Relationship between demoralization and quality of life in end‐of‐life cancer patients.

Objective: To examine the relationship between demoralization and health‐related quality of life (HRQoL) in a sample of end‐of‐life cancer patients with a life expectancy of 4 months or less undergoing palliative care, controlling for sociodemographic, clinical, and psychological variables. Methods: Sociodemographic, clinical, and psychological data from 170 end‐of‐life cancer patients were collected using the following scales: Edmonton Symptom Assessment System for palliative care patients' symptoms; Patient Health Questionnaire‐9 (PHQ‐9) for depressive symptoms; Functional Assessment of Cancer Therapy Scale ‐ General Measure (FACT‐G) for HRQoL; Functional Assessment of Chronic Illness Therapy ‐ Spiritual Well‐Being for spirituality (FACIT‐Sp); Demoralization Scale ‐ Italian Version (DS‐IT) for demoralization. Results: The DS‐IT showed that 51.8% of cancer patients were severely demoralized. In addition, 36.5% of the sample had clinically significant depressive symptoms and QoL was severely impaired (FACT‐G). The result of regression analysis showed that demoralization (especially "Disheartenment" and "Sense of failure") was the strongest contributor for HRQoL, followed by ESAS_Lack of Well‐Being and depression (PHQ‐9), with the final model explaining 66% of the variance of the FACT‐G. Conclusions: The results highlight a very high prevalence of severe demoralization in end‐of life cancer patients. Moreover, demoralization was not only associated with patients' HRQoL, but it was also the most important contributing factor. This finding underscores the need to identify preventive or therapeutic psychological interventions that focus on preventing existential distress, and thus improve the QoL of dying patients in their last days of life. [ABSTRACT FROM AUTHOR]

Copyright of Psycho-Oncology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)