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Cited by 114Palliative and Oncologic CarePalliative Care and End-of-Life IssuesCancer survivorship and care

Determinants of death anxiety in patients with advanced cancer

Open access
Neel, Caroline, Lo, Chris, Rydall, Anne, Hales, Sarah, Rodin, Gary·2015·BMJ Supportive & Palliative Care
DOI 10.1136/bmjspcare-2012-000420
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Abstract

Objective: To examine the presence of death anxiety in patients with advanced cancer and to identify the psychosocial and disease-related factors associated with it. Design: Cross-sectional analysis of baseline data from a phase 2 pilot intervention trial. Setting: Princess Margaret Cancer Centre, University Health Network, Toronto, Canada. Participants: 60 adult outpatients with metastatic breast, endocrine, gastrointestinal, gynaecological, genitourinary and lung cancer. Main outcome measure: Death anxiety, as measured by the Death and Dying Distress Scale (DADDS). Results: Thirty-two per cent of the sample reported death anxiety of at least moderate severity. The most distressing concern involved fears about the impact of one's death on others, and the least distressing concerns were related to dying alone or suddenly. According to regression analyses, death anxiety was negatively associated with self-esteem, b=−1.73, CI 0.95(−2.57 to −0.90) and positively associated with physical symptom burden, b=1.38, CI 0.95(0.44 to 2.31), having children under 18 years of age in the family, b=13.3, CI 0.95(2.15 to 24.5), and age, b=0.40, CI 0.95(0.0023 to 0.79). The physical symptoms most strongly associated with death anxiety were changes in physical appearance, b=18.8, CI 0.95(8.21 to29.5), and pain, b=10.1, CI 0.95(0.73 to 19.5). Conclusions: The findings suggest that death anxiety in patients with advanced cancer is common and determined by the interaction of individual factors, family circumstances and physical suffering. Multidimensional interventions that take into account these and other factors may be most likely to be effective to alleviate this death-related distress.

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Research works printed but not linked: 3

  1. [1]1. Becker E. The Denial of Death. New York, NY: The Free Press 1973;xvii.
  2. [15]15. Drolet J. Transcending death during early adulthood: symbolic immortality, death anxiety, and purpose in life. J Clin Psychol 2006;46:148-60.
  3. [18]18. Shaver P, Mikulincer M. Attachment in Adulthood: Structures, Dynamics and Change. New York, NY: Guilford Press 2007.

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Authors
Neel, C., Lo, C., Rydall, A., Hales, S., & Rodin, G.
Affiliations
University Health Network (CA)
ORCID
Venue
BMJ Supportive & Palliative Care
Publisher
BMJ
Published
2013-08-22
Volume
5
Issue
4
Pages
373-380
ISSN
  • 2045-435X (ISSN-L)
  • 2045-4368
DOI
10.1136/bmjspcare-2012-000420
OpenAlex
W2147151003
Cited by
114
References
45
Citations by year
2026: 15 · 2025: 7 · 2024: 18 · 2023: 8 · 2022: 13 · 2021: 8 · 2020: 10 · 2019: 13 · 2018: 8 · 2017: 3 · 2016: 4 · 2015: 4 · 2014: 3
FWCI
3.74
Type
journal article
Language
en
Open access
Licence
public-domain
Locations
  • BMJ Supportive & Palliative Care (publishedVersion)
  • PubMed (publishedVersion)
  • ResearchOnline - JCU (James Cook University) (submittedVersion)
  • TSpace (University of Toronto) (submittedVersion, public-domain)
Funders
  • University Health Network
  • Canadian Institutes of Health Research (MOP106473)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
Keywords
fear of death, advanced cancer, psychosocial factors, physical symptom burden, self-esteem, pain, family situation, children under 18, age
MeSH terms
Adult, Aged, Aged, 80 and over, Anxiety, Attitude to Death, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Neoplasm Metastasis, Neoplasms, Self Concept

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