Rodríguez-Mayoral Oscar, Monreal-Carrillo Edith, Contreras-Yáñez Irazú, Allende-Pérez Silvia, Agazzi Evandro, Pascual-Ramos Virginia
Mental Health Department, Instituto Nacional de Cancerología, Mexico City, Mexico.
Palliative Care Service, Instituto Nacional de Cancerología, Mexico City, Mexico.
PLoS One. 2025 Aug 7;20(8):e0329736. doi: 10.1371/journal.pone.0329736. eCollection 2025.
The wish to hasten death (WTHD) is a clinically significant phenomenon that arises from complex suffering. It has been predominantly studied in Caucasian populations, emphasizing the importance of gaining more diverse cultural perspectives. This study explores the factors associated with the WTHD in Mexican cancer patients receiving palliative care from one academic center, with a specific focus on its connection to dignity.".
The study, a cross-sectional research conducted between October 12, 2023, and August 30, 2024, involved patients with confirmed cancer diagnoses who were attending a palliative care service. Patients had applied the Patient Dignity Inventory (PDI), Schedule of Attitudes Toward Hastened Death (SAHD), Brief Edinburgh Depression Scale (BEDS), EORTC QLQ-C15-PAL to assess health-related quality of life, Karnofsky Performance Status Scale (KPSS) to assess functional capacity, and the Edmonton Symptom Assessment System. A PDI score ≥55 indicated a fractured sense of dignity (DPD), while a SAHD score ≥1 indicated the WTHD. Factors associated with the WTHD were identified using multiple logistic regression analysis. The study was approved by the IRB.
The study included 302 primarily middle-aged (54.5 [45-64]) females (225 [74.5%]), with 9 years of education. They reported high severity of well-being (7 [1-7]) and tiredness (3 [0-6]). Their median KPSS score showed independence (80 [70-80]), despite impacts across all EORTC QLQ-C15-PAL dimensions. DPD was noted in 110 patients (36.5%). The most frequent diagnoses were breast cancer (114 [38%]), lung cancer (33 [11%]), and gastrointestinal cancer (28 [9%]). The WTHD was found in 94 patients (31.1%). Factors significantly associated included tiredness score (OR: 1.147, 95% CI: 1.044-1.261, p = 0.004), BEDS score (1.181, 1.085-1.284, p ≤ 0.001) and a DPD (1.979, 1.038-3.772, p = 0.04).
The WTHD was found in one out of every three Mexican cancer patients receiving palliative care and was linked to biological-, mental health-, and existential-related factors.
希望加速死亡（WTHD）是一种源于复杂痛苦的具有临床意义的现象。它主要在白种人群体中进行研究，这凸显了获得更多样化文化视角的重要性。本研究探讨了在一家学术中心接受姑息治疗的墨西哥癌症患者中与希望加速死亡相关的因素，特别关注其与尊严的联系。
该研究为横断面研究，于2023年10月12日至2024年8月30日进行，纳入确诊患有癌症且正在接受姑息治疗服务的患者。患者应用了患者尊严量表（PDI）、对加速死亡的态度量表（SAHD）、爱丁堡简短抑郁量表（BEDS）、欧洲癌症研究与治疗组织生活质量问卷C15-PAL以评估健康相关生活质量，卡氏功能状态量表（KPSS）以评估功能能力，以及埃德蒙顿症状评估系统。PDI评分≥55表明尊严感受损（DPD），而SAHD评分≥1表明希望加速死亡。使用多因素逻辑回归分析确定与希望加速死亡相关的因素。该研究获得了机构审查委员会（IRB）的批准。
该研究纳入了302名主要为中年（54.5[45 - 64]岁）女性（225名[74.5%]），她们接受过9年教育。她们报告幸福感严重程度较高（7[1 - 7]）且疲劳感较强（3[0 - 6]）。尽管欧洲癌症研究与治疗组织生活质量问卷C15-PAL的所有维度都有影响，但她们的KPSS评分中位数显示其具有独立性（80[70 - 80]）。110名患者（36.5%）存在尊严感受损。最常见的诊断为乳腺癌（114例[38%]）、肺癌（33例[11%]）和胃肠道癌（28例[9%]）。94名患者（31.1%）存在希望加速死亡的情况。显著相关的因素包括疲劳评分（比值比：1.147，95%置信区间：1.044 - 1.261，p = 0.004）、BEDS评分（1.181，1.085 - 1.284，p≤0.001）和尊严感受损（1.979，1.038 - 3.772，p = 0.04）。
在每三名接受姑息治疗的墨西哥癌症患者中就有一名存在希望加速死亡的情况，且这与生物、心理健康和生存相关因素有关。
