Death anxiety and its relationship with family function and meaning in life in patients with advanced cancer—A cross-sectional survey in China

Liu, Hui; Liu, Xiaocheng; Liu, Zhili; Wang, Yao; Feng, Ruoqiang; Zheng, Ruihua; Xie, Rongrong; Tao, Hongmei; Wu, Yanchun; Li, Xiaomin; Ying, Wenjuan; Wu, Xiaoying

doi:10.1016/j.apjon.2022.100134

Cited by 20 publications

(11 citation statements)

References 57 publications

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“…A discussion about death and dying was open after three sessions if it fit the patients' preferfences, and these discussions were generally introduced through two opportunities: talking about their future and the uncontrolled aspects of living with advanced cancer life. Significant death anxiety in Chinese advanced cancer patients has been reported by researchers 31 – 33 , and talking about death and dying with this population during our research was not as difficult as reported in a previous study 34 . However, the magnitude of improvements in the domains of ‘planning end-of-life’ and ‘fears of death and dying’ was small, as not all participants were willing to enter into a discussion of death and dying.…”

Section: Discussionsupporting

confidence: 54%

Feasibility of online managing cancer and living meaningfully (CALM) in Chinese patients with metastatic breast cancer: a pilot randomized control trial

Zhang,

Pang,

et al. 2024

Sci Rep

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Metastatic breast cancer could cause various psychological symptoms. Managing Cancer and Living Meaningfully (CALM) is a brief, manualized psychotherapy that has been validated for advanced cancer patients. We conducted a pilot randomized control trial (RCT) to verify the feasibility and preliminary efficacy of CALM therapy in this population. Patients who met the inclusion criteria were randomly assigned into CALM or Wait-list Control (WLC) groups. Patients in the CALM group received CALM therapy and usual care; patients in WLC group first received usual care and then underwent CALM therapy after completing all assessments. All patients were asked to complete three assessments: T0(baseline), T1(3 months), and T2(6 months). The primary outcomes was death anxiety; other outcomes were depression, distress, suicide ideation, attachment security, spiritual well-being and quality of life at the end of life. Analysis of Covariance (ANCOVA) and t-test were used for statistics analysis. Thirty-six patients were randomly assigned to either of the two groups, with 34 patients completing the three assessments. At six months, we found significant between group differences in suicide ideation, distress, and life completion between the CALM and WLC groups. At T2, patients in CALM group reported lower levels of depression (F = 5.016, p = 0.033, partial η2 = 0.143), distress (F = 7.969, p = 0.010, partial η2 = 0.257), attachment avoidance (F = 4.407, p = 0.044, partial η2 = 0.128), and better sense of life completion (F = 5.493, p = 0.026, partial η2 = 0.155) than patients in the WLC group. Compared with results of the T0 assessments, we found significant differences in socres for depression (T2&T0, t = − 2.689, p = 0.011, Cohen’s d = 0.940) and distress (T2&T0, t = − 2.453, p = 0.022, Cohen’s d = 0.965) between the two groups. CALM therapy was well received by the study population, and CALM therapy can reduce depression, distress, attachment avoidance while improving quality of life in Chinese metastatic breast cancer patients. A Phase III RCT was recommended to verify the impact of CALM therapy on psychological burden and survival in this population.Trial registration: This study is part of the “Preliminary application study for Managing Cancer and Living Meaningfully (CALM) therapy in Chinese advanced cancer patients” clinical trial, with the Trial Registration Number of ChiCTR1900023129 (13/05/2019) in the Chinese Clinical Trial Registry (ChiCTR) website. (https://www.chictr.org.cn/index.html).

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Section: Discussionsupporting

confidence: 54%

Feasibility of online managing cancer and living meaningfully (CALM) in Chinese patients with metastatic breast cancer: a pilot randomized control trial

Zhang,

Pang,

et al. 2024

Sci Rep

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“…Younger people are less able to deal with trauma and are more likely to feel distressed than older people (Dobretsova & Derakshan, 2021). Additionally, younger patients may worry about child dependents, the raising of young children and their future, which increases the level of death anxiety (Liu et al., 2022). Therefore, death anxiety in young cancer patients should be given more attention by medical staff.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, younger patients may worry about child dependents, the raising of young children and their future, which increases the level of death anxiety (Liu et al, 2022). Therefore, death anxiety in young cancer patients should be given more attention by medical staff.…”

Section: Demographicvariablesmentioning

confidence: 99%

Correlates of death anxiety for patients with cancer: A systematic review and meta‐analysis

Li,

Dong,

Tang

et al. 2024

Journal of Clinical Nursing

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ObjectiveA systematic review and meta‐analysis was performed to identify the factors related to cancer death anxiety based on available evidence.DesignThis systematic review and meta‐analysis followed the PRISMA 2020 guidelines.MethodsSeven databases were searched to identify studies on the relationships of cancer death anxiety with demographic characteristics, disease factors and psychosocial factors from inception to May 2023. The Agency for Medical Research and Quality (AHRQ) scale was used to evaluate the quality of the included studies. After two researchers independently completed the literature search, data extraction and quality evaluation, meta‐analysis was conducted by using RevMan5.3 and Stata 17.0 software.ResultsIn total, 52 studies were included in this review. The results revealed that there were positive correlations of death anxiety with female sex, the symptom burden, anxiety levels, depression levels, fear of recurrence, attachment avoidance, psychological distress, resignation and confrontation coping. Death anxiety was negatively correlated with age, education level, ability to perform daily activities, self‐esteem, spiritual well‐being, sense of meaning in life, resilience, quality of life, social support and religious beliefs.ConclusionsOur results can inform the design of interventions to address death anxiety and improve the overall quality of life of cancer patients. Healthcare professionals should promptly identify and focus on death anxiety in high‐risk populations of cancer patients.Relevance to Clinical PracticeCancer patients commonly experience death anxiety, and this anxiety has a nonnegligible impact on patients' mental health and overall quality of life. This study can inform the development of interventions by clinical healthcare professionals.No Patient or Public ContributionThis was a meta‐analysis based on data from previous studies.

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“…It was also observed that caregivers with high-level financial toxicity had more social security and work needs. “Poverty reinstatement due to illness” and “poverty due to illness” were standard in China and were known by the patient and their caregivers [ 40 ]. Van Hof et al’s study showed that continuous financial problems in the care process often led to more unmet SCN of caregivers [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

Supportive care needs and associated factors among caregivers of patients with colorectal cancer: a cross-sectional study

Zhang,

Wang,

Shao

et al. 2024

Support Care Cancer

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To assess the level of supportive care needs of caregivers of colorectal cancer patients and explore the related key influencing factors. Totaling 283 caregivers of patients with colorectal cancer were investigated in this study. Firstly, caregivers were invited to complete a set of questionnaires, including the general information questionnaire, the Supportive Care Needs Survey-Partners and the Caregivers of cancer patients, the Caregiver Preparedness Scale, the Benefit Finding Scale, and the Comprehensive Score for Financial Toxicity. Univariate and multivariate linear regression were performed to investigate the associated factors of supportive care needs. The caregivers of patients with colorectal cancer have a moderate level of needs, scored at 2.71 ± 0.42. Caregiver preparedness, benefit finding, and financial toxicity were significantly negatively associated with the supportive care needs of caregivers (r = − 0.555, P < 0.001; r = − 0.534, P < 0.001; and r = − 0.615, P < 0.001, respectively). Our multivariate regression analysis identified some factors that directly affected the supportive care needs of caregivers, including the duration of illness, tumor stage, the age and educational level of caregivers, caregiver preparedness, benefit finding, and financial toxicity (R2 = 0.574, F = 23.337, P < 0.001). Supportive care needs are common among caregivers of colorectal cancer patients. Higher caregiver preparedness, benefit finding, and financial toxicity tend to ease these needs. Healthcare workers should have an in-depth understanding of the needs of caregivers of colorectal cancer patients and actively provide targeted financial/informational/technical/emotional support to promote nursing skills and reduce caregivers’ burdens.

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Death anxiety and its relationship with family function and meaning in life in patients with advanced cancer—A cross-sectional survey in China

Cited by 20 publications

References 57 publications

Feasibility of online managing cancer and living meaningfully (CALM) in Chinese patients with metastatic breast cancer: a pilot randomized control trial

Feasibility of online managing cancer and living meaningfully (CALM) in Chinese patients with metastatic breast cancer: a pilot randomized control trial

Correlates of death anxiety for patients with cancer: A systematic review and meta‐analysis

Supportive care needs and associated factors among caregivers of patients with colorectal cancer: a cross-sectional study

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