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Meaning in life as a mediator between physical impairment and the wish to hasten death in patients with advanced cancer
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CONTEXT: Meaning in life (MiL) is a key factor for ensuring spiritual wellbeing and quality of life among patients with life-threatening illnesses. However, the role of MiL in relation to the wish to hasten death (WTHD) and its interaction with other physical and psychological factors in patients with advanced cancer has not yet been studied.
OBJECTIVE: To analyse the relationship between the WTHD and MiL, and to propose a theoretical model of functional relationships between WTHD, performance status, depression and MiL.
METHODS: Cross-sectional study of 101 patients in a palliative care unit, who were assessed in the context of a clinical interview. Outcome measures included performance status, depression, MiL and the WTHD. Structural equation modelling (SEM) was used to analyse the functional relationships between these factors.
RESULTS: The WTHD correlated significantly (p < .01) with MiL (r = 0.60), performance status (r = 0.548) and depression (r = 0.397). The SEM analysis showed that although there was no significant direct effect between performance status and the WTHD, there was a significant total effect, due to the mediation of depression and MiL. The latter played the most significant role, accounting for 76.5% of the mediation.
CONCLUSION: These results support the proposed model and provide evidence of a mediator effect of MiL and depression on the relationship between physical impairment and the WTHD in advanced patients. Our findings suggest that interventions to enhance MiL could help to address and/or prevent the emergence of a WTHD in this population.
http://dx.doi.org/10.1016/j.jpainsymman.2017.04.018
Voir la revue «JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 54»
Autres numéros de la revue «JOURNAL OF PAIN AND SYMPTOM MANAGEMENT»
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