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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
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
Corresponding
E-mail address:

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.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2009

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