Demoralization and death anxiety in advanced cancer

An, Ekaterina, Lo, Christopher, Hales, Sarah, Zimmermann, Camilla, and Rodin, Gary (2018) Demoralization and death anxiety in advanced cancer. Psycho-Oncology, 27 (11). pp. 2566-2572.

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Abstract

Objective: The circumstances of advanced cancer can cause considerable psychological distress, including death anxiety and demoralization. Although these states of existential distress have a negative impact on the quality of life of patients with advanced cancer, they are rarely evaluated as outcomes or targets of interventions in this population. In an effort to improve understanding of existential distress, a structural model of relationships among death anxiety, demoralization, symptom burden, and social relatedness was tested in patients with advanced cancer.

Methods: A total of 307 patients with advanced cancer completed baseline measures including the Death and Dying Distress Scale, the Demoralization Scale, the modified Experiences in Close Relationships Scale, the Life Completion subscale of the Quality of Life Evaluation—Cancer scale, the Memorial Symptom Assessment Scale, and Karnofsky Performance Status. A structural equation model of protective and risk factors for demoralization and death anxiety was tested.

Results: The final model had good fit (SRMR = 0.061; RMSEA = 0.077; CFI = 0.927; NNFI = 0.902) in which death anxiety was positively associated with demoralization (β = 0.71), and demoralization was positively associated with symptom burden (β = 0.31) and negatively associated with social relatedness (β = −0.74).

Conclusions: The findings of this study suggest that demoralization and death anxiety are closely linked in patients with advanced cancer. The contribution of both symptom burden and low social relatedness to demoralization suggests that an integrated intervention addressing both physical and psychosocial disease factors may be most effective at alleviating such states of existential distress.

Item ID: 69138
Item Type: Article (Research - C1)
ISSN: 1099-1611
Keywords: advanced cancer, death anxiety, demoralization, existential distress, structural equation modeling,terror management theory
Copyright Information: © 2018 John Wiley & Sons, Ltd.
Funders: Princess Margaret Cancer Foundation (PMCF) Canada, Canadian Institutes of Health Research (CIHR)
Projects and Grants: PMCF Hertz Centre Fund, CIHR Grant/Award Number: MOP106473
Date Deposited: 01 Sep 2021 02:24
FoR Codes: 52 PSYCHOLOGY > 5203 Clinical and health psychology > 520304 Health psychology @ 100%
SEO Codes: 20 HEALTH > 2001 Clinical health > 200105 Treatment of human diseases and conditions @ 100%
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