Symptomatic distress, hopelessness, and the desire for hastened death in hospitalized cancer patients.
OBJECTIVE
This study evaluated the desire for hastened death (DHD) in cancer patients at varying stages of disease to determine its frequency and relationship to physical and psychological distress.


METHODS
Two hundred twenty-four inpatients at Princess Margaret Hospital completed questionnaires assessing pain, physical symptoms, depression, hopelessness, and DHD.


RESULTS
There was significant physical and psychological distress in this sample with a mean of nine physical symptoms reported by each subject. Seven percent reported moderate DHD on the Schedule of Attitudes Towards Hastened Death (SAHD) and 2% reported high DHD. Hopelessness and stage of disease were the only significant independent predictors of DHD and their interaction was associated with increased DHD. Hopelessness and, less so, depression both mediated the pathways between illness-related factors and DHD.


CONCLUSIONS
Findings suggest that DHD is significantly related to hopelessness and advancing disease. Assessment of this phenomenon prior to the end of life may provide opportunities for intervention.
Department of Psychosocial Oncology and Palliative Care, Princess Margaret Hospital, University Health Network, 610 University Avenue, 5th Floor, Room 605, M5G 2M9 Toronto, ON, Canada. jennifer.jones@uhn.on.ca
Jennifer M
JM
Jones
Mary Anne
MA
Huggins
Anne C
AC
Rydall
Gary M
GM
Rodin
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001293:Attitude to Death; D002170:Canada; D016000:Cluster Analysis; D003863:Depression / Q000523:psychology; D004644:Emotions; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D010146:Pain / Q000523:psychology; D013315:Stress, Psychological / Q000628:therapy; D011795:Surveys and Questionnaires