Tong Eryn, Deckert Amy, Gani Nina, Nissim Rinat, Rydall Anne, Hales Sarah, Rodin Gary, Lo Chris
Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany.
Palliat Med. 2016 Sep;30(8):772-9. doi: 10.1177/0269216316628780. Epub 2016 Feb 8.
Death anxiety is important but understudied in palliative care. New self-report measurements have been developed, but their interpretation and clinical utility may not be evident.
To inform our understanding of death anxiety in patients with advanced cancer by exploring the relationship between this self-reported symptom and its clinical presentation.
Participants were part of a psychotherapy trial in advanced cancer. First therapy session transcripts were analyzed using interpretive description in patients reporting low, moderate, and high death anxiety on the Death and Dying Distress Scale (DADDS).
SETTING/PARTICIPANTS: A total of 16 participants (10 women and 6 men) with advanced or metastatic cancer were sampled from the Princess Margaret Cancer Centre, Toronto, Canada. Six participants reported low death anxiety scores (Death and Dying Distress Scale: 0-19), five moderate (Death and Dying Distress Scale: 20-50), and five high (Death and Dying Distress Scale: 51-75).
The low death anxiety group exhibited psychological readiness for death, or contrastingly, non-reflectiveness about death. The moderate group recognized the imminence of mortality, which impacted treatment decisions and future plans. Prior experience with death was discussed as raising the salience of mortality. The high group felt dominated by powerful emotions and could not make sense of their situation. Their distress was exacerbated by substantial relational concerns.
Self-reported death anxiety is affected by the awareness and ability to reflect on mortality. Death and Dying Distress Scale scores may facilitate exploration of this symptom as part of a clinical assessment and may serve to guide treatment approaches. Greater attention to death anxiety is consistent with and recommended by contemporary approaches to palliative care.
死亡焦虑在姑息治疗中很重要，但研究较少。新的自我报告测量方法已经开发出来，但其解释和临床实用性可能并不明显。
通过探讨这种自我报告症状与其临床表现之间的关系，增进我们对晚期癌症患者死亡焦虑的理解。
参与者是一项晚期癌症心理治疗试验的一部分。对在死亡与临终困扰量表（DADDS）上报告低、中、高死亡焦虑的患者，使用解释性描述分析其首次治疗会话记录。
设置/参与者：从加拿大多伦多玛格丽特公主癌症中心抽取了16名晚期或转移性癌症患者（10名女性和6名男性）。6名参与者报告低死亡焦虑评分（死亡与临终困扰量表：0 - 19），5名中度（死亡与临终困扰量表：20 - 50），5名高度（死亡与临终困扰量表：51 - 75）。
低死亡焦虑组表现出对死亡的心理准备，或者相反，对死亡缺乏反思。中度组认识到死亡的临近，这影响了治疗决策和未来计划。讨论了先前的死亡经历会提高对死亡的关注度。高度组感到被强烈情绪所左右，无法理解自己的处境。他们的痛苦因大量人际关系问题而加剧。
自我报告的死亡焦虑受对死亡的认知和反思能力影响。死亡与临终困扰量表评分可能有助于在临床评估中探索这一症状，并可用于指导治疗方法。对死亡焦虑给予更多关注与当代姑息治疗方法一致且受到推荐。
