title: Spirituality and Awareness of Diagnoses in Terminally Ill Patients With Cancer.
abstract: OBJECTIVE
  Aims of the present study were to investigate the association between awareness of own illness condition and psychological outcome in end-of-life phase and to test the association between the spirituality and the awareness of own illness condition.
  
  
  METHODS
  Three hundred and ninety-nine terminally ill patients with cancer were enrolled in a hospice in central Italy. One hundred patients satisfied the inclusion criteria. The Systems of Belief Inventory, the Hospital Anxiety and Depression Scale, and a psychological interview to determine the level of awareness of the illness diagnosis (aware; partially aware; and not aware) were administered to terminally ill patients.
  
  
  RESULTS
  The main finding was that the awareness of one's own illness condition was positively associated with the extrinsic spirituality and negatively associated with intrinsic spirituality (regression model R = .26; R2= .07; adjusted R2= .05; F2, 97= 3.45; P = .036). The aware group showed lower anxiety and depression ( F2, 97= 1.9; P = . 075; F2, 97= 2.6; P = .04) scores than partially aware and not aware groups. The psychological outcome was not associated with the spirituality level.
  
  
  CONCLUSIONS
  In terminally ill patients with cancer, the levels of depression and anxiety were lower in patients aware of their own illness state. Moreover, higher levels of extrinsic and lower levels of intrinsic spirituality predicted the awareness of one's own illness state.
authors: 1 Dynamic and Clinical Psychology, Sapienza University of Rome, Italy.
authors: Carlo
authors: C
authors: Lai
authors: 2 Psychiatry and Psychology Institute, Catholic University of Sacred Heart, Rome, Italy.
authors: Massimiliano
authors: M
authors: Luciani
authors: 1 Dynamic and Clinical Psychology, Sapienza University of Rome, Italy.
authors: Federico
authors: F
authors: Galli
authors: 3 Palliative Care Unit, Fondazione Roma Sanità, Italy.
authors: Emanuela
authors: E
authors: Morelli
authors: 1 Dynamic and Clinical Psychology, Sapienza University of Rome, Italy.
authors: Francesca
authors: F
authors: Del Prete
authors: 3 Palliative Care Unit, Fondazione Roma Sanità, Italy.
authors: Patrizia
authors: P
authors: Ginobbi
authors: 3 Palliative Care Unit, Fondazione Roma Sanità, Italy.
authors: Italo
authors: I
authors: Penco
authors: 4 Department of Anaesthesiology and Intensive Care, Catholic University of Sacred Heart, Rome, Italy.
authors: Paola
authors: P
authors: Aceto
authors: 3 Palliative Care Unit, Fondazione Roma Sanità, Italy.
authors: Luigi
authors: L
authors: Lombardo
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D010361:Patients / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D029181:Spirituality; D019452:Terminally Ill / Q000523:psychology*
keywords: anxiety; awareness of diagnosis; cancer; depression; extrinsic spirituality; intrinsic spirituality