Psychosocial-spiritual correlates of death distress in patients with life-threatening medical conditions.
The purpose of this study was to identify demographic, disease, health care, and psychosocial-spiritual factors associated with death distress (death-related depression and anxiety). Cross-sectional baseline data from a randomized controlled trial were used. Outpatients (n=70) were recruited from an urban academic medical centre and proprietary hospital. All patients had life-threatening medical conditions, including cancer; pulmonary, cardiac, liver, or kidney disease; HIV/AIDS; or geriatric frailty. Measures of death distress, physical symptom severity, depression and anxiety symptoms, spiritual well-being, social support, patient-perceived physician communication, and patient-perceived quality of health care experiences were administered. In a hierarchical multiple regression model, higher death distress was significantly associated with living alone, greater physical symptom severity, more severe depression symptoms, lower spiritual well-being, and less physician communication as perceived by the patient. Death distress as a unique experiential construct was discriminable among younger patients with specific, diagnosable life-threatening conditions, but less so among geriatric frailty patients. The findings suggest that the experience of death distress among patients with life-threatening medical conditions is associated with the psychosocial-spiritual dimensions of the patient's life. Attention to these dimensions may buffer the negative affects of death distress.
Chibnall
John T
JT
Department of Psychiatry, Saint Louis University School of Medicine, Missouri 63104, USA. chibnajt@slu.edu
Videen
Susan D
SD
Duckro
Paul N
PN
Miller
Douglas K
DK
D001007:Anxiety / Q000209:etiology*; D001293:Attitude to Death; D016638:Critical Illness / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D010817:Physician-Patient Relations; D012044:Regression Analysis; D012067:Religion; D029181:Spirituality