title: Prediction of end-of-life fears in COPD - hoping for the best but preparing for the worst.
abstract: OBJECTIVE
  The diagnosis of a life-threatening illness can trigger end-of-life fears. Early studies show that end-of-life fears play an important role in chronic obstructive pulmonary disease (COPD). However, predictors of these fears have not yet been identified. This study investigated the relevance of socio-demographic variables, illness severity, psychological distress and disease-specific anxieties as predictors of end-of-life fears in COPD.
  
  
  METHODS
  A total of 131 COPD patients participated at two time points. Regression and mediation analyses, as well as cross-lagged panel analyses were conducted.
  
  
  METHODS
  The participants completed questionnaires assessing end-of-life fears (Multidimensional Orientation toward Dying and Death Inventory), psychological distress (Hospital Anxiety and Depression Scale), and disease-specific anxieties (COPD Anxiety Questionnaire). Pulmonary function and a 6-min walk test served as measures of illness severity.
  
  
  RESULTS
  Illness severity was not predictive of end-of-life fears. However, gender and psychological distress explained incremental variance. When disease-specific anxieties were included as additional predictors, psychological distress was no longer significant. Cross-lagged panel analyses mostly supported these results. Moreover, disease-specific anxieties mediated the association between psychological distress and end-of-life fears.
  
  
  CONCLUSIONS
  Administration and intensity of end-of-life care (especially concerning end-of-life fears) in COPD patients should be based not only on illness severity, but rather on psychological distress and disease-specific anxieties.
authors: a Department of Psychology, Division of Clinical Psychology and Psychotherapy , University of Leipzig , Leipzig , Germany.
authors: Nikola Maria
authors: NM
authors: Stenzel
authors: Isabelle
authors: I
authors: Vaske
authors: Kerstin
authors: K
authors: Kühl
authors: Klaus
authors: K
authors: Kenn
authors: Winfried
authors: W
authors: Rief
mesh_terms: D000368:Aged; D001007:Anxiety / Q000175:diagnosis; D001293:Attitude to Death; D005239:Fear; D005260:Female; D065026:Hope; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000523:psychology*; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: chronic obstructive pulmonary disease; coping with chronic illnesses; disease-specific anxieties; end-of-life fears