Dignity and Its Influencing Factors in Patients with Cancer in North China: A Cross-Sectional Study

Abstract

Background Patients with cancer experience various levels of loss of dignity. Exploring levels of loss of dignity and the factors that influence such losses for patients with cancer is rare, but important in palliative care in China.Methods Participants were cancer patients with early and advanced cancer recruited from a tertiary cancer hospital in North China. Patients were surveyed to assess their level of loss of dignity and potentially relevant factors. Data were collected using the Patient Dignity Inventory, the MD Anderson Symptom Inventory–Chinese, the distress thermometer, the Hospital Anxiety and Depression Scale, and the 30-question core Quality of Life Questionnaire from the European Organisation for Research and Treatment of Cancer, and were analyzed using quantitative methods.Results The study included 202 cancer patients, 143 of whom experienced mild loss of dignity (71%); 37, moderate loss of dignity (18%); and 10, severe loss of dignity (5%). The problems with dignity were slightly different in patients with early-stage disease than in those with advanced-stage disease. Loss of dignity in the patients was significantly correlated with psychological distress, symptom burden, and quality of life (p < 0.05). Logistic regression showed that age, Karnofsky performance status, anxiety, and symptom burden were significant predictors of loss of dignity.Conclusions Most patients with early and advanced cancer experienced some level of loss of dignity. Loss of dignity was more likely for patients of younger age, high Karnofsky performance status, high symptom burden, and anxiety. Understanding the dignity of cancer patients and potentially relevant factors is of great value for implementing comprehensive palliative care in China.

How patients with cancer experience dignity: An integrative review

“…Psychosocial status includes the patients' level of psychological distress, as well as communication, closeness and social support. Patients with a higher level of depression and anxiety, 39,41,43,44 or with poor communication, 32 or detrimental interactions with the closed others 38 had a higher level of dignity‐related distress. Social support was positively associated with patients' sense of dignity 36,41 …”

“…Wang et al 41 Mainland China 1 A cross-sectional study (n = 202). Measurements were PDI, MDASI-C, NCCN-DT, HADS and EQLQ-30.…”

Percepções e sentimentos de pacientes em fim de vida: um olhar sobre os cuidados paliativos

“…Os problemas com dignidade eram ligeiramente diferentes em pacientes com doença em estágio inicial do que naqueles com doença em estágio avançado. A idade, a ansiedade e a carga de sintomas foram preditores significativos de perda de dignidade (Wang et al, 2019).…”

The development of a family participatory dignity therapy programme for patients with haematologic neoplasms and their family caregivers in China: A feasibility study

“…Studies of dignity and end‐of‐life care have shown that there is a strong association between an undermining of dignity and desire for death, depression, anxiety, hopelessness, feeling of being a burden on families and poorer quality of life (HM et al, ; HM, ). Importantly, advanced cancer patients deem a sense of dignity and spiritual peace, relieving burden and strengthening relationships with loved ones as some important facets of palliative care (Ho et al, ; Wang, Wei, Xue, Guo, & Liu, ). A systematic review showed that spiritual care including dignity therapy had a potentially beneficial effect on the quality of life and spiritual well‐being of patients with terminal illness, suggesting that healthcare professionals should pay greater attention to patients’ spiritual well‐being (Chen, Lin, Yan, Wu, & Hu, ).…”

“…Studies of dignity and end-of-life care have shown that there is a strong association between an undermining of dignity and desire for death, depression, anxiety, hopelessness, feeling of being a burden on families and poorer quality of life (HM et al, 2002;HM, 2002). Importantly, advanced cancer patients deem a sense of dignity and spiritual peace, relieving burden and strengthening relationships with loved ones as some important facets of palliative care (Ho et al, 2013;Wang, Wei, Xue, Guo, & Liu, 2019).…”