Uncovering Relationships Between Demoralization, Attachment, and Social Support in Oncology Patients

Demoralization is a syndrome of existential distress characterized by helplessness, hopelessness, loss of meaning, personal failure, and difficulty coping. This study explored the correlation between demoralization, social support, and attachment to health care providers in cancer patients. We conducted an observational, cross-sectional study with 150 inpatients and outpatients (≥ 18 years) from two hospitals. Personal and medical data were collected; patients completed psychometric instruments: Demoralization Scale II (DS-II), Experiences in Close Relationship Scale-Modified Short Form (ECR-M16), and Medical Outcomes Study (MOS) Social Support Survey. Participants' mean age was 62 years (range 20-85); 59.3% were women. Diagnoses included breast (33%), gastrointestinal (24%), and lung cancer (15%). Women had significantly higher DS-II factor 2 scores (p = 0.058). DS-II factor 2 correlated positively with age (p = 0.016). Multiple linear regression indicated that ECR-Discomfort significantly impacted DS-II factor 1 (p = 0.011, R2 = 9.3%) and factor 2 (p < 0.001, R2 = 12.1%). ECR-Anxiety also influenced DS-II factor 1 (p = 0.055, R2 = 2.7%) and factor 2 (p = 0.054, R2 = 2.4%). No significant correlation was found between demoralization and social support. Anxious and discomfort attachment patterns to health care providers exacerbate demoralization in cancer patients. Early identification of attachment styles may help reduce existential distress. These findings underscore the importance of incorporating psychological training into oncology education to better equip professionals in recognizing and addressing emotional vulnerability.