Rodin, Gary, Lo, Christopher, Mikulincer, Mario, Donner, Allan, Gagliese, Lucia, and Zimmermann, Camilla (2009) Pathways to distress: the multiple determinants of depression, hopelessness, and the desire for hastened death in metastatic cancer patients. Social Science and Medicine, 68 (3). pp. 562-569.

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Abstract

We tested a model in which psychosocial and disease-related variables act as multiple protective and risk factors for psychological distress in patients with metastatic cancer. We hypothesized that depression and hopelessness constitute common pathways of distress, which mediate the effects of psychosocial and disease-related factors on the desire for hastened death. This model was tested on a cross-sectional sample of 406 patients with metastatic gastrointestinal or lung cancer recruited at outpatient clinics of a Toronto cancer hospital, using structural equation modeling. The results supported the model. High disease burden, insecure attachment, low self-esteem, and younger age were risk factors for depression. Low spiritual well-being was a risk factor for hopelessness. Depression and hopelessness were found to be mutually reinforcing, but distinct constructs. Both depression and hopelessness independently predicted the desire for hastened death, and mediated the effects of psychosocial and disease-related variables on this outcome. The identified risk factors support a holistic approach to palliative care in patients with metastatic cancer, which attends to physical, psychological, and spiritual factors to prevent and treat distress in patients with advanced disease.

Item ID:	86525
Item Type:	Article (Research - C1)
ISSN:	1873-5347
Copyright Information:	© 2008 Elsevier Ltd. All rights reserved.
Date Deposited:	06 Aug 2025 00:38
FoR Codes:	42 HEALTH SCIENCES > 4203 Health services and systems > 420316 Palliative care @ 30% 32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320221 Psychiatry (incl. psychotherapy) @ 30% 52 PSYCHOLOGY > 5203 Clinical and health psychology > 520399 Clinical and health psychology not elsewhere classified @ 40%
SEO Codes:	20 HEALTH > 2004 Public health (excl. specific population health) > 200499 Public health (excl. specific population health) not elsewhere classified @ 100%
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