Dignity and psychosocial related variables in elderly advanced cancer patients

Abstract

Introduction Most cancers occur in older individuals, who are more vulnerable due to functional impairment, multiple comorbidities, cognitive impairment, and lack of socio-familial support. These can undermine patients’ sense of dignity. This study seeks to compare dignity scores in older patients with advanced cancer on sociodemographic and clinical variables and analyze the predictive value of anxiety, depression, functional limitations, and social support on dignity scores. Methods A prospective, multicenter, observational study conducted with participation of 15 hospitals in Spain from February 2020 to October 2021. Patients with newly-diagnosed, advanced cancer completed the dignity (PPDS), anxiety and depression (BSI), Social Support (Duke–UNC-11), and functional limitations (EORTC-C30) scales. Lineal regression analyses explored the effects of anxiety, depression, functional status, and social support on dignity, adjusting for sociodemographic and clinical variables. Results A total of 180 subjects participated in this study. The results of the correlation analysis revealed that dignity correlated negatively with anxiety, depression, and sex, and positively with social support, functional status, and longer estimated survival. Thus, women, and more anxious and depressed individuals scored lower on the dignity scale, whereas patients with more social support, fewer functional limitations, and longer estimated survival scored higher. Conclusion In conclusion, being female, having a lower educational level, lower estimated survival, depression, anxiety, less social support, and limited functionality are correlated with less dignity in the elderly with advanced cancer. It is a priority to manage both physical and psychological symptoms in patients with unresectable advanced cancer to mitigate psychological distress and increase their sense of dignity.

Self‐reported dignity and factors that influence dignity in hospitalised older adults: A cross‐sectional survey

“…There was a significant association between dignity and sex, with male participants more likely to report higher levels of dignity compared to female participants. This finding aligns with previous research on older adults' dignity, which also demonstrated that males tend to report higher levels of dignity than females (Karimi et al, 2019; Martín‐Abreu et al, 2022). This finding may have cultural implications because in most parts of Africa and Asia, men are generally given patriarchal authority as ‘breadwinners’ and heads of the family, while women are subordinated with their roles focussed on domestic chores (Ahmed, 2000; Azuh et al, 2015; Vlassoff, 2007).…”

“…For instance, Karimi et al (2019) found in Iran that dignity was more critical to unemployed individuals than employed individuals, which differs from our findings. Additionally, a study by Martín‐Abreu et al (2022) in Spain revealed significant differences in dignity based on educational level, with individuals with primary education reporting lower dignity levels than those with higher levels of education. These differences in findings may be attributed to variations in data collection instruments and sample characteristics.…”

Unveiling Psychological Perspectives on Aging Minds and Cancer: A Review

“…Understanding these dynamics provided insights into tailored interventions and support systems [56]. Caregiver-patient relationships within support systems emerged as crucial components in mitigating challenges faced by elderly patients [57,58]. By recognizing and optimizing these relationships, tailored interventions and educational initiatives could be implemented to enhance the well-being of both patients and caregivers [59].…”

Psychosocial burden in transfusion dependent beta-thalassemia patients and its impact on the quality of life and the problem of dignity

“… 14 , 15 It is essential to understand the psychosocial burdens and the concept of dignity because increased hopelessness, depression, and desire to hasten death are associated with the loss of dignity. 16 …”