title: Determinants of death anxiety in patients with advanced cancer.
abstract: OBJECTIVE
  To examine the presence of death anxiety in patients with advanced cancer and to identify the psychosocial and disease-related factors associated with it.
  
  
  METHODS
  Cross-sectional analysis of baseline data from a phase 2 pilot intervention trial.
  
  
  METHODS
  Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.
  
  
  METHODS
  60 adult outpatients with metastatic breast, endocrine, gastrointestinal, gynaecological, genitourinary and lung cancer.
  
  
  METHODS
  Death anxiety, as measured by the Death and Dying Distress Scale (DADDS).
  
  
  RESULTS
  Thirty-two per cent of the sample reported death anxiety of at least moderate severity. The most distressing concern involved fears about the impact of one's death on others, and the least distressing concerns were related to dying alone or suddenly. According to regression analyses, death anxiety was negatively associated with self-esteem, b=-1.73, CI0.95 (-2.57 to -0.90) and positively associated with physical symptom burden, b=1.38, CI0.95 (0.44 to 2.31), having children under 18 years of age in the family, b=13.3, CI0.95 (2.15 to 24.5), and age, b=0.40, CI0.95 (0.0023 to 0.79). The physical symptoms most strongly associated with death anxiety were changes in physical appearance, b=18.8, CI0.95 (8.21 to29.5), and pain, b=10.1, CI0.95 (0.73 to 19.5).
  
  
  CONCLUSIONS
  The findings suggest that death anxiety in patients with advanced cancer is common and determined by the interaction of individual factors, family circumstances and physical suffering. Multidimensional interventions that take into account these and other factors may be most likely to be effective to alleviate this death-related distress.
authors.affiliation: Psychosocial Oncology and Palliative Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.
authors.forename: Caroline
authors.initials: C
authors.lastname: Neel
authors.affiliation: Psychosocial Oncology and Palliative Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada Psychosocial Oncology and Palliative Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada Department of Psychiatry, University of Toronto, Toronto, Canada.
authors.forename: Chris
authors.initials: C
authors.lastname: Lo
authors.affiliation: Psychosocial Oncology and Palliative Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.
authors.forename: Anne
authors.initials: A
authors.lastname: Rydall
authors.affiliation: Psychosocial Oncology and Palliative Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada Department of Psychiatry, University of Toronto, Toronto, Canada.
authors.forename: Sarah
authors.initials: S
authors.lastname: Hales
authors.affiliation: Psychosocial Oncology and Palliative Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada Psychosocial Oncology and Palliative Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada Department of Psychiatry, University of Toronto, Toronto, Canada.
authors.forename: Gary
authors.initials: G
authors.lastname: Rodin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety; D001293:Attitude to Death; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009369:Neoplasms / Q000523:psychology*; D012649:Self Concept
keywords: Advanced Cancer; Cancer; Death Anxiety; Self-Esteem; Terminal Care; Terror Management Theory