Preparatory grief, psychological distress and hopelessness in advanced cancer patients

Abstract

Preparatory grief, psychological distress and hopelessness in advanced cancer patientsA study was undertaken to evaluate the preparatory grief process in advanced cancer patients and its relationship with hopelessness, depression and anxiety. In total, 94 advanced cancer patients treated in a Pain Relief and Palliative Care Unit completed the Preparatory Grief in Advanced Cancer Patients (PGAC) Scale, the Greek Hospital Anxiety and Depression (G-HAD) scales, and a measure of hopelessness the Beck Hopelessness Scale. The strongest correlation was found between grief and hopelessness (r = 0.63, P < 0.0005) and PGAC-1 'self-consciousness' (r = 0.54, P < 0.0005). Similarly, strong associations revealed between PGAC total with anxiety (HAD-D) and depression (HAD-D) (P < 0.0005). Significant associations were depicted between hopelessness, depression and anxiety with PGAC-total as well as with its components. Statistically significant associations were also obtained between grief, metastases (P = 0.073) and education (P = 0.043). In the multiple regression analysis (enter method), anxiety (P < 0.0005) was the strongest predictor of preparatory grief followed by hopelessness (P = 0.002), presence of metastases (P = 0.004) and depression (P = 0.033). Depression, hopelessness, anxiety and terminally ill patients' metastases contribute to the prediction of preparatory grief in this population.

Gender, age and surgery as a treatment modality leads to higher distress in patients with cancer

“…It is clear that a host of different variables predict higher or lower hazard ratios of physical, emotional or spiritual distress in cancer patients. This does provide us with some insight on patient demographic clusters that are at greater risk for higher distress and its subscales [6,11,12,27,28,[37][38][39][40]. Although literature on the effect of gender with specific reference to pre-clinical emotional distress is sparse (i.e.…”

“…Psychological distress in cancer has received more attention in recent years as new cancer treatments are being developed and cancer survival rates have improved [8][9][10][11][12]. Besides, patients have become more willing to accept higher risks, trading off potential deficits, for a chance to live longer [13].…”

How Family Physicians Address Diagnosis and Management of Depression in Palliative Care Patients

“…9,12,13 This diffi culty could be even more prominent in palliative care, where physical symptoms and grief may hamper the interpretation of mood symptoms. 5,[14][15][16] The aim of this study was to explore the variation in the opinions of family physicians regarding the recognition, diagnosis, and management of depression in palliative care patients, and to ascertain their suggestions for optimizing this process. …”

Outcomes for End-of-Life Patients With Anticipatory Grieving

“…24 Eleven studies were with family caregivers of terminal patients, 4,12-17,20,22-24 and four were with patients. 8,18,19,21 Because only 4 studies were identified that evaluated anticipatory grief in patients, we present background information on the measurement of this concept in both the caregivers and patients. Only 6 of the reviewed studies were published in the last 5 years.…”

“…8,14,23 Of the 12 quantitative studies, only nine studies had sample sizes larger than 80. 4,12,13,15,17-19,21,24 Nine studies had a single group design, 4,13,16,18-22,24 three had a two-group design, 12,15,17 and none had an intervention, used randomization, or focused on nurse caregivers. Only four studies were completed in the United States.…”