Skip to main content Accessibility help
×
Home

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

  • Eileen Huh Shinn (a1), Cindy L. Carmack Taylor (a1), Kelly Kilgore (a1), Alan Valentine (a2), Diane C. Bodurka (a3), John Kavanagh (a3), Anil Sood (a3), Yisheng Li (a4) and Karen Basen-Engquist (a1)...

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.

Copyright

Corresponding author

Address correspondence and reprint requests to: Eileen Shinn, Department of Behavioral Science, P.O. Box 301439, Houston, TX 77230. E-mail: eshinn@mdanderson.org

References

Hide All
Armstrong, D., Bundy, B., Wenzel, L., et al. (2006). Intraperitoneal cisplatin and paclitaxel in ovarian cancer. The New England Journal of Medicine, 354, 3443.
Basen-Engquist, K., Bodurka-Bevers, D. & Carmack, C. (2001). Psychological distress and sexual function of ovarian cancer survivors. Quality of Life Research, 10, 229.
Beck, A. & Steer, R. (1988). Beck Hopelessness Inventory Manual. Philadelphia: Harcourt Brace, Jovanovich.
Beck, J. (1995). Cognitive Therapy: Basics and Beyond. New York: Guilford Press.
Brady, M., Peterman, A., Fitchett, G., et al. (1999). A case for including spirituality in quality of life measurement in oncology. Psychooncology, 8, 417428.
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, 29072911.
Cella, D., Tusky, D. & Gray, G. (1993). Development and validation of the general measure. Journal of Clinical Oncology, 11, 570579.
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, 335354.
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, 21012107.
Feroz, I. & Beg, M. (1987). Death anxiety in malignant cancer patients as related to age and socioeconomic status. Perspectives in Psychological Research, 10, 16.
Ferrell, B., Smith, S., Cullinane, C., et al. (2003). Psychological well being and quality of life in ovarian cancer survivors. Cancer, 98, 10611071.
Fortner, B. & Neimeyer, R. (1999). Death anxiety in older adults: A quantitative review. Death Studies, 23, 387407.
Gil, S. & Gilbar, O. (2001). Hopelessness among cancer patients. Journal of Psychosocial Oncology, 19, 2133.
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, 2332.
Houck, K., Avis, N., Gallant, J., et al. (1999). Quality of life in advanced ovarian cancer: Identifying specific concerns. Journal of Palliative Medicine, 2, 397402.
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, 411418.
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, 41774183.
Kroenke, K. & Spitzer, R. (2002). The PHQ-9: A new depression diagnostic and severity measure. Journal of General Internal Medicine, 16, 606613.
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, 28172823.
Lutgendorf, S., Anderson, B., Rothrock, N., et al. (2000). Quality of life and mood in women receiving extensive chemotherapy for gynecologic cancer. Cancer, 89, 14021411.
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, 484486.
McCullagh, P. & Nelder, J. (eds.). (1989). General and Linear Models. 2nd ed.Boca Raton, FL: Chapman and Hall/CRC.
McGill, J. & Paul, P. (1993). Functional status and hope in elderly people with and without cancer. Oncology Nursing Forum, 20, 12071313.
Powe, B. & Finnie, R. (2003). Cancer fatalism. The state of the science. Cancer Nursing, 26, 454464.
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, 25022507.
Ringdal, G. (1995). Correlates of hopelessness in cancer patients. Journal of Psychosocial Oncology, 13, 4766.
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.
Templer, D. (1970). The construction and validation of a Death Anxiety Scale. Journal of General Psychology, 82, 165177.

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed