Rosenfeld B, Breitbart W, Galietta M, Kaim M, Funesti-Esch J, Pessin H, Nelson C J, Brescia R
Department of Psychology, Long Island University, Brooklyn, NY 11201, USA.
Cancer. 2000 Jun 15;88(12):2868-75. doi: 10.1002/1097-0142(20000615)88:12<2868::aid-cncr30>3.0.co;2-k.
The authors examined the reliability and validity of the Schedule of Attitudes toward Hastened Death (SAHD), a self-report measure of desire for death previously validated in a population of individuals with the acquired immunodeficiency syndrome (AIDS), among terminally ill patients with cancer.
The authors interviewed 92 terminally ill cancer patients, all with a life expectancy of < 6 months, after admission to a palliative care hospital. Patients were administered the SAHD, a clinician-rated measure of desire for death (the Desire for Death Rating Scale [DDRS]), and several measures of physical and psychosocial well-being.
The average number of SAHD items endorsed was 4. 76 (standard deviation, 4.3); 15 patients (16.3%) endorsed > or = 10 items, indicating a high desire for death. Internal consistency was strong (coefficient alpha = 0.88, median item-total correlation = 0. 49), as were indices of convergent validity. Total SAHD scores were correlated significantly (correlation coefficient [r] = 0.67) with the DDRS, and somewhat less so with measures of depression (r = 0. 49) and hopelessness (r = 0.55). Lower, but substantial, correlations were observed between the SAHD and measures of spiritual well-being (r = -0.42), quality of life (r = -0.36), physical symptoms (r = 0.38), and symptom distress (r = 0.38). No significant correlation was observed between SAHD scores and social support (r = -0.06) or pain intensity (r = 0.16); however, pain-related functional interference and overall physical functioning were correlated significantly with SAHD scores (r = 0.31 and r = -0.23, respectively).
The SAHD appears to be a reliable and valid measure of desire for death among terminally ill cancer patients. Coupled with previous research in patients with AIDS, these results support the utility of the SAHD for research addressing interest in hastened death in patients with a life-threatening medical illness.
作者研究了速死态度量表（SAHD）的信度和效度，该量表是一种自我报告式的死亡意愿测量工具，此前已在获得性免疫缺陷综合征（AIDS）患者群体中得到验证，此次研究对象为晚期癌症患者。
作者对92名晚期癌症患者进行了访谈，这些患者均入住了一家姑息治疗医院，预期寿命均小于6个月。患者接受了SAHD、医生评定的死亡意愿测量工具（死亡意愿评定量表[DDRS]）以及几项身体和心理社会幸福感测量。
SAHD认可项目的平均数量为4.76（标准差为4.3）；15名患者（16.3%）认可了≥10个项目，表明其对死亡的渴望程度较高。内部一致性较强（系数α=0.88，项目与总分的中位数相关性=0.49），收敛效度指标也是如此。SAHD总分与DDRS显著相关（相关系数[r]=0.67），与抑郁测量指标（r=0.49）和绝望测量指标（r=0.55）的相关性略低。SAHD与精神幸福感测量指标（r=-0.42）、生活质量（r=-0.36）、身体症状（r=0.38）和症状困扰（r=0.38）之间存在较低但显著的相关性。SAHD得分与社会支持（r=-0.06）或疼痛强度（r=0.16）之间未观察到显著相关性；然而，与疼痛相关的功能干扰和总体身体功能与SAHD得分显著相关（分别为r=0.31和r=-0.23）。
SAHD似乎是一种可靠且有效的晚期癌症患者死亡意愿测量工具。结合此前对AIDS患者的研究，这些结果支持了SAHD在研究危及生命的疾病患者对速死的兴趣方面的实用性。
