and Pharmacy of Iasi , Iasi , Romania
| | - Violeta Enea
- c Faculty of Psychology and Education Sciences, Department of Psychology , "Alexandru Ioan Cuza" University of Iasi , Iasi , Romania
| | - Ion Dafinoiu
- c Faculty of Psychology and Education Sciences, Department of Psychology , "Alexandru Ioan Cuza" University of Iasi , Iasi , Romania
| | - Iuliana Petrov
- c Faculty of Psychology and Education Sciences, Department of Psychology , "Alexandru Ioan Cuza" University of Iasi , Iasi , Romania
| | - Doina Azoicăi
- b Faculty of Medicine, Department of Oncogenetics , "Grigore T. Popa" University of Medicine and Pharmacy of Iasi , Iasi , Romania
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Initial psycho-oncological counselling in neuro-oncology: analysis of topics and needs of brain tumour patients. J Neurooncol 2017; 136:505-514. [PMID: 29147859 DOI: 10.1007/s11060-017-2670-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 11/11/2017] [Indexed: 10/18/2022]
Abstract
Diagnosis of a brain tumour is associated with a tremendous disruption of emotional, physical and social well-being. Due to the complexity of the disease and the affection of the central organ, the brain, brain tumour patients differ from other cancer patients. The purpose of this study was to evaluate the concerns and burdens presented by brain tumour patients during their initial psycho-oncological consultation. We performed a retrospective analysis of 53 patients with the diagnosis of either benign or malignant brain tumour, seeking counsel by a neurosurgeon specialised in psycho-oncology. We performed a thematic analysis of the interviews at first consultation identifying themes and patterns and created thematic categories. The main concerns of the patients presented during the first consultations were psychological problems, reported by 40 patients (75.5%). Death and dying was mentioned by more than half of the patients (n = 30, 56.6%). In addition, 62.3% of the patients (n = 33) asked for information regarding the medical treatment and diagnosis. With our study, we created greater awareness of the psychological needs of brain tumour patients in order to define treatment strategies for this important aspect of disease. We showed that there is a need for patients to talk about death even during the initial consultation. Psycho-oncologist in a neuro-oncological setting should be prepared for topics like that and should have a neurosurgical background or collaborate with members of the surgical team in order to provide the patients with medical details and to better understand the impact of the disease.
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Hedman C, Strang P, Djärv T, Widberg I, Lundgren CI. Anxiety and Fear of Recurrence Despite a Good Prognosis: An Interview Study with Differentiated Thyroid Cancer Patients. Thyroid 2017; 27:1417-1423. [PMID: 28874092 DOI: 10.1089/thy.2017.0346] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Despite a good prognosis, fear of recurrence is prevalent, even several years after a diagnosis of differentiated thyroid cancer (DTC). For this reason, the aim of this study was to make an in-depth exploration of anxiety, sources of anxiety, and protective strategies. METHODS In order to capture a broad description of the phenomenon, a purposeful, maximum variation sampling strategy regarding age, sex, stage of disease, educational level, and time since diagnosis was used. In total, 21 patients were included in the study. Semi-structured interviews were tape-recorded, transcribed verbatim, and analyzed with a qualitative content analysis. RESULTS Patients with and without recurrences narrated a picture indicating anxiety related to their current situation; future risks and threats were central to this picture. However, they initially minimized or even denied having anxiety, but subsequently described it as a major problem at the end of the interviews. Anxiety was related to risk of recurrence and the risk of developing other cancers, but also to fears of a future situation where no further treatment options were available. Previous experiences of delayed investigations added to these fears. In order to cope, patients developed protective strategies in order to keep evasive and frightening thoughts away. Everyday life, distractions, and focusing on "the small things in life" were examples of such strategies. CONCLUSIONS Anxiety is a common, although partially hidden, problem in DTC survivors, as they tended to deny it early in the dialogues. As anxiety is clearly related to follow-up routines, these should therefore be revaluated.
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Affiliation(s)
- Christel Hedman
- 1 Department of Molecular Medicine and Surgery, Karolinska Institutet , Stockholm, Sweden
- 2 R&D Department, Stockholms Sjukhem Foundation , Stockholm, Sweden
| | - Peter Strang
- 2 R&D Department, Stockholms Sjukhem Foundation , Stockholm, Sweden
- 3 Department of Oncology-Pathology, Karolinska Institutet , Stockholm, Sweden
| | - Therese Djärv
- 4 Department of Medicine, Karolinska Institutet , Stockholm, Sweden
| | - Ida Widberg
- 1 Department of Molecular Medicine and Surgery, Karolinska Institutet , Stockholm, Sweden
- 5 Gustavsberg's Health Care Centre , Gustavsberg, Sweden
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Ramirez C, Christophe V, Dassonneville C, Grynberg D. Caregivers' quality of life and psychological health in response to functional, cognitive, neuropsychiatric and social deficits of patients with brain tumour: protocol for a cross-sectional study. BMJ Open 2017; 7:e016308. [PMID: 29061609 PMCID: PMC5665306 DOI: 10.1136/bmjopen-2017-016308] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION Patients with gliomas generally present cognitive, neuropsychiatric and functional deficits. Although previous research has shown that their caregivers present a poor quality of life and poor mental health, only a few studies have tested in a comprehensive way which deficits/preserved abilities of patients predominantly impact their caregivers. Furthermore, only a few studies have focused on the social impact of gliomas, which may also damage the caregivers' quality of life. Therefore, this cross-sectional study aims to investigate which patients' impairments are particularly deleterious for the caregivers and whether the histological characteristics of the gliomas also affect their quality of life. METHODS AND ANALYSIS In order to examine these research questions, this study intends to include 180 patients (60 patients with grade II gliomas, 60 patients with grade III gliomas and 60 patients with grade IV gliomas), their caregivers and 60 healthy controls. While patients will complete a full battery of cognitive, neuropsychiatric, functional and social tests, caregivers will complete questionnaires about their quality of life, depression, anxiety and burden. Patients' performances and caregivers' reports of depression and anxiety will be compared with the scores of healthy controls. Eventually, our aim will be to provide specific care support both to reduce patients' deficits and alleviate caregivers' difficulties. ETHICS AND DISSEMINATION The study has obtained the approval of the local faculty ethics committee ('Comité d'éthique en sciences comportementales'; 2016-5 S41 and 2015-3 S37). On completion of the study, data will be kept by Lille University for 5 years before they are destroyed. Study findings will be disseminated through peer-reviewed journal publications and conference presentations with no reference to a specific individual.
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Affiliation(s)
- Carole Ramirez
- Department of Neurosurgery, CHRU de Lille, Lille, France
| | - Véronique Christophe
- UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, Univ. Lille, Lille, France
- SIRIC ONCOLille, Maison Régionale de la Recherche Clinique, Lille, France
| | - Charlotte Dassonneville
- UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, Univ. Lille, Lille, France
- SIRIC ONCOLille, Maison Régionale de la Recherche Clinique, Lille, France
| | - Delphine Grynberg
- UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, Univ. Lille, Lille, France
- SIRIC ONCOLille, Maison Régionale de la Recherche Clinique, Lille, France
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Ebenau A, van Gurp J, Hasselaar J. Life values of elderly people suffering from incurable cancer: A literature review. PATIENT EDUCATION AND COUNSELING 2017; 100:1778-1786. [PMID: 28578833 DOI: 10.1016/j.pec.2017.05.027] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 04/28/2017] [Accepted: 05/21/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Due to aging Western societies, older patients suffering from incurable cancer will present themselves more often to health care professionals. To be of service to these severely ill elderly patients, more knowledge is needed on which life values are guiding them through their last phases of life. This review aims to describe which life values play an important part in the lives of elderly people suffering from incurable cancer. METHODS We conducted a literature review with a structured search to identify empirical studies (January 1950-February 2016) using six databases. RESULTS The analysis of thirty articles resulted in the extensive description of eight life values: comfort, continuity, humility, dignity, honesty, optimism, hope and preparedness. CONCLUSION Elderly patients suffering from incurable cancer use the abovementioned life values to give meaning to a life interrupted by disease. Furthermore, these values will play a role in communication and decision-making. PRACTICE IMPLICATIONS Knowledge about life values can help professionals discuss and clarify personal preferences with elderly patients suffering from incurable cancer, contributing to more personalized care and treatment. Communication should focus on to what extent patient empowerment, life-prolonging treatment and the involvement of the patient's supporting systems suit the wishes of these patients.
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Affiliation(s)
- Anne Ebenau
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Nijmegen Medical Center, Nijmegen, Netherlands.
| | - Jelle van Gurp
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Nijmegen Medical Center, Nijmegen, Netherlands; Department of IQ Healthcare, Section Ethics, Radboud University Nijmegen Medical Center, Nijmegen, Netherlands.
| | - Jeroen Hasselaar
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Nijmegen Medical Center, Nijmegen, Netherlands.
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Bergqvist J, Strang P. The will to live - breast cancer patients perceptions' of palliative chemotherapy. Acta Oncol 2017; 56:1168-1174. [PMID: 28524711 DOI: 10.1080/0284186x.2017.1327719] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND For women with metastatic breast cancer, late lines of chemotherapy might be beneficial but also harmful. Ongoing chemotherapy late in life increase the risk of late or absent discussions of palliative care and access to symptom relief by other options than chemotherapy. Our aim was, therefore, to investigate breast cancer patients' motives, perceptions, and experiences of late lines of palliative oncologic treatment. MATERIAL AND METHODS A qualitative study with semi-guided face-to-face interviews with 20 women on at least their second line of palliative chemotherapy (second-eighth line). All women had breast cancer and were 40-80 years old. The interviews were analyzed by a phenomenographical approach according to seven steps, which uses a second-order perspective, i.e., how the informants experience the world. RESULTS The categories that surrounded the decision to continue with palliative chemotherapy were: The decision, Personal motives and goals and The treatment. All women acknowledged that they knew they had incurable breast cancer and that the treatment goal was to slow down cancer growth. Fear of death was a strong motive for all women in addition to experience of new values of life, still they preferred the doctor to make the decision. Cancer symptoms, especially pain triggered death anxiety, whereas the patients patiently accepted similar side effects from the treatment. There were also external motives for treatment like wishes from family, friends, but also health care staff. CONCLUSIONS All women knew they had disseminated breast cancer, still they expressed hopes for cure, therefore, death was more of a threat than a reality of an imminent death. None of the women had perceived there was an option to stop treatment. They felt both their families and doctors expected them to continue. Death threat was their main motive for accepting treatment.
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Affiliation(s)
- Jenny Bergqvist
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- Capio St. Görans Sjukhus, Stockholm, Sweden
| | - Peter Strang
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- Department of Research and Development, Stockholms Sjukhem Foundation, Stockholm, Sweden
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An E, Wennberg E, Nissim R, Lo C, Hales S, Rodin G. Death talk and relief of death-related distress in patients with advanced cancer. BMJ Support Palliat Care 2017; 10:e19. [PMID: 28768681 DOI: 10.1136/bmjspcare-2016-001277] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 05/19/2017] [Accepted: 06/26/2017] [Indexed: 11/03/2022]
Abstract
OBJECTIVES The circumstances of advanced cancer heighten the need for affected individuals to communicate mortality-related concerns, although there may be obstacles to such communication. Managing Cancer and Living Meaningfully(CALM) is a supportive-expressive therapy designed to address such barriers and to facilitate communication of mortality-related concerns in patients and caregivers facing advanced disease. This study explores death-related distress in patients with advanced cancer and the perceived influence of CALM therapy on overcoming barriers to communication of this distress. METHODS Semistructured interviews were conducted with a subset of patients with advanced cancer (n=17) participating in a CALM phase III trial at a large urban regional cancer centre. Interviews were transcribed, and qualitative data were analysed using thematic analysis. RESULTS Death-related distress was experienced in terms of three key themes: diffuse and overwhelming fear, fear of uncertainty and fear of suffering. The perceived barriers to communicating such distress were as follows: reluctance of loved ones to discuss mortality-related issues and the participants´ own reluctance to discuss death-related concerns to protect their loved ones or themselves from distress. CALM therapists were perceived to facilitate discussions on dying and death in sessions and to support patients´ communication of death-related distress with healthcare providers and loved ones. CONCLUSIONS Patients with advanced cancer perceive barriers to effective communication of death distress to be related to their own reluctance, as well as reluctance of their loved ones to address such fears. CALM therapy may help patients with advanced cancer to overcome obstacles to communication and to alleviate death-related distress. TRIAL REGISTRATION NUMBER NCT01506492.
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Affiliation(s)
- Ekaterina An
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.,Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Erica Wennberg
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Rinat Nissim
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Christopher Lo
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada.,Department of Psychology, University of Guelph-Humber, Toronto, Canada
| | - Sarah Hales
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Gary Rodin
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.,Institute of Medical Science, University of Toronto, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada
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Anxiety in the context of cancer: A systematic review and development of an integrated model. Clin Psychol Rev 2017; 56:40-54. [DOI: 10.1016/j.cpr.2017.06.003] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 06/11/2017] [Accepted: 06/26/2017] [Indexed: 12/23/2022]
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Chow HPH. A time to be born and a time to die: Exploring the determinants of death anxiety among university students in a western Canadian city. DEATH STUDIES 2017; 41:345-352. [PMID: 28060575 DOI: 10.1080/07481187.2017.1279240] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Using data collected from a questionnaire survey of 501 university students in a western Canadian city, this article explores the death anxiety among young adults and the factors influencing their levels of death anxiety. Results demonstrated that respondents displayed a moderate level of death anxiety. Multiple regression analysis further revealed that females, non-Caucasians and those who demonstrated to be less religious, indicated a higher level of loneliness, scored lower on the purpose in life scale, expressed dissatisfaction with their self-image, and reported a higher socio-economic status were found to exhibit a higher level of death anxiety.
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Affiliation(s)
- Henry P H Chow
- a Department of Sociology & Social Studies , University of Regina , Regina , Saskatchewan , Canada
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Pace A, Dirven L, Koekkoek JAF, Golla H, Fleming J, Rudà R, Marosi C, Rhun EL, Grant R, Oliver K, Oberg I, Bulbeck HJ, Rooney AG, Henriksson R, Pasman HRW, Oberndorfer S, Weller M, Taphoorn MJB. European Association for Neuro-Oncology (EANO) guidelines for palliative care in adults with glioma. Lancet Oncol 2017; 18:e330-e340. [DOI: 10.1016/s1470-2045(17)30345-5] [Citation(s) in RCA: 147] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 03/08/2017] [Accepted: 03/09/2017] [Indexed: 12/14/2022]
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Insecure attachment predicts depression and death anxiety in advanced cancer patients. Palliat Support Care 2017; 16:308-316. [PMID: 28502270 DOI: 10.1017/s1478951517000281] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
ABSTRACTObjective:The prevalence of depression as well as adjustment and anxiety disorders is high in advanced cancer patients, and research exploring intraindividual factors leading to high psychological distress is underrepresented. Cancer patients' feelings about security and trust in their healthcare providers have a significant influence on how they deal with their disease. The perception of social support is affected by patients' attachment styles and influences their reactions to feelings of dependency and loss of control. We therefore aimed to explore attachment and its association with psychological distress in patients with advanced cancer. METHOD We obtained data from the baseline measurements of a randomized controlled trial in advanced cancer patients. Patients were sampled from the university medical centers of Hamburg and Leipzig, Germany. The main outcome measures included the Patient Health Questionnaire, the Death and Dying Distress Scale, the Memorial Symptom Assessment Scale, and the Experience in Close Relationships Scale for assessing attachment insecurity. RESULTS A total of 162 patients were included. We found that 64% of patients were insecurely attached (fearful-avoidant 31%, dismissing 17%, and preoccupied 16%). A dismissing attachment style was associated with more physical symptoms but did not predict psychological distress. A fearful-avoidant attachment style significantly predicted higher death anxiety and depression, whereas preoccupied attachment predicted higher death anxiety only. Overall, insecure attachment contributed to the prediction of depression (10%) and death anxiety (14%). SIGNIFICANCE OF RESULTS The concept of attachment plays a relevant role in advanced cancer patients' mental health. Healthcare providers can benefit from knowledge of advanced cancer patients' attachment styles and how they relate to specific mental distress. Developing a better understanding of patients' reactions to feelings of dependency and distressing emotions can help us to develop individually tailored advanced cancer care programs and psychotherapeutic interventions.
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Cubis L, Ownsworth T, Pinkham MB, Chambers S. The social trajectory of brain tumor: a qualitative metasynthesis. Disabil Rehabil 2017; 40:1857-1869. [PMID: 28420297 DOI: 10.1080/09638288.2017.1315183] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Research indicates that strong social ties can buffer the adverse effects of chronic illness on psychological well-being. Brain tumor typically leads to serious functional impairments that affect relationships and reduce social participation. This metasynthesis aimed to identify, appraise and integrate the findings of qualitative studies that reveal the impact of brain tumor on social networks. METHODS Four major databases (PubMed, CINAHL, Cochrane Library and PsycINFO) were systematically searched from inception to September 2016 for qualitative studies that reported findings on the impact of primary brain tumor on social networks during adulthood. Twenty-one eligible studies were identified and appraised according to the Consolidated Criteria for Reporting Qualitative Research. Key findings of these studies were integrated to form superordinate themes. RESULTS The metasynthesis revealed the core themes of: 1) Life disrupted; 2) Navigating the new reality of life; and 3) Social survivorship versus separation. CONCLUSIONS Multiple changes typically occur across the social trajectory of brain tumor, including a loss of pre-illness networks and the emergence of new ones. Understanding the barriers and facilitators for maintaining social connection may guide interventions for strengthening social networks and enhancing well-being in the context of brain tumor. Implications for rehabilitation Social networks and roles are disrupted throughout the entire trajectory of living with brain tumor Physical, cognitive and psychological factors represent barriers to social integration Barriers to social integration may be addressed by supportive care interventions Compensatory strategies, adjusting goals and expectations, educating friends and family and accepting support from others facilitate social reintegration throughout the trajectory of living with brain tumor.
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Affiliation(s)
- Lee Cubis
- a School of Applied Psychology , Menzies Health Institute Queensland, Griffith University , Mt Gravatt , Australia
| | - Tamara Ownsworth
- a School of Applied Psychology , Menzies Health Institute Queensland, Griffith University , Mt Gravatt , Australia
| | - Mark B Pinkham
- b Princess Alexandra Hospital , University of Queensland , Woolloongabba , Australia
| | - Suzanne Chambers
- c Menzies Health Institute , Queensland , Nathan , Australia.,d Cancer Council Queensland , Brisbane , Australia
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47
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Martin C. Oncolytic Viruses: Treatment and Implications for Patients With Gliomas. Clin J Oncol Nurs 2017; 21:60-64. [DOI: 10.1188/17.cjon.s2.60-64] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Lang S, Cadeaux M, Opoku-Darko M, Gaxiola-Valdez I, Partlo LA, Goodyear BG, Federico P, Kelly J. Assessment of Cognitive, Emotional, and Motor Domains in Patients with Diffuse Gliomas Using the National Institutes of Health Toolbox Battery. World Neurosurg 2017; 99:448-456. [DOI: 10.1016/j.wneu.2016.12.061] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Revised: 12/13/2016] [Accepted: 12/14/2016] [Indexed: 12/31/2022]
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50
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Engelmann D, Scheffold K, Friedrich M, Hartung TJ, Schulz-Kindermann F, Lordick F, Schilling G, Lo C, Rodin G, Mehnert A. Death-Related Anxiety in Patients With Advanced Cancer: Validation of the German Version of the Death and Dying Distress Scale. J Pain Symptom Manage 2016; 52:582-587. [PMID: 27521283 DOI: 10.1016/j.jpainsymman.2016.07.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 06/18/2016] [Accepted: 07/29/2016] [Indexed: 10/21/2022]
Abstract
CONTEXT Distress and anxiety about issues related to death and dying is commonly experienced in patients with advanced disease and a limited life expectancy. OBJECTIVES To evaluate the psychometric properties of the German version of the Death and Dying Distress Scale (DADDS-G) in advanced cancer patients. METHODS We recruited advanced patients with mixed tumor entities (Union for International Cancer Control [UICC] Stage III/IV) treated in two German University Medical Centers during their outpatient treatment. After testing a preliminary version of the state-of-the-art translated original Death and Dying Distress Scale, we analyzed the psychometric properties of the shortened nine-item adapted DADDS-G using validated instruments measuring distress, anxiety, depression, fear of progression, and quality of life. RESULTS We obtained complete questionnaires from 77 of 93 patients with advanced cancer (response rate: 83%). Participants were mostly married or cohabiting (75%), well-educated, and both sexes were almost equally represented (52% men; mean age 58 years, SD = 12). The total mean DADDS-G score was 13.3 (SD = 8.5). Patients reported to be most distressed by the feeling of being a burden to others. The exploratory factor analysis led to one factor that accounted for more than 59% of the variance. The DADDS-G's internal consistency was excellent with Cronbach alpha = 0.91. The confirmatory factor analysis demonstrated a very good model fit. Death-related anxiety was significantly associated with distress, depression, anxiety, fear of progression, and lower quality of life (P < 0.001). CONCLUSION Results provide further evidence that the DADDS-G is a valid and reliable instrument of high clinical relevance for use in patients with advanced cancer.
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Affiliation(s)
- Dorit Engelmann
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Katharina Scheffold
- Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Friedrich
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Tim J Hartung
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Frank Schulz-Kindermann
- Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Florian Lordick
- University Cancer Center Leipzig (UCCL), University Medical Center Leipzig, Leipzig, Germany
| | | | - Chris Lo
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Gary Rodin
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Anja Mehnert
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany.
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