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Death Anxiety and Correlates in Cancer Patients Receiving Palliative Care
Linda L Emanuel1,2, Sheldon Solomon3, Harvey Max Chochinov4,5
1Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts, USA.
Journal of Palliative Medicine
|September 6, 2022
Summary
Death anxiety in palliative care patients is linked to religious struggle and dignity distress, not demographics. Interventions may improve end-of-life distress and awareness.
Area of Science:
- Palliative Care Medicine
- Psychosocial Oncology
- Thanatology
Background:
- Death anxiety is a significant concern in serious illness but understudied in palliative care.
- The Death Anxiety and Distress Scale (DADDS) offers a tool for assessing death anxiety.
- Understanding factors associated with death anxiety is crucial for effective patient care.
Purpose of the Study:
- To explore associations between death anxiety and physical/psychosocial factors in older adults with cancer.
- To investigate the relationship between death anxiety, dignity-related distress, existential quality of life, and terminal illness awareness.
- To evaluate the impact of Dignity Therapy (DT) on death anxiety.
Main Methods:
- A convenience sample of 167 older adults with cancer receiving outpatient palliative care was studied.
- Participants completed the DADDS, alongside measures of demographics, religious struggle, dignity distress, existential QoL, and terminal illness awareness.
- Data were analyzed to identify correlations and associations, including a subset analysis post-Dignity Therapy.
Main Results:
- DADDS scores showed no significant relation to demographic factors.
- DADDS scores positively correlated with religious struggle and dignity-related distress (p < 0.001).
- DADDS scores negatively correlated with existential QoL (p < 0.001), and terminal illness awareness showed nonlinear associations with DADDS scores.
Conclusions:
- Death anxiety in palliative care is associated with psychosocial factors like religious struggle and dignity distress, rather than demographics.
- Findings suggest a need for further research into death anxiety and prognostic awareness in palliative medicine.
- Screening for death anxiety and prognostic awareness may optimize spiritual and psychosocial interventions in end-of-life care.
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