Older Age: A Protective Factor Against Perceived Dignity-Related Distress in Patients With Advanced Cancer?

Pergolizzi, Denise; Monforte-Royo, Cristina; Balaguer, Albert; Porta-Sales, Josep; Rodríguez-Prat, Andrea; Crespo, Iris

doi:10.1016/j.jpainsymman.2020.09.041

Cited by 6 publications

(8 citation statements)

References 53 publications

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“…They found that the total scores of older patients were 2.6% lower for perceived dignity-related distress compared to younger patients. These results point toward aging as a protective factor against loss of perceived dignity, contrary to what our study found with a larger population that revealed lower perceived dignity score among older individuals which could be due to loss of independence and autonomy and greater frailty ( Pergolizzi et al, 2021 ).…”

Section: Discussioncontrasting

confidence: 99%

Perceived Dignity of Advanced Cancer Patients and Its Relationship to Sociodemographic, Clinical, and Psychological Factors

et al. 2022

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ObjectiveLoss of dignity is one of the main reasons for wishing for an early death in patients with incurable diseases such as cancer and is strongly associated with psychological distress and loss of quality of life. The present study aims to analyze the perceived dignity of patients with advanced cancer undergoing systemic treatment and their relationship with sociodemographic, clinical, and psychological factors.MethodsA prospective, cross-sectional, multicenter study was conducted in 15 oncology departments in Spain. Patients with locally advanced, unresectable, or metastatic cancer who were candidates for systemic treatment were included. Participants completed demographic information and Palliative Patients’ Dignity Scale, Brief Symptom Inventory, Mental Adjustment to Cancer, Functional Social Support Questionnaire, and Illness Uncertainty.ResultsA total of 508 patients were recruited between February 2020 and October 2021. Most were male, aged > 65 years, with digestive tumors (41%), and metastatic disease at diagnosis. Subjects were classified as having low (56%, N = 283) or high (44%, N = 225) perceived dignity. Patients ≥ 65 years, with worse baseline status (ECOG ≥ 1), and worse estimated 18-month survival had lower levels of perceived dignity. People with lower perceived dignity scored higher for anxious preoccupation and hopelessness and lower for positive attitude. They also displayed higher levels of anxiety, depression, and somatic symptoms, greater uncertainty, and less social support.ConclusionSelf-perceived dignity in advancer cancer patients is significantly associated with psychological factors, psychological distress, uncertainty, less social support. Knowledge of these specific interactions is importance for adequate, comprehensive palliative care.

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Section: Discussioncontrasting

confidence: 99%

Perceived Dignity of Advanced Cancer Patients and Its Relationship to Sociodemographic, Clinical, and Psychological Factors

et al. 2022

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“…The sources of dignity-related distress were very similar in both groups, and they concluded that a better understanding of these would help clinicians provide more effective end-of-life care. On the other hand, Pergolizzi et al [ 15 ] conducted a study comparing young and elderly people with advanced cancer. Older patients conveyed an apparent adaptation to dignity-related threats, especially in the domains of psychological and existential distress.…”

Section: Introductionmentioning

confidence: 99%

Dignity and psychosocial related variables in elderly advanced cancer patients

et al. 2022

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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.

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“…Studies revealed that younger female patients, being employed, not having religious affiliation and high income were associated with high level of sense of dignity. The association between sense of dignity and education was inconsistent in two studies 31,33,37 …”

Section: Resultsmentioning

confidence: 99%

“…Patients' individual demographic characteristics such as age, gender, education, employment status, income and religious affiliation were identified to be associated with their sense of dignity. 31,33,37 Studies revealed that younger female patients, being employed, not having religious affiliation and high income were associated with high level of sense of dignity. The association between sense of dignity and education was inconsistent in two studies.…”

Section: Relationship Between Dignity and Other Variablesmentioning

confidence: 99%

“…The association between sense of dignity and education was inconsistent in two studies. 31,33,37 Physical status such as symptom distress and functional impairment were the most common variables reported to be associated with dignity in the included studies. 7,19,36,41,43 Specifically, these factors were positively correlated with the dignity-related distress.…”

Section: Relationship Between Dignity and Other Variablesmentioning

confidence: 99%

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How patients with cancer experience dignity: An integrative review

Xiao

Yan

et al. 2021

Psycho-Oncology

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Background A diagnosis of cancer and its treatments can be associated with a prominent issue of loss of dignity or an undermined sense of dignity for patients. Research is increasingly being conducted into how patients with cancer experience dignity, with the aim to build clinical foundations for care that preserves patients' sense of dignity. Aim This review summarises and synthesises the available empirical literature on the experience of dignity in patients with cancer regarding both the perception of dignity and associated factors. Method An integrative review method was used. A literature search was conducted in 11 databases using the search terms ‘dignity’ OR ‘existential’ OR ‘existentialism’ combined with ‘cancer’. The Mixed Methods Appraisal Tool (version 2011) was adopted to appraise the methodological quality of the included studies. Results Nine qualitative studies and 13 quantitative studies met the selection criteria and were included in the review. The ways that patients with cancer perceived dignity include autonomy/control, respect, self‐worth, family connectedness, acceptance, hope/future and God/religious. Factors associated with dignity include demographics, physical and psychosocial distress, experiences of suffering and coping strategies. Conclusion Dignity‐conserving care should respect patients' human autonomy to strengthen their sense of self‐worth, acceptance, hope, reinforce family connectedness, and foster coping strategies to control the physical, psychosocial factors and experience of sufferings that threaten their sense of dignity.

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Older Age: A Protective Factor Against Perceived Dignity-Related Distress in Patients With Advanced Cancer?

Cited by 6 publications

References 53 publications

Perceived Dignity of Advanced Cancer Patients and Its Relationship to Sociodemographic, Clinical, and Psychological Factors

Perceived Dignity of Advanced Cancer Patients and Its Relationship to Sociodemographic, Clinical, and Psychological Factors

Dignity and psychosocial related variables in elderly advanced cancer patients

How patients with cancer experience dignity: An integrative review

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