Death anxiety among advanced cancer patients: a cross-sectional survey

• Published in: Supportive care in cancer Vol. 30; no. 4; pp. 3531 - 3539
• Main Authors: Hong, Yang, Yuhan, Lu, Youhui, Gu, Zhanying, Wang, Shili, Zheng, Xiaoting, Hou, Wenhua, Yu
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.04.2022; Springer; Springer Nature B.V
• Subjects: Adaptation, Psychological; Adult; Adult Children; Aged; Anxiety; Anxiety - epidemiology; Anxiety - etiology; Attitude to Death; Cancer; Cancer patients; Care and treatment; Caregivers; Coping; Cross-Sectional Studies; Humans; Medicine; Medicine & Public Health; Neoplasms; Nursing; Nursing Research; Oncology; Oncology, Experimental; Original; Original Article; Pain Medicine; Questionnaires; Rehabilitation Medicine; Self esteem; Social aspects; Surveys and Questionnaires; Coping mode; Thanatophobia; Self-esteem; Death anxiety; Attitude to death; Resilience
• ISSN: 0941-4355; 1433-7339; 1433-7339
• DOI: 10.1007/s00520-022-06795-z

Purpose This study aimed to investigate death anxiety in advanced cancer patients and identify associated factors in the context of Chinese culture. Methods Participants ( N  = 270) with advanced cancer in a tertiary cancer hospital completed anonymous questionnaire surveys. Measures included the Chinese version of a Likert-type Templer-Death Anxiety Scale, Rosenberg’s Self-esteem Scale, Medical Coping Modes Questionnaire, the Social Support Rating Scale, and Connor-Davidson Resilience Scale. Data were analyzed in SPSS using descriptive statistics, Student’s t test, Pearson correlation test, and linear regression. Results Respondents returned 252 (93.33%) of the 270 questionnaires. The total CL-TDAS score was 39.56 ± 10.20. The top three items were “I fear dying a painful death” (3.59 ± 1.41), “I often think about how shortly life really is” (3.11 ± 1.33), and “1 am not particularly afraid of getting cancer” (3.09 ± 1.35). Associated factors of death anxiety ( R 2  = .333, F  = 15.756, p  < .001) were the medical coping mode (resignation, confronce), self-esteem, the participants’ adult children, the patient-primary caregivers’ relationship, resilience, and the level of activity of daily living. Conclusions Our results demonstrate high levels of death anxiety in advanced cancer patients. Generally, patients with adult children, high self-esteem and resilience had low death anxiety. Conversely, patients with low levels of activity of daily living and high coping mode (resignation, confrontation) reported high death anxiety. We determined that associated factors contributed to reduce death anxiety. Social interventions are recommended to improve the end-of-life transition for patients and caregivers.