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Cited by 323Palliative and Oncologic CareCancer survivorship and carePalliative Care and End-of-Life Issues

The DOI matches its Crossref record; 91 of the 92 references it cites were found in a registry or an index.

Pathways to distress: The multiple determinants of depression, hopelessness, and the desire for hastened death in metastatic cancer patients

Rodin, Gary, Lo, Christopher, Mikulincer, Mario, Donner, Allan, Gagliese, Lucia, Zimmermann, Camilla·2009·Social Science & Medicine
DOI 10.1016/j.socscimed.2008.10.037
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Abstract

We tested a model in which psychosocial and disease-related variables act as multiple protective and risk factors for psychological distress in patients with metastatic cancer. We hypothesized that depression and hopelessness constitute common pathways of distress, which mediate the effects of psychosocial and disease-related factors on the desire for hastened death. This model was tested on a cross-sectional sample of 406 patients with metastatic gastrointestinal or lung cancer recruited at outpatient clinics of a Toronto cancer hospital, using structural equation modeling. The results supported the model. High disease burden, insecure attachment, low self-esteem, and younger age were risk factors for depression. Low spiritual well-being was a risk factor for hopelessness. Depression and hopelessness were found to be mutually reinforcing, but distinct constructs. Both depression and hopelessness independently predicted the desire for hastened death, and mediated the effects of psychosocial and disease-related variables on this outcome. The identified risk factors support a holistic approach to palliative care in patients with metastatic cancer, which attends to physical, psychological, and spiritual factors to prevent and treat distress in patients with advanced disease.

Overview

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Crossref · 10.1016/j.socscimed.2008.10.037

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  1. Bowlby, 1982, Attachment and loss, Vol. 1.

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Metadata

Authors
Rodin, G., Lo, C., Mikulincer, M., Donner, A., Gagliese, L., & Zimmermann, C.
Affiliations
  • University Health Network (CA)
  • Reichman University (IL)
  • Western University (CA)
  • York University (CA)
Corresponding author
Rodin, Gary
ORCID
Venue
Social Science & Medicine
Publisher
Elsevier BV
Published
2009-02
Volume
68
Issue
3
Pages
562-569
ISSN
0277-9536 (ISSN-L)
DOI
10.1016/j.socscimed.2008.10.037
OpenAlex
W2145839824
Cited by
323
References
92
Citations by year
2026: 15 · 2025: 18 · 2024: 23 · 2023: 12 · 2022: 22 · 2021: 30 · 2020: 22 · 2019: 18 · 2018: 12 · 2017: 24 · 2016: 14 · 2015: 22 · 2014: 20 · 2013: 20 · 2012: 11
FWCI
13.19
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Social Science & Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • ResearchOnline - JCU (James Cook University) (submittedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
Keywords
metastatic cancer, psychological distress, depression, hopelessness, suicidal ideation, psychosocial risk factors, disease burden, insecure attachment, self-esteem, spiritual well-being, palliative care, gastrointestinal cancer, lung cancer, mediation
MeSH terms
Age Factors, Aged, Anxiety, Attitude to Death, Attitude to Health, Cancer Care Facilities, Depressive Disorder, Female, Gastrointestinal Neoplasms, Humans, Lung Neoplasms, Male, Middle Aged, Models, Psychological, Neoplasm Metastasis, Neoplasm Staging, Ontario, Risk Factors, Self Concept, Cost of Illness, Sickness Impact Profile, Spirituality

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