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Death anxiety in patients with primary brain tumor: Measurement, prevalence, and determinants

Published online by Cambridge University Press:  22 June 2021

Ashlee R. Loughan*
Affiliation:
School of Medicine, Virginia Commonwealth University, Richmond, VA Massey Cancer Center, Richmond, VA
Mariya Husain
Affiliation:
School of Medicine, Virginia Commonwealth University, Richmond, VA
Scott G. Ravyts
Affiliation:
Department of Psychology, Virginia Commonwealth University, Richmond, VA
Kelcie D. Willis
Affiliation:
Department of Psychology, Virginia Commonwealth University, Richmond, VA
Sarah Ellen Braun
Affiliation:
School of Medicine, Virginia Commonwealth University, Richmond, VA Massey Cancer Center, Richmond, VA
Julia K. Brechbiel
Affiliation:
Department of Psychology, Virginia Commonwealth University, Richmond, VA
Farah J. Aslanzadeh
Affiliation:
Department of Psychology, Virginia Commonwealth University, Richmond, VA
Gary Rodin
Affiliation:
Department of Psychiatry, University of Toronto, Toronto, ON, Canada Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
Dace S. Svikis
Affiliation:
Department of Psychology, Virginia Commonwealth University, Richmond, VA
Leroy Thacker
Affiliation:
Massey Cancer Center, Richmond, VA Department of Biostatistics, Virginia Commonwealth University, Richmond, VA
*
Author for correspondence: Ashlee R. Loughan, Virginia Commonwealth University and Massey Cancer Center, McGlothlin Medical Education Center, 1201 East Marshall Street, Room 12-213, P.O. Box 980070, Richmond, VA 23298-0070, USA. E-mail: ashlee.loughan@vcuhealth.org

Abstract

Objective

This study investigated death anxiety in patients with primary brain tumor (PBT). We examined the psychometric properties of two validated death anxiety measures and determined the prevalence and possible determinants of death anxiety in this often-overlooked population.

Methods

Two cross-sectional studies in neuro-oncology were conducted. In Study 1, 81 patients with PBT completed psychological questionnaires, including the Templer Death Anxiety Scale (DAS). In Study 2, 109 patients with PBT completed similar questionnaires, including the Death and Dying Distress Scale (DADDS). Medical and disease-specific variables were collected across participants in both studies. Psychometric properties, including construct validity, internal consistency, and concurrent validity, were investigated. Levels of distress were analyzed using frequencies, and determinants of death anxiety were identified using logistic regression.

Results

The DADDS was more psychometrically sound than the DAS in patients with PBT. Overall, 66% of PBT patients endorsed at least one symptom of distress about death and dying, with 48% experiencing moderate-severe death anxiety. Generalized anxiety symptoms and the fear of recurrence significantly predicted death anxiety.

Significance of results

The DADDS is a more appropriate instrument than the DAS to assess death anxiety in neuro-oncology. The proportion of patients with PBT who experience death anxiety appears to be higher than in other advanced cancer populations. Death anxiety is a highly distressing symptom, especially when coupled with generalized anxiety and fears of disease progression, which appears to be the case in patients with PBT. Our findings call for routine monitoring and the treatment of death anxiety in neuro-oncology.

Type
Original Article
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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