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


METHODS
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.


CONCLUSIONS
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.
Department of Behavioral Science, University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA. eshinn@mdanderson.org
Eileen Huh
EH
Shinn
Cindy L Carmack
CL
Taylor
Kelly
K
Kilgore
Alan
A
Valentine
Diane C
DC
Bodurka
John
J
Kavanagh
Anil
A
Sood
Yisheng
Y
Li
Karen
K
Basen-Engquist
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000523:psychology*; D001293:Attitude to Death; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D018450:Disease Progression; D005239:Fear; D005260:Female; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D009042:Motivation; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000523:psychology; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000523:psychology*; D010166:Palliative Care / Q000523:psychology; D011788:Quality of Life / Q000523:psychology; D012944:Social Support; D011795:Surveys and Questionnaires; D055815:Young Adult