Death talk and relief of death-related distress in patients with advanced cancer

An, Ekaterina; Wennberg, Erica; Nissim, Rinat; Lo, Christopher; Hales, Sarah; Rodin, Gary

doi:10.1136/bmjspcare-2016-001277

Cited by 30 publications

(24 citation statements)

References 28 publications

(28 reference statements)

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“…With 16 invited and 11 interviewed patients, the sample may appear small. However, a sample size of 10 -20 is both common and suitable for a qualitative analysis, 56,57 if textual saturation is achieved.…”

Section: Study Limitationsmentioning

confidence: 99%

The Desire to Die in Palliative Care: A sequential mixed methods study to develop a semi-structured clinical aproach

Kremeike

Frerich

Romotzky

et al. 2020

Preprint

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Background: Although desire to die of varying intensity and permanence is frequent in patients receiving palliative care, uncertainty exists concerning appropriate therapeutic responses to it. To support health professionals in dealing with patients´ potential desire to die, a training program and a semi-structured clinical interview approach was developed. This study aimed for a revision of and consensus building on the clinical approach to support proactively addressing desire to die and routine exploration of death and dying distress. Methods: Within a sequential mixed methods design, we invited 16 palliative patients to participate in semi-structured interviews and 377 (inter-)national experts to attend a two-round Delphi process. Interviews were analyzed using qualitative content analysis and an agreement consensus for the Delphi was determined according to predefined criteria. Results: 11 (69%) patients from different settings participated in face-to-face interviews. As key issues for conversations on desire to die they pointed out the relationship between professionals and patients, the setting and support from external experts, if required. A set of 149 (40%) experts (132/89% from Germany, 17/11% from 9 other countries) evaluated ten domains of the semi-structured clinical approach. There was immediate consensus on nine domains concerning conversation design, suggestions for (self-)reflection, and further recommended action. The one domain in which consensus was not achieved until the second round was “proactively addressing desire to die”. Conclusions: We have provided the first semi-structured clinical approach to identify and address desire to die and to respond therapeutically – based on evidence, patients’ views and consensus among professional experts. Trial registration: The study is registered in the German Clinical Trials Register (DRKS00012988; registration date: 27.9.2017) and in the Health Services Research Database (VfD_DEDIPOM_17_003889; registration date: 14.9.2017).

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Section: Study Limitationsmentioning

confidence: 99%

The Desire to Die in Palliative Care: A sequential mixed methods study to develop a semi-structured clinical aproach

Kremeike

Frerich

Romotzky

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Study Limitationsmentioning

confidence: 99%

The Desire to Die in Palliative Care: A sequential mixed methods study to develop a semi-structured clinical aproach

Kremeike

Frerich

Romotzky

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

Background: Although desire to die of varying intensity and permanence is frequent in patients receiving palliative care, uncertainty exists concerning appropriate therapeutic responses to it. To support health professionals in dealing with patients´ potential desire to die, a training program and a semi-structured clinical interview approach was developed. This study aimed for a revision of and consensus building on the clinical approach to support proactively addressing desire to die and routine exploration of death and dying distress. Methods: Within a sequential mixed methods design, we invited 16 palliative patients to participate in semi-structured interviews and 377 (inter-)national experts to attend a two-round Delphi process. Interviews were analyzed using qualitative content analysis and an agreement consensus for the Delphi was determined according to predefined criteria. Results : 11 (69%) patients from different settings participated in face-to-face interviews. As key issues for conversations on desire to die they pointed out the relationship between professionals and patients, the setting and support from external experts, if required. A set of 149 (40%) experts (132/89% from Germany, 17/11% from 9 other countries) evaluated ten domains of the semi-structured clinical approach. There was immediate consensus on nine domains concerning conversation design, suggestions for (self-)reflection, and further recommended action. The one domain in which consensus was not achieved until the second round was “proactively addressing desire to die”. Conclusions : We have provided the first semi-structured clinical approach to identify and address desire to die and to respond therapeutically – based on evidence, patients’ views and consensus among professional experts. Trial registration: The study is registered in the German Clinical Trials Register (DRKS00012988; registration date: 27.9.2017) and in the Health Services Research Database (VfD_DEDIPOM_17_003889; registration date: 14.9.2017).

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“…La falta de significación del ingreso económico debe atribuirse a que es una variable con tamaño del efecto pequeño sobre el distrés (Carlson et al, 2004) o no significativo (Andreu et al, 2012;Jacobsen et al, 2005;Kagee et al, 2018), ya que el tratamiento en sus aspectos económicos, especialmente en el caso del cáncer de mama, es solventado por algún tipo de seguro o programa de beneficencia. Lo abrumador o estresante para estas mujeres son otros aspectos, como si van a sobrevivir y qué pasará con su familia en caso de morir (An et al, 2017).…”

Section: Participantesunclassified

Asociación y relación predictiva del distrés con variables sociodemográficas y clínicas en cáncer mamario

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El distrés es un estado emocional negativo que puede ser inducido por enfermedades crónicas como el cáncer. Para su medición existe un instrumento con buenas propiedades métricas como el Inventario Breve de Síntomas. Su forma abreviada a 18 ítems (BSI-18) ha sido validada en aspectos de estructura factorial y consistencia interna en México, pero no en aspectos de validez concurrente. En la práctica clínica con mujeres con cáncer de mama, es importante identificar las variables que predicen mayor distrés para enfocar la atención psicológica. A este fin se puede aplicar el BSI-18 con la nueva estructura factorial identificada en México. Esta investigación tuvo como objetivo estudiar la relación del distrés con variables sociodemográficas y clínicas. Se utilizó un muestreo intencional. La muestra quedó integrada por 203 mujeres mexicanas tratadas por cáncer de mama. Se aplicó un cuestionario de autorreporte integrado por preguntas cerradas sobre información sociodemográfica y clínica y el BSI-18. La puntuación total y los tres factores del BSI-18 fueron independientes de las variables sociodemográficas. En la muestra total, recibir terapia antihormonal y recibir radioterapia destacaron como correlatos y predictores entre las variables clínicas. Entre las mujeres mastectomizadas, recibir quimioterapia y desear conservar la mama fueron los correlatos y predictores más importantes. Mayores períodos de tiempo transcurrido desde el diagnóstico y desde la cirugía se asociaron a más distrés. Se concluye que proporcionar apoyo psicológico a las mujeres que reciben terapia antihormonal y radioterapia es importante, especialmente considerando que a más tiempo de tratamiento se incrementa el distrés.

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Death talk and relief of death-related distress in patients with advanced cancer

Abstract: NCT01506492.

Cited by 30 publications

References 28 publications

The Desire to Die in Palliative Care: A sequential mixed methods study to develop a semi-structured clinical aproach

The Desire to Die in Palliative Care: A sequential mixed methods study to develop a semi-structured clinical aproach

The Desire to Die in Palliative Care: A sequential mixed methods study to develop a semi-structured clinical aproach

Asociación y relación predictiva del distrés con variables sociodemográficas y clínicas en cáncer mamario

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