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Supportive Care in Cancer

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01-05-2021 | Care | Original Article

Effects of meaning in life and individual characteristics on dignity in patients with advanced cancer in China: a cross-sectional study

Authors: Xiaocheng Liu, Zhili Liu, Qinqin Cheng, Nuo Xu, Hui Liu, Wenjuan Ying

Published in: Supportive Care in Cancer | Issue 5/2021

Abstract

Purpose

This study was conducted to evaluate the effects of meaning in life and individual characteristics on dignity in patients with advanced cancer.

Methods

One hundred sixty-seven patients with advanced cancer participated in this study. Dignity was assessed with the Patient Dignity Inventory (PDI), meaning in life was assessed with the Meaning in Life Scale (MiLS), and performance status was defined as the Karnofsky Performance Status (KPS). Sociodemographic and clinical variables were also measured. Independent T tests and one-way ANOVA were performed for the PDI scores and sociodemographic and clinical variables. Relationships among the PDI, MiLS, and KPS scores were evaluated with bivariate analyses (Spearman rank correlation). A multiple linear regression analysis was conducted to determine the predictors the of PDI score.

Results

Patients reported a mean of 4.2 (SD 4.9) problems affecting their sense of dignity; 21.6% reported moderate to severe loss of their sense of dignity. Multivariable regression analyses revealed that a lower MiLS score, younger age, inpatient status, and a lower KPS score predicted the loss of dignity. Stepwise regression showed that 49.8% of dignity-related distress could be explained by the MiLS score, age, inpatient status, and the KPS score.

Conclusion

Self-perceived dignity is significantly negatively associated with meaning in life, age, inpatient status, and performance status. The early recognition of risk factors for the loss of dignity and interventions to enhance meaning in life may prevent the loss of dignity in patients with advanced cancer.

Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A (2018) Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 68:394–424CrossRef

Feng RM, Zong YN, Cao SM, Xu RH (2019) Current cancer situation in China: good or bad news from the 2018 Global Cancer Statistics? Cancer Commun (Lond) 39:22–33CrossRef

Yin Z, Li J, Ma K, Ning X, Chen H, Fu H, Zhang H, Wang C, Bruera E, Hui D (2017) Development of palliative care in China: a tale of three cities. Oncologist 22:1362–1367CrossRef

Chochinov HM (2002) Dignity-conserving care--a new model for palliative care: helping the patient feel valued. JAMA 287:2253–2260CrossRef

Chochinov HM, Hack T, McClement S, Kristjanson L, Harlos M (2002) Dignity in the terminally ill: a developing empirical model. Soc Sci Med 54:433–443CrossRef

Vehling S, Mehnert A (2014) Symptom burden, loss of dignity, and demoralization in patients with cancer: a mediation model. Psycho-oncology 23:283–290CrossRef

Parpa E, Kostopoulou S, Tsilika E, Galanos A, Mystakidou K (2019) Depression as a mediator or moderator between preparatory grief and sense of dignity in patients with advanced cancer. Am J Hosp Palliat Care 36:1063–1067CrossRef

Hosseini A, Rezaei M, Bahrami M, Abbasi M, Hariri H (2017) The relationship between dignity status and quality of life in Iranian terminally ill patients with cancer. Iran J Nurs Midwifery Res 22:178–183PubMedPubMedCentral

Georges JJ, Onwuteaka-Philipsen BD, van der Heide A, van der Wal G, van der Maas PJ (2006) Requests to forgo potentially life-prolonging treatment and to hasten death in terminally ill cancer patients: a prospective study. J Pain Symptom Manag 31:100–110CrossRef

10.

Bagheri H, Yaghmaei F, Ashktorab T, Zayeri F (2018) Relationship between illness-related worries and social dignity in patients with heart failure. Nurs Ethics 25:618–627CrossRef

11.

Zirak M, Ghafourifard M, Aliafsari Mamaghani E (2017) Patients’ dignity and its relationship with contextual variables: a cross-sectional study. J Caring Sci 6:49–51CrossRef

12.

Chochinov HM, Hack T, Hassard T, Kristjanson LJ, McClement S, Harlos M (2002) Dignity in the terminally ill: a cross-sectional, cohort study. Lancet 360:2026–2030CrossRef

13.

Chochinov HM, Hassard T, McClement S, Hack T, Kristjanson LJ, Harlos M, Sinclair S, Murray A (2009) The landscape of distress in the terminally ill. J Pain Symptom Manag 38:641–649CrossRef

14.

Albers G, Pasman HR, Deliens L, de Vet HC, Onwuteaka-Philipsen BD (2013) Does health status affect perceptions of factors influencing dignity at the end of life? J Pain Symptom Manag 45:1030–1038CrossRef

15.

Chochinov HM, Hack T, Hassard T, Kristjanson LJ, McClement S, Harlos M (2005) Dignity therapy: a novel psychotherapeutic intervention for patients near the end of life. J Clin Oncol 23:5520–5525CrossRef

16.

Chochinov HM, Hassard T, McClement S, Hack T, Kristjanson LJ, Harlos M, Sinclair S, Murray A (2008) The patient dignity inventory: a novel way of measuring dignity-related distress in palliative care. J Pain Symptom Manag 36:559–571CrossRef

17.

Periyakoil VS, Kraemer HC, Noda A (2009) Creation and the empirical validation of the dignity card-sort tool to assess factors influencing erosion of dignity at life’s end. J Palliat Med 12:1125–1130CrossRef

18.

Rudilla D, Oliver A, Galiana L, Barreto P (2016) A new measure of home care patients’ dignity at the end of life: the Palliative Patients’ Dignity Scale (PPDS). Palliat Support Care 14:99–108CrossRef

19.

AHY H, CLW C, PPY L et al (2013) Living and dying with dignity in Chinese society: perspectives of older palliative care patients in Hong Kong. Age Ageing 42:455–461CrossRef

20.

Xiao J, Chow KM, Chan CW, Li M, Deng Y (2019) Qualitative study on perceived dignity of cancer patients undergoing chemotherapy in China. Support Care Cancer 28:2921–2929CrossRef

21.

Winger JG, Adams RN, Mosher CE (2016) Relations of meaning in life and sense of coherence to distress in cancer patients: a meta-analysis. Psychooncology 25:2–10CrossRef

22.

Breitbart W, Rosenfeld B, Pessin H, Applebaum A, Kulikowski J, Lichtenthal WG (2015) Meaning-centered group psychotherapy: an effective intervention for improving psychological well-being in patients with advanced cancer. J Clin Oncol 33:749–754CrossRef

23.

Breitbart W, Pessin H, Rosenfeld B, Applebaum AJ, Lichtenthal WG, Li Y, Saracino RM (2018) Individual meaning-centered psychotherapy for the treatment of psychological and existential distress: a randomized controlled trial in patients with advanced cancer. Cancer 124:3231–3239CrossRef

24.

Zhang J, Peng J, Gao P, Huang H, Cao Y, Zheng L, Miao D (2019) Relationship between meaning in life and death anxiety in the elderly: self-esteem as a mediator. BMC Geriatr 19:308CrossRef

25.

Lee V, Robin Cohen S, Edgar L, Laizner AM, Gagnon AJ (2006) Meaning-making intervention during breast or colorectal cancer treatment improves self-esteem, optimism, and self-efficacy. Soc Sci Med 62:3133–3145CrossRef

26.

Wagner J, Lüdtke O, Robitzsch A, Göllner R, Trautwein U (2018) Self-esteem development in the school context: The roles of intrapersonal and interpersonal social predictors. J Pers 86:481–497CrossRef

27.

Sturm BA, Dellert JC (2016) Exploring nurses’ personal dignity, global self-esteem and work satisfaction. Nurs Ethics 23:384–400CrossRef

28.

Fernández-Sola C, Cortés MM, Hernández-Padilla JM, Torres CJ, Terrón JM, Granero-Molina J (2017) Defining dignity in end-of-life care in the emergency department. Nurs Ethics 24:20–32CrossRef

29.

Oh PJ, Shin SR (2014) Effects of dignity interventions on psychosocial and existential distress in terminally ill patients: a meta-analysis. J Korean Acad Nurs 44:471–483CrossRef

30.

Yanmei, C (2015) The preliminary revision of the patient dignity inventory and the research on dignity in patients with advanced cancer[D]. Shanxi Medical University [Article in Chinese]

31.

Yongsheng, W (2009) Preliminary preparation and evaluation of purpose in life test for advanced cancer patients[D]. Guangxi Medical University [Article in Chinese]

32.

Evans JD (1996) Straightforward statistics for the behavioral sciences. Brooks/Cole Pub. Co, Pacific Grove

33.

Park CL, Pustejovsky JE, Trevino K, Sherman AC, Esposito C, Berendsen M, Salsman JM (2019) Effects of psychosocial interventions on meaning and purpose in adults with cancer: a systematic review and meta-analysis. Cancer 125(14):2383–2393CrossRef

34.

Krause N (2009) Meaning in life and mortality. J Gerontol B Psychol Sci Soc Sci 64:517–527CrossRef

35.

Czekierda K, Banik A, Park CL, Luszczynska A (2017) Meaning in life and physical health: systematic review and meta-analysis. Health Psychol Rev 11:387–418CrossRef

36.

Guerrero-Torrelles M, Monforte-Royo C, Rodríguez-Prat A, Porta-Sales J, Balaguer A (2017) Understanding meaning in life interventions in patients with advanced disease: a systematic review and realist synthesis. Palliat Med 31:798–813CrossRef

37.

Dobrikova P, Pcolkova D, AlTurabi LK et al (2015) The effect of social support and meaning of life on the quality-of-life care for terminally ill patients. Am J Hosp Palliat Care 32(7):767–771CrossRef

38.

Oechsle K, Wais MC, Vehling S, Bokemeyer C, Mehnert A (2014) Relationship between symptom burden, distress, and sense of dignity in terminally ill cancer patients. J Pain Symptom Manag 48:313–321CrossRef

39.

Wang L, Wei Y, Xue L, Guo Q, Liu W (2019) Dignity and its influencing factors in patients with cancer in North China: a cross-sectional study. Curr Oncol 26:e188–e193CrossRef

40.

Yeung N, Lu Q, Mak W (2019) Self-perceived burden mediates the relationship between self-stigma and quality of life among Chinese American breast cancer survivors. Support Care Cancer 27:3337–3345CrossRef

41.

Baillie L (2009) Patient dignity in an acute hospital setting: a case study. Int J Nurs Stud 46:23–36CrossRef

42.

Cai J, Zhao H, Coyte PC (2017) Socioeconomic differences and trends in the place of death among elderly people in China. Int J Environ Res Public Health 14:1210CrossRef

Title: Effects of meaning in life and individual characteristics on dignity in patients with advanced cancer in China: a cross-sectional study
Authors: Xiaocheng Liu
Zhili Liu
Qinqin Cheng
Nuo Xu
Hui Liu
Wenjuan Ying
Publication date: 01-05-2021
Publisher: Springer Berlin Heidelberg
Keyword: Care
Published in: Supportive Care in Cancer / Issue 5/2021
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-020-05732-2

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