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Associations with worry about dying and hopelessness in ambulatory ovarian cancer patients

Published online by Cambridge University Press:  30 September 2009

Eileen Huh Shinn ,
Cindy L. Carmack Taylor ,
Kelly Kilgore ,
Alan Valentine ,
Diane C. Bodurka ,
John Kavanagh ,
Anil Sood ,
Yisheng Li  and
Karen Basen-Engquist
Eileen Huh Shinn*
Affiliation:
Department of Behavioral Science, University of Texas M.D. Anderson Cancer Center, Houston, Texas
Cindy L. Carmack Taylor
Affiliation:
Department of Behavioral Science, University of Texas M.D. Anderson Cancer Center, Houston, Texas
Kelly Kilgore
Affiliation:
Department of Behavioral Science, University of Texas M.D. Anderson Cancer Center, Houston, Texas
Alan Valentine
Affiliation:
Department of Psychiatry, University of Texas M.D. Anderson Cancer Center, Houston, Texas
Diane C. Bodurka
Affiliation:
Department of Gynecologic Oncology, University of Texas M.D. Anderson Cancer Center, Houston, Texas
John Kavanagh
Affiliation:
Department of Gynecologic Oncology, University of Texas M.D. Anderson Cancer Center, Houston, Texas
Anil Sood
Affiliation:
Department of Gynecologic Oncology, University of Texas M.D. Anderson Cancer Center, Houston, Texas
Yisheng Li
Affiliation:
Department of Biostatistics, University of Texas M.D. Anderson Cancer Center, Houston, Texas
Karen Basen-Engquist
Affiliation:
Department of Behavioral Science, University of Texas M.D. Anderson Cancer Center, Houston, Texas
*
Address correspondence and reprint requests to: Eileen Shinn, Department of Behavioral Science, P.O. Box 301439, Houston, TX 77230. E-mail: [email protected]
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Abstract

Objective: Women with ovarian cancer face a poor prognosis, with prolonged periods of treatment but relatively high levels of physical functioning. Their thoughts and feelings regarding the prospect of dying are complex and have not been adequately studied. Various demographic, medical and psychosocial factors were examined to determine their independent associations with fear of dying and hopelessness in a cross-sectional design.

Method: Two hundred fifty-four ovarian cancer patients were assessed at the beginning of a new chemotherapy regimen. Separate logistic regressions were performed for worry about dying and loss of hope. For each analysis, psychosocial variables were entered after the demographic and medical variables to determine whether the psychosocial variables had an independent association with the respective outcome.

Results: Fifty-five percent of the sample acknowledged fear of dying, and 31.6% acknowledged loss of hope in the fight against their illness. Being younger (p = .001), being of non-Hispanic White ethnicity (p = .026), and having poorer physical well-being (p = .000) were significantly associated with worry about dying after controlling for all other variables in the model. Regarding loss of hope, depressive symptoms (p = .002), lack of social support/well-being (p = .001), and number of treatments (p = .04) were significant.

Significance of results: This is one of the largest studies to examine end-of-life concerns in a sample of advanced cancer patients. Our results underscore the importance of demographic and psychosocial variables in the examination of ovarian cancer patients' end-of-life concerns. Their fears and concerns should be openly acknowledged, even when the clinical focus is still on curative treatment.

Keywords

Patient careAttitude to deathDepressionAdjustment disorderOvarian neoplasms
Type
Original Articles
Information
Palliative & Supportive Care , Volume 7 , Issue 3 , September 2009 , pp. 299 - 306
Copyright
Copyright © Cambridge University Press 2009

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References

REFERENCES

Armstrong, D., Bundy, B., Wenzel, L., et al. (2006). Intraperitoneal cisplatin and paclitaxel in ovarian cancer. The New England Journal of Medicine, 354, 34–43.CrossRefGoogle ScholarPubMed
Basen-Engquist, K., Bodurka-Bevers, D. & Carmack, C. (2001). Psychological distress and sexual function of ovarian cancer survivors. Quality of Life Research, 10, 229.Google Scholar
Beck, A. & Steer, R. (1988). Beck Hopelessness Inventory Manual. Philadelphia: Harcourt Brace, Jovanovich.Google Scholar
Beck, J. (1995). Cognitive Therapy: Basics and Beyond. New York: Guilford Press.Google Scholar
Brady, M., Peterman, A., Fitchett, G., et al. (1999). A case for including spirituality in quality of life measurement in oncology. Psychooncology, 8, 417–428.3.0.CO;2-4>CrossRefGoogle ScholarPubMed
Breitbart, W., Rosenfeld, B., Pessin, H., Kaim, M., et al. (2000). Depression, hopelessness, and desire for hastened death in terminally ill patients with cancer. Journal of the American Medical Association, 284, 2907–2911.Google Scholar
Cella, D., Tusky, D. & Gray, G. (1993). Development and validation of the general measure. Journal of Clinical Oncology, 11, 570–579.CrossRefGoogle ScholarPubMed
Depaola, S., Griffin, M. & Young, J. (2003). Death anxiety and attitudes toward the elderly among older adults: The role of gender and ethnicity. Death Studies, 27, 335–354.Google Scholar
DiMatteo, M.R., Lepper, H.S. & Croghan, T.W. (2000). Depression is a risk factor for noncompliance with medical treatment. Archive of Internal Medicine, 160, 2101–2107.Google Scholar
Feroz, I. & Beg, M. (1987). Death anxiety in malignant cancer patients as related to age and socioeconomic status. Perspectives in Psychological Research, 10, 1–6.Google Scholar
Ferrell, B., Smith, S., Cullinane, C., et al. (2003). Psychological well being and quality of life in ovarian cancer survivors. Cancer, 98, 1061–1071.Google Scholar
Fortner, B. & Neimeyer, R. (1999). Death anxiety in older adults: A quantitative review. Death Studies, 23, 387–407.Google ScholarPubMed
Gil, S. & Gilbar, O. (2001). Hopelessness among cancer patients. Journal of Psychosocial Oncology, 19, 21–33.Google Scholar
Grumman, M. & Spiegel, D. (2003). Living in the face of death: Interviews with 12 terminally ill women on home hospice care. Palliative and Supportive Care, 1, 23–32.CrossRefGoogle Scholar
Houck, K., Avis, N., Gallant, J., et al. (1999). Quality of life in advanced ovarian cancer: Identifying specific concerns. Journal of Palliative Medicine, 2, 397–402.Google Scholar
Jones, J., Huggins, M., Rydall, A., et al. (2003). Symptomatic distress, hopelessness, and the desire for hastened death in hospitalized cancer patients. Journal of Psychosomatic Research, 55, 411–418.Google Scholar
Konski, A., Pajak, T., Movsas, B., et al. (2006). Disadvantage of men living alone participating in radiation therapy oncology group head and neck trials. Journal of Clinical Oncology, 24, 4177–4183.CrossRefGoogle ScholarPubMed
Kroenke, K. & Spitzer, R. (2002). The PHQ-9: A new depression diagnostic and severity measure. Journal of General Internal Medicine, 16, 606–613.Google Scholar
Kugaya, A., Akechi, T., Okuyama, T., et al. (2000). Prevalence, predictive factors, and screening for psychologic distress in patients with newly diagnosed head and neck cancer. Cancer, 88, 2817–2823.3.0.CO;2-N>CrossRefGoogle ScholarPubMed
Lutgendorf, S., Anderson, B., Rothrock, N., et al. (2000). Quality of life and mood in women receiving extensive chemotherapy for gynecologic cancer. Cancer, 89, 1402–1411.3.0.CO;2-H>CrossRefGoogle ScholarPubMed
McClain-Jacobsen, C., Rosenfeld, B., Kosinski, A., et al. (2004). Belief in an afterlife, spiritual well-being and end-of-life despair in patients with advanced cancer. General Hospital Psychiatry, 26, 484–486.CrossRefGoogle Scholar
McCullagh, P. & Nelder, J. (eds.). (1989). General and Linear Models. 2nd ed.Boca Raton, FL: Chapman and Hall/CRC.Google Scholar
McGill, J. & Paul, P. (1993). Functional status and hope in elderly people with and without cancer. Oncology Nursing Forum, 20, 1207–1313.Google Scholar
Powe, B. & Finnie, R. (2003). Cancer fatalism. The state of the science. Cancer Nursing, 26, 454–464.Google Scholar
Quill, T. (2000). Initiating end-of-life discussions with seriously ill patients: Addressing the “elephant in the room.” Journal of the American Medical Association, 284, 2502–2507.Google Scholar
Ringdal, G. (1995). Correlates of hopelessness in cancer patients. Journal of Psychosocial Oncology, 13, 47–66.CrossRefGoogle Scholar
Sugimoto, A. & Thomas, G. (1998). Early-stage ovarian carcinoma. In Cancer in Women, Kavanah, J., Singletary, S., Einhorn, N., et al. , eds. Malden: Blackwell Science.Google Scholar
Templer, D. (1970). The construction and validation of a Death Anxiety Scale. Journal of General Psychology, 82, 165–177.Google Scholar