Death anxiety interventions in patients with advanced cancer: A systematic review

2017 ◽  
Vol 32 (1) ◽  
pp. 172-184 ◽  
Author(s):  
Christopher H Grossman ◽  
Joanne Brooker ◽  
Natasha Michael ◽  
David Kissane
Keyword(s):  
Cancer Patients ◽  
Advanced Cancer ◽  
Death Anxiety ◽  
Well Being ◽  
Adult Patients ◽  
Cancer Therapies ◽  
Advanced Cancer Patients ◽  
Quantitative Studies ◽  
Spiritual Well Being ◽  
Randomised Controlled

Background: Death anxiety is a common issue in adult patients with advanced cancer and can have a large impact on quality of life and end-of-life care. Interventions are available to assist but are scarcely used in everyday practice. Aim: To assess quantitative studies on interventions for adult patients with advanced cancer suffering from death anxiety. Data sources: MEDLINE, PsycINFO, Embase and CINAHL were searched to identify quantitative or mixed studies on death anxiety or relatable existential intervention studies in advanced cancer patients published from 1990 to December 2016. Two reviewers independently screened titles and abstracts and assessed relevant studies for eligibility. Data were then extracted from included studies for analysis. Results: Nine unique quantitative studies were identified, including five randomised controlled trials, involving a total overall of 1179 advanced cancer patients. All studies were psychotherapeutic in nature and centred on existential themes such as meaning, dignity, relationships and spiritual well-being. The therapies investigated shared overlapping themes but varied in duration, therapist experience, training required and burden on patient. Heterogeneity of studies and measures prevented determination of an overall effect size. Conclusion: Interventions were identified for this clinical scenario of death anxiety in patients with advanced cancer. Therapies of short duration incorporating spiritual well-being and those evoking a sense of meaning were claimed to be the most beneficial, despite lacking rigorous statistical analysis. More high-quality studies with tailored outcome measures are required to fully evaluate the most effective interventions for death anxiety in patients with advanced cancer.

Individual Meaning-Centered Psychotherapy for Advanced Cancer Patients

2017 ◽  
Author(s):  
William Breitbart ◽  
Wendy G. Lichtenthal ◽  
Allison J. Applebaum ◽  
Melissa Masterson
Keyword(s):  
Clinical Trials ◽  
End Of Life ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Therapeutic Intervention ◽  
Well Being ◽  
Existential Psychology ◽  
Advanced Cancer Patients ◽  
Spiritual Well Being ◽  
Existential Concerns

Among the advanced cancer population, existential concerns are major issues that promote significant distress. For patients who are facing death, meaning and the preservation of meaning are not only clinically and existentially important but also central concepts to a therapeutic intervention. Based on Viktor Frankl’s logotherapy and the principles of existential psychology and philosophy, “meaning-centered psychotherapy” was developed to help patients with advanced cancer sustain or enhance a sense of meaning, peace, and purpose in their lives. This chapter provides an overview of work developing and testing individual meaning-centered psychotherapy (IMCP). It provides an overview of the session content in the IMCP intervention. It also presents findings from clinical trials, which support the efficacy of IMCP as an intervention to increase a sense of meaning, spiritual well-being, and hope while decreasing end-of-life despair. Furthermore, it presents difficult scenarios that may arise when delivering IMCP for clinicians interested in this work.

Unmet spiritual care needs impact emotional and spiritual well-being in advanced cancer patients

2011 ◽  
Vol 20 (10) ◽  
pp. 2269-2276 ◽  
Author(s):  
Michelle J. Pearce ◽  
April D. Coan ◽  
James E. Herndon ◽  
Harold G. Koenig ◽  
Amy P. Abernethy
Keyword(s):  
Cancer Patients ◽  
Advanced Cancer ◽  
Spiritual Care ◽  
Well Being ◽  
Advanced Cancer Patients ◽  
Care Needs ◽  
Spiritual Well Being

Spiritual well-being of Italian advanced cancer patients in the home palliative care setting

2017 ◽  
Vol 26 (4) ◽  
pp. e12677 ◽  
Author(s):  
A. A. Martoni ◽  
S. Varani ◽  
B. Peghetti ◽  
D. Roganti ◽  
E. Volpicella ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Care Setting ◽  
Well Being ◽  
Advanced Cancer Patients ◽  
Palliative Care Setting ◽  
Spiritual Well Being

Spiritual well-being mediates the association between attachment insecurity and psychological distress in advanced cancer patients

2019 ◽  
Vol 27 (11) ◽  
pp. 4317-4325 ◽  
Author(s):  
Katharina Scheffold ◽  
Rebecca Philipp ◽  
Sigrun Vehling ◽  
Susan Koranyi ◽  
Dorit Engelmann ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Well Being ◽  
Advanced Cancer Patients ◽  
Attachment Insecurity ◽  
Spiritual Well Being

Meaning-Centered Group Psychotherapy for Advanced Cancer Patients

2017 ◽  
Author(s):  
William Breitbart ◽  
Allison J. Applebaum ◽  
Melissa Masterson
Keyword(s):  
Cancer Patients ◽  
Group Psychotherapy ◽  
Advanced Cancer ◽  
Symptom Burden ◽  
Well Being ◽  
Evidence Base ◽  
Advanced Cancer Patients ◽  
Spiritual Well Being ◽  
Desire For Death ◽  
Anxiety Depression

The ability to sustain a sense of meaning is significantly associated with important elements of end-of-life despair. Meaning-centered group psychotherapy (MCGP), an eight-session group psychotherapy intervention, was developed to help patients with advanced cancer sustain or enhance a sense of meaning. MCGP has been shown to significantly improve spiritual well-being, sense of meaning, and quality of life and to diminish anxiety, depression, hopelessness, symptom burden distress, and desire for death. The mechanism of this benefit is through the enhancement of meaning. MCGP appears to be a beneficial intervention for emotional and spiritual suffering in advanced cancer patients. This chapter describes the theoretical framework and research basis for pursuing an intervention to enhance or sustain meaning. It also describes the development of MCGP, its evidence base for clinical efficacy, and outlines the intervention in great detail.

scholarly journals Health-related quality of life and its socio-economic and cultural predictors among advanced cancer patients: evidence from the APPROACH cross-sectional survey in Hyderabad-India

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Jean Jacob ◽  
Gayatri Palat ◽  
Naina Verghese ◽  
Priya Chandran ◽  
Vineela Rapelli ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Advanced Cancer ◽  
Well Being ◽  
Pain Severity ◽  
Psychological State ◽  
Advanced Cancer Patients ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Minority Religions ◽  
Spiritual Well Being

Abstract Background Patients with advanced cancer often experience poor health-related quality-of-life (HRQoL) due to cancer and treatment-related side-effects. With India’s palliative care landscape in its infancy, there is a concern that advanced cancer patients, especially individuals who are from disadvantaged populations experience poor HRQoL outcomes. We aim to assess HRQoL of advanced cancer patients in terms of general well-being (physical, functional, emotional, and social/family well-being), pain experiences, psychological state, and spiritual well-being, and determine the relationship between belonging to a disadvantaged group and HRQoL outcomes. We hypothesize that patients from disadvantaged or minority backgrounds, identified in this paper as financially distressed, female, lower years of education, lower social/family support, minority religions, and Non-General Castes, would be associated with worse HRQoL outcomes compared to those who are not from a disadvantaged group. Methods We administered a cross-sectional survey to 210 advanced cancer patients in a regional cancer center in India. The questionnaire included standardized instruments for general well-being (FACT-G), pain experiences (BPI), psychological state (HADS), spiritual well-being (FACT-SP); socio-economic and demographic characteristics. Results Participants reported significantly lower general well-being (mean ± SD) (FACT-G = 62.4 ± 10.0) and spiritual well-being (FACT-SP = 32.7 ± 5.5) compared to a reference population of cancer patients in the U.S. Patients reported mild to moderate pain severity (3.2 ± 1.8) and interference (4.0 ± 1.6), normal anxiety (5.6 ± 3.1) and borderline depressive symptoms (9.7 ± 3.3). Higher financial difficulty scores predicted most of the HRQoL domains (p ≤ 0.01), and being from a minority religion predicted lower physical well-being (p ≤ 0.05) and higher pain severity (p ≤ 0.05). Married women reported lower social/family well-being (p ≤ 0.05). Pain severity and interference were significant predictors of most HRQoL domains. Conclusions Advanced cancer patients, especially those with lower financial well-being and belonging to minority religions, reported low physical, functional, emotional, social/family, and spiritual well-being, and borderline depressive symptoms. Future studies should be directed at developing effective interventions supporting vulnerable groups such as those with financial distress, and those belonging to minority religions.

scholarly journals Symptom Burden, Depression, and Spiritual Well-Being: A Comparison of Heart Failure and Advanced Cancer Patients

2009 ◽  
Vol 24 (5) ◽  
pp. 592-598 ◽  
Author(s):  
David B. Bekelman ◽  
John S. Rumsfeld ◽  
Edward P. Havranek ◽  
Traci E. Yamashita ◽  
Evelyn Hutt ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Symptom Burden ◽  
Well Being ◽  
Advanced Cancer Patients ◽  
Spiritual Well Being

scholarly journals Exploring the relationship between spiritual well-being and death anxiety in patients with gynecological cancer: a cross-section study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Yue Feng ◽  
Xingcan Liu ◽  
Tangwei Lin ◽  
Biru Luo ◽  
Qianqian Mou ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Cross Section ◽  
Death Anxiety ◽  
Religious Beliefs ◽  
Gynecological Cancer ◽  
Well Being ◽  
Life Questionnaire ◽  
Section Study ◽  
Spiritual Well Being ◽  
The Relationship

Abstract Background In recent years, spiritual well-being has gradually gained the attention of health care providers in China, especially those in oncology departments, who have recognized the importance of improving spiritual well-being in cancer patients. Since most of the current research on spiritual well-being has been carried out in areas with religious beliefs, this study was conducted in the context of no development of formal religion. The purpose of this study was to explore the relationship between death anxiety and spiritual well-being and the related factors of spiritual well-being among gynecological cancer patients. Methods This cross-section study was conducted among 586 gynecological cancer patients. The European Organization for Research and Treatment for Cancer Quality of Life Questionnaire-spiritual well-being32 (EORTC QLQ-SWB32) and Templer's Death Anxiety Scale (T-DAS) were used to measure spiritual well-being and death anxiety. The Multiple Linear Regression Model was used to determine the relationship between spiritual well-being and death anxiety. Results For all participants, the highest QLQ-SWB32 centesimal score was 75.13 on the Relationship with Other scale, and the lowest was 60.33 on the Relationship with Someone or Something Greater Scale. The mean Death Anxiety score was 5.31 (SD 3.18). We found that Relationship with Someone or Something Greater was the only scale not associated with death anxiety. Overall, patients with lower death anxiety have a higher level of spiritual well-being. Besides, a high Relationship with Other score was associated with living with a partner (B = 2.471, P < 0.001) and married (B = -6.475, P = 0.001). Patients with higher Global-SWB were retired (B = 0.387, P = 0.019). Conclusions Our study found that the spiritual well-being of patients with gynecological cancer in China was no worse than in other countries with religious beliefs and patients with lower death anxiety have a higher level of spiritual well-being. Clinical staff should pay attention to the spiritual health of cancer patients, and spiritual care should be regarded as an essential element in cancer care.

Assessing hope at the end of life: Validation of an experience of hope scale in advanced cancer patients

2004 ◽  
Vol 2 (3) ◽  
pp. 243-253 ◽  
Author(s):  
CHERYL L. NEKOLAICHUK ◽  
EDUARDO BRUERA
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Symptom Assessment ◽  
Well Being ◽  
Assessment System ◽  
Validity Evidence ◽  
Advanced Cancer Patients ◽  
Factor I ◽  
Factor Ii

Objective:The purpose of this study was to gather validity evidence for an innovative experience of hope scale, theHope Differential-Short (HDS), and evaluate its clinical utility for assessing hope in advanced cancer patients.Methods:A consecutive sampling approach was used to recruit 96 patients from an inpatient tertiary palliative care unit and three hospice settings. Each participant completed an in-person survey interview, consisting of the following measures: HDS (nine items), Herth Hope Index (HHI), hope visual analog scale (Hope-VAS) and Edmonton Symptom Assessment System (ESAS).Results:Using factor analytic procedures, a two-factor structure for the HDS was identified, consisting ofauthentic spirit(Factor I) andcomfort(Factor II). The HDS factors had good overall internal consistency (α = 0.83), with Factor I (α = 0.83) being higher than Factor II (α = 0.69). The two factors positively correlated with the HHI, Hope-VAS, and one of the ESAS visual analog scales, well-being (range: 0.38 to 0.64) and negatively correlated with depression and anxiety, as measured by the ESAS (range: −0.25 to −0.42).Significance of results:This is the first validation study of the HDS in advanced cancer patients. Its promising psychometric properties and brief patient-oriented nature provide a solid initial foundation for its future use as a clinical assessment measure in oncology and palliative care. Additional studies are warranted to gather further validity evidence for the HDS before its routine use in clinical practice.

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