Receiving palliative treatment moderates the effect of age and gender on demoralization in patients with cancer
Open accessAbstract
BACKGROUND: Existential distress is an important factor affecting psychological well-being in cancer patients. We studied occurrence and predictors of demoralization, a syndrome of existential distress, in particular the interaction of age, gender, and curative vs. palliative treatment phase. METHODS: A cross-sectional sample of N = 750 patients with different tumor sites was recruited from in- and outpatient treatment facilities. Patients completed the following self-report questionnaires: Demoralization Scale, Patient Health Questionnaire-9, Illness-Specific Social Support Scale Short Version-8, and physical problems list of the NCCN Distress Thermometer. Moderated multiple regression analyses were conducted. RESULTS: We found high demoralization in 15% and moderate demoralization in 8% of the sample. Curative vs. palliative treatment phase moderated the impact of age and gender on demoralization (three-way interaction: b = 1.30, P = .02): the effect of age on demoralization was negative for women receiving palliative treatment (b = -.26, P = .02) and positive for men receiving palliative treatment (b = .25, P = .03). Effects of age and gender were not significant among patients receiving curative treatment. Female gender was associated with higher demoralization among younger patients receiving palliative treatment only. Analyses were controlled for significant effects of the number of physical problems (b = 6.10, P<.001) and social support (b = -3.17, P<.001). CONCLUSIONS: Existential distress in terms of demoralization is a relevant problem within the spectrum of cancer-related distress. It is associated with a complex interaction of demographic and medical patient characteristics; existential challenges related to palliative treatment may exacerbate the impact of age- and gender-related vulnerability factors on demoralization. Psychosocial interventions should acknowledge this interaction in order to address the individual nature of existential distress in subgroups of cancer patients.
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In four studies (n = 1631), demoralization was higher or more frequent in women.
“In four studies (n = 1631), demoralization was higher or more frequent in women.”
From A systematic review of the demoralization syndrome in individuals with progressive disease and cancer: a decade of research (2015) · cites this paper as [33]
The effect of curative versus palliative treatment moderated the relationship between demoralization and both age and gender.
“the effect of curative vs. palliative treatment moderated the relationship between demoralization and both age and gender.”
From A systematic review of the demoralization syndrome in individuals with progressive disease and cancer: a decade of research (2015) · cites this paper as [33]
The negative correlation between age and demoralization may be explained by the moderating effect of curative versus palliative treatment.
“This may be explained by the results of the study by Vehling et al. in 2013”
From A systematic review of the demoralization syndrome in individuals with progressive disease and cancer: a decade of research (2015) · cites this paper as [33]
A negative correlation between age and demoralization was reported in two studies totaling 1266 subjects.
“a negative correlation between age and demoralization was reported in two studies totaling 1266 subjects.”
From A systematic review of the demoralization syndrome in individuals with progressive disease and cancer: a decade of research (2015) · cites this paper as [33]
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Cites
Multiple regression: testing and interpreting interactions
(1992) · Choice Reviews Online · doi:10.5860/choice.29-3352 · Cited by 36,644 · see citing works
(1991) · Cited by 7,187 · see citing works
Applied Regression Analysis and Generalized Linear Models
Fox, J. (2008) · Cited by 2,051 · see citing works
Dawson, J., & Richter, A. W. (2006) · Journal of Applied Psychology · doi:10.1037/0021-9010.91.4.917 · Cited by 1,861 · see citing works
Sex Differences in Coping Behavior: A Meta-Analytic Review and an Examination of Relative Coping
Tamres, L. K., Janicki, D., & Helgeson, V. S. (2002) · Personality and Social Psychology Review · doi:10.1207/s15327957pspr0601_1 · Cited by 1,807 · cited 1× · see citing works
“On the other hand, male gender role expectations of stoicism and self-reliance have been suggested to explain distracting coping responses in men [50].”
BackgroundLöwe, B., Kroenke, K., Herzog, W., & Gräfe, K. (2004) · Journal of Affective Disorders · doi:10.1016/s0165-0327(03)00198-8 · Cited by 1,558 · cited 1× · see citing works
“Depression within the past two weeks was assessed using the DSM-IV-based depression module of the Patient Health Questionnaire (PHQ-9) [29].”
MethodEmotion Regulation and Psychopathology: The Role of Gender
Nolen–Hoeksema, S. (2012) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-032511-143109 · Cited by 1,276 · see citing works
Kuehner, C. (2003) · Acta Psychiatrica Scandinavica · doi:10.1034/j.1600-0447.2003.00204.x · Cited by 839 · see citing works
Hagedoorn, M., Sanderman, R., Bolks, H. N., Tuinstra, J., & Coyne, J. C. (2008) · Psychological Bulletin · doi:10.1037/0033-2909.134.1.1 · Cited by 777 · see citing works
Demoralization Syndrome — a Relevant Psychiatric Diagnosis for Palliative Care
Kissane, D. W., Clarke, D. M., & Street, A. F. (2001) · Journal of Palliative Care · doi:10.1177/082585970101700103 · Cited by 624 · see citing works
Demoralization: its phenomenology and importance
Clarke, D. M., & Kissane, D. W. (2002) · Australian & New Zealand Journal of Psychiatry · doi:10.1046/j.1440-1614.2002.01086.x · Cited by 590 · see citing works
The demoralization scale: a report of its development and preliminary validation
Kissane, D. W., Wein, S., Love, A., Lee, X. Q., Kee, P. L., & Clarke, D. M. (2004) · Journal of Palliative Care · doi:10.1177/082585970402000402 · Cited by 442 · see citing works
Revenson, T. A., Schiaffino, K. M., Majerovitz, S. D., & Gibofsky, A. (1991) · Social Science & Medicine · doi:10.1016/0277-9536(91)90385-p · Cited by 426 · see citing works
Breitbart, W., Poppito, S., Rosenfeld, B., Vickers, A. J., Li, Y., Abbey, J., Olden, M., Pessin, H., Lichtenthal, W., Sjoberg, D., et al. (2012) · Journal of Clinical Oncology · doi:10.1200/jco.2011.36.2517 · Cited by 426 · cited 1× · see citing works
“Adequate management of existential distress is essential to psychosocial care in cancer, yet it has only recently been focused in specialized interventions and distress measures [1–3].”
BackgroundDesigning, testing, and interpreting interactions and moderator effects in family research
Whisman, M. A., & McClelland, G. H. (2005) · Journal of Family Psychology · doi:10.1037/0893-3200.19.1.111 · Cited by 421 · cited 1× · see citing works
“The variance explained by the interaction was small, but within the range usually expected for three-way interactions [32].”
BackgroundDying, Dignity, and New Horizons in Palliative End-of-Life Care
Chochinov, H. M. (2006) · CA A Cancer Journal for Clinicians · doi:10.3322/canjclin.56.2.84 · Cited by 388 · see citing works
Rodin, G., Lo, C., Mikulincer, M., Donner, A., Gagliese, L., & Zimmermann, C. (2009) · Social Science & Medicine · doi:10.1016/j.socscimed.2008.10.037 · Cited by 323 · see citing works
Treatment of existential distress in life threatening illness: A review of manualized interventions
LeMay, K., & Wilson, K. G. (2008) · Clinical Psychology Review · doi:10.1016/j.cpr.2007.07.013 · Cited by 280 · see citing works
Depression and demoralization: Phenomenologic differences and research perspectives
de Figueiredo, J. M. (1993) · Comprehensive Psychiatry · doi:10.1016/0010-440x(93)90016-w · Cited by 217 · see citing works
MEHNERT, A., LEHMANN, C., GRAEFEN, M., HULAND, H., & KOCH, U. (2010) · European Journal of Cancer Care · doi:10.1111/j.1365-2354.2009.01117.x · Cited by 202 · see citing works
Handbook of psychiatry in palliative medicine.
Chochinov, H. M., & BREITBART, W. S. (2000) · Cited by 193 · see citing works
Monforte‐Royo, C., Villavicencio‐Chávez, C., Tomás‐Sábado, J., Mahtani‐Chugani, V., & Balaguer, A. (2012) · PLoS ONE · doi:10.1371/journal.pone.0037117 · Cited by 192 · see citing works
The Relief of Existential Suffering
Kissane, D. W. (2012) · Archives of Internal Medicine · doi:10.1001/archinternmed.2012.3633 · Cited by 175 · see citing works
Mehnert, A., Vehling, S., Höcker, A., Lehmann, C., & Koch, U. (2011) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2011.02.013 · Cited by 171 · see citing works
The Landscape of Distress in the Terminally Ill
Chochinov, H. M., Hassard, T. H., McClement, S., Hack, T. F., Kristjanson, L. J., Harlos, M., Sinclair, S., & Murray, A. (2009) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2009.04.021 · Cited by 168 · see citing works
Diagnostic criteria for psychosomatic research and psychosocial variables in breast cancer patients
Grassi, L., Rossi, E., Sabato, S., Cruciani, G., & Zambelli, M. (2004) · Psychosomatics · doi:10.1176/appi.psy.45.6.483 · Cited by 133 · see citing works
A Review of Age Differences in Psychological Adjustment to Breast Cancer
Mosher, C. E., & Danoff‐Burg, S. (2005) · Journal of Psychosocial Oncology · doi:10.1300/j077v23n02_07 · Cited by 131 · see citing works
Nissim, R., Freeman, E., Lo, C., Zimmermann, C., Gagliese, L., Rydall, A., Hales, S., & Rodin, G. (2012) · Palliative Medicine · doi:10.1177/0269216311425096 · Cited by 129 · see citing works
Use of the diagnostic criteria for psychosomatic research in oncology
Grassi, L., Sabato, S., Rossi, E., Biancosino, B., & Marmai, L. (2005) · Psychotherapy and Psychosomatics · doi:10.1159/000083168 · Cited by 123 · see citing works
A gerontologic perspective on cancer and aging
Blank, T., & Bellizzi, K. M. (2008) · Cancer · doi:10.1002/cncr.23444 · Cited by 122 · see citing works
Psychoanalytic Reflections on Mortality: A Reconsideration
Rodin, G., & Zimmermann, C. (2008) · Journal of the American Academy of Psychoanalysis and Dynamic Psychiatry · doi:10.1521/jaap.2008.36.1.181 · Cited by 121 · see citing works
Major depression and demoralization in cancer patients: diagnostic and treatment considerations
Angelino, A. F., & Treisman, G. J. (2001) · Supportive Care in Cancer · doi:10.1007/s005200000195 · Cited by 120 · see citing works
Demoralization, anhedonia and grief in patients with severe physical illness.
Clarke, D. M., Kissane, D. W., Trauer, T., & Smith, G. C. (2005) · PubMed Central · Cited by 118 · see citing works
Vehling, S., Lehmann, C., Oechsle, K., Bokemeyer, C., Krüll, A., Koch, U., & Mehnert, A. (2010) · Supportive Care in Cancer · doi:10.1007/s00520-010-0845-6 · Cited by 118 · see citing works
Jones, J. M., Huggins, M. A., Rydall, A. C., & Rodin, G. (2003) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(03)00526-9 · Cited by 110 · see citing works
The Chronology of Distress, Anxiety, and Depression in Older Prostate Cancer Patients
Nelson, C. J., Weinberger, M. I., Balk, E., Holland, J. C., BREITBART, W. S., & Roth, A. J. L. (2009) · The Oncologist · doi:10.1634/theoncologist.2009-0059 · Cited by 105 · see citing works
Psychological distress and its correlates in ovarian cancer: a systematic review
Arden-Close, E. J., Gidron, Y., & Moss-Morris, R. E. (2008) · Psycho-Oncology · doi:10.1002/pon.1363 · Cited by 104 · see citing works
Effect of error variance heterogeneity on the power of tests for regression slope differences.
Alexander, R. A., & DeShon, R. P. (1994) · Psychological Bulletin · doi:10.1037/0033-2909.115.2.308 · Cited by 102 · see citing works
Vehling, S., Lehmann, C., Oechsle, K., Bokemeyer, C., Krüll, A., Koch, U., & Mehnert, A. (2012) · Psycho-Oncology · doi:10.1002/pon.1866 · Cited by 97 · see citing works
Giese‐Davis, J., Waller, A. E., Carlson, L. E., Groff, S. L., Zhong, L., Neri, E., Bachor, S. M., Adamyk-Simpson, J., Rancourt, K. M., Dunlop, B., et al. (2012) · BMC Cancer · doi:10.1186/1471-2407-12-441 · Cited by 94 · see citing works
Mehnert, A., Koch, U., Schulz, H., Wegscheider, K., Weis, J., Faller, H., Keller, M., Brähler, E., & Härter, M. C. (2012) · BMC Psychiatry · doi:10.1186/1471-244x-12-70 · Cited by 93 · see citing works
Sachs, E., Kolva, E., Pessin, H., Rosenfeld, B. D., & BREITBART, W. S. (2012) · American Journal of Hospice and Palliative Medicine® · doi:10.1177/1049909112445371 · Cited by 88 · see citing works
Demoralization syndrome among cancer outpatients in Taiwan
Lee, C., Fang, C., Yang, Y., Liu, C., Leu, Y., Wang, T.-E., Chang, Y.-F., Hsieh, R.-K., Chen, Y.-J., Tsai, L., et al. (2011) · Supportive Care in Cancer · doi:10.1007/s00520-011-1332-4 · Cited by 84 · see citing works
Hopelessness as a predictor of depressive symptoms for breast cancer patients coping with recurrence
Brothers, B. M., & Andersen, B. L. (2008) · Psycho-Oncology · doi:10.1002/pon.1394 · Cited by 83 · see citing works
Mehnert, A., Lehmann, C., Cao, P., & Koch, U. (2006) · PPmP - Psychotherapie · Psychosomatik · Medizinische Psychologie · doi:10.1055/s-2006-951828 · Cited by 81 · see citing works
Diagnosis and measurement of subjective incompetence: the clinical hallmark of demoralization
Cockram, C. A., Doros, G., & de Figueiredo, J. M. (2009) · Psychotherapy and Psychosomatics · doi:10.1159/000235737 · Cited by 79 · see citing works
Boscaglia, N., & M. Clarke, D. (2007) · Psycho-Oncology · doi:10.1002/pon.1044 · Cited by 77 · see citing works
Differences in health-related quality of life of prostate cancer patients based on stage of cancer
Rosenfeld, B., Roth, A. J., Gandhi, S., & Penson, D. (2004) · Psycho-Oncology · doi:10.1002/pon.797 · Cited by 71 · see citing works
Jacobsen, J., Vanderwerker, L., Block, S., Friedlander, R., Maciejewski, P., & Prigerson, H. (2006) · Indian Journal of Palliative Care · doi:10.4103/0973-1075.25913 · Cited by 61 · cited 1× · see citing works
“Factor analytic studies support the conceptual and clinical separation of demoralization and major depression in cancer patients [12,13].”
ResultAguinis, H., & Pierce, C. A. (1998) · Organizational Research Methods · doi:10.1177/109442819813002 · Cited by 58 · see citing works
Age-Related Distress Among Young Women with Breast Cancer
Siegel, K., Gluhoski, V. L., & Gorey, E. (1999) · Journal of Psychosocial Oncology · doi:10.1300/j077v17n01_01 · Cited by 56 · see citing works
Lo, C., LIN, J., Gagliese, L., Zimmermann, C., Mikulincer, M., & Rodin, G. (2009) · Ageing and Society · doi:10.1017/s0144686x09990201 · Cited by 54 · see citing works
Demoralization in Medical Practice
Jacobsen, J. C., Maytal, G., & Stern, T. A. (2007) · The Primary Care Companion to The Journal of Clinical Psychiatry · doi:10.4088/pcc.v09n0208 · Cited by 51 · see citing works
Demoralization and remoralization: a review of these constructs in the healthcare literature
Connor, M., & Walton, J. A. (2011) · Nursing Inquiry · doi:10.1111/j.1440-1800.2010.00501.x · Cited by 28 · see citing works
Miller, S., Lo, C., Gagliese, L., Hales, S., Rydall, A. C., Zimmermann, C., Li, M., & Rodin, G. (2010) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-010-0246-7 · Cited by 25 · see citing works
Scheier, M. F., & Helgeson, V. S. (2006) · Journal of Clinical Oncology · doi:10.1200/jco.2005.05.5244 · Cited by 15 · see citing works
Ryan, D. A., Gallagher, P., Wright, S., & Cassidy, E. (2012) · Palliative Medicine · doi:10.1177/0269216311399663 · Cited by 13 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Robinson, S., Kissane, D. W., Brooker, J., & Burney, S. (2015) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2014.07.008 · Cited by 401 · see citing works
Demoralization: a systematic review on its clinical characterization
Tecuta, L., Tomba, E., Grandi, S., & Fava, G. A. (2014) · Psychological Medicine · doi:10.1017/s0033291714001597 · Cited by 195 · see citing works
Vehling, S., Kissane, D. W., Lo, C., Glaesmer, H., Hartung, T. J., Rodin, G., & Mehnert, A. (2017) · Cancer · doi:10.1002/cncr.30749 · Cited by 182 · see citing works
Symptom burden, loss of dignity, and demoralization in patients with cancer: a mediation model
Vehling, S., & Mehnert, A. (2013) · Psycho-Oncology · doi:10.1002/pon.3417 · Cited by 135 · see citing works
Kissane, D. W., Bobevski, I., Gaitanis, P., Brooker, J., Michael, N., Lethborg, C. E., Richardson, G. E., Webster, P., & Hempton, C. (2017) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2017.01.007 · Cited by 80 · see citing works
Existential distress and meaning-focused interventions in cancer survivorship
Vehling, S., & Philipp, R. (2017) · Current Opinion in Supportive and Palliative Care · doi:10.1097/spc.0000000000000324 · Cited by 79 · see citing works
Tang, L., Li, Z., & Pang, Y. K. (2019) · Psycho-Oncology · doi:10.1002/pon.5296 · Cited by 57 · see citing works
Scheffold, K., Philipp, R., Engelmann, D., Schulz‐Kindermann, F., Rosenberger, C., Oechsle, K., Härter, M. C., Wegscheider, K., Lordick, F., Lo, C., et al. (2015) · BMC Cancer · doi:10.1186/s12885-015-1589-y · Cited by 52 · see citing works
Kapogiannis, A., Tsoli, S., & Chrousos, G. (2018) · EXPLORE · doi:10.1016/j.explore.2017.10.008 · Cited by 49 · see citing works
Characterizing death acceptance among patients with cancer
Philipp, R., Mehnert, A., Lo, C., Müller, V., Reck, M., & Vehling, S. (2019) · Psycho-Oncology · doi:10.1002/pon.5030 · Cited by 51 · see citing works
Belar, A., Arantzamendi, M., Rodríguez-Núñez, A., Santesteban, Y., Martínez, M., López-Saca, J. M., Consigli, S., López–Fidalgo, J., & Centeno, C. (2018) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2018.11.016 · Cited by 43 · see citing works
Hong, Y., Lin, Y., Pan, Y. X., Lin, J. L., Lin, X. J., Zhang, J., & Huang, F. (2022) · Psycho-Oncology · doi:10.1002/pon.6023 · Cited by 41 · see citing works
Relationship between demoralization and quality of life in end‐of‐life cancer patients
Bovero, A., Opezzo, M., & Tesio, V. (2023) · Psycho-Oncology · doi:10.1002/pon.6095 · Cited by 42 · see citing works
Wang, Y., Sun, H., Ji, Q., Wu, Q., Wei, J., & Zhu, P. (2023) · American Journal of Hospice and Palliative Medicine® · doi:10.1177/10499091231154887 · Cited by 37 · see citing works
Koranyi, S., Hinz, A., Hufeld, J. M., Hartung, T. J., Garzón, L. Q., Fendel, U., Letsch, A., Rose, M., Esser, P., & Mehnert, A. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.789793 · Cited by 30 · see citing works
Cheng, J., Chen, J., Zhang, Y., Kissane, D. W., & Yan, J. (2019) · European Journal of Oncology Nursing · doi:10.1016/j.ejon.2019.09.001 · Cited by 25 · see citing works
Demoralization in Cancer Patients and Related Factors in Taiwan
Li, Y., Ho, C., & Wang, H. (2016) · Cancer Nursing · doi:10.1097/ncc.0000000000000352 · Cited by 25 · see citing works
Vehling, S., Kamphausen, A., Oechsle, K., Hroch, S., Bokemeyer, C., & Mehnert, A. (2015) · Journal of Palliative Medicine · doi:10.1089/jpm.2015.0112 · Cited by 23 · see citing works
Li, J., Liu, X., Xu, L., & Jin, Z. (2020) · The European Journal of Psychiatry · doi:10.1016/j.ejpsy.2020.06.007 · Cited by 24 · see citing works
Hao, R., Zhang, M., Zuo, J., Qi, Y., & Hu, J. (2023) · BMJ Open · doi:10.1136/bmjopen-2022-065796 · Cited by 23 · see citing works
Wu, Y.-C., Tung, H., & Wei, J. (2018) · European Journal of Cardiovascular Nursing · doi:10.1177/1474515118800397 · Cited by 24 · see citing works
Garzón, L. Q., Hinz, A., Koranyi, S., & Mehnert, A. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.681977 · Cited by 22 · see citing works
Emotion-Focused Therapy for Anxiety and Depression in Women with Breast Cancer
Connolly-Zubot, A., Timulak, L., Hession, N., & Coleman, N. (2020) · Journal of Contemporary Psychotherapy · doi:10.1007/s10879-019-09439-2 · Cited by 21 · see citing works
“2015), and has been positively associated with distress and negatively associated with hopefulness and purposefulness in life (Vehling et al. 2013).”
BackgroundLi, Y., Ho, C., & Wang, H. (2017) · Asian Nursing Research · doi:10.1016/j.anr.2017.07.001 · Cited by 19 · see citing works
Psychoonkologische Unterstützung von Patienten und Angehörigen in der Terminalphase
Mehnert, A., & Vehling, S. (2017) · Forum · doi:10.1007/s12312-017-0363-2 · Cited by 15 · see citing works
Spangenberg, L., Zenger, M., García‐Torres, F., Müller, V., Reck, M., Mehnert, A., & Vehling, S. (2015) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2015.11.008 · Cited by 14 · see citing works
Liu, M., Qin, F., & Wang, D. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1365246 · Cited by 13 · see citing works
Chan, W. C. H., Yu, C. T. K., Kwok, D. K. S., & Wan, J. K. M. (2022) · Palliative & Supportive Care · doi:10.1017/s1478951522001171 · Cited by 13 · see citing works
Factors associated with demoralisation syndrome in patients before and after cardiac surgery
Liao, H., Chiu, C., Ying-Ying, K. O., & Chen, H. (2017) · Journal of Clinical Nursing · doi:10.1111/jocn.14094 · Cited by 13 · see citing works
Demoralization: A concept analysis through a scoping review methodology
Hua, R., & Bhatarasakoon, P. (2024) · International Journal of Nursing Studies Advances · doi:10.1016/j.ijnsa.2024.100272 · Cited by 12 · see citing works
Ramm, M., Jedamzik, J., Lenz, P., Poopana, A., Heuft, G., & Conrad, R. (2023) · BMC Psychiatry · doi:10.1186/s12888-023-05187-9 · Cited by 10 · see citing works
Kupas, E. N., Karimi, Z., Rahmani, B., & Shoaee, F. (2020) · Practice in Clinical Psychology · doi:10.32598/jpcp.8.3.515.1 · Cited by 9 · see citing works
Ping, Z., He, C., Liu, S., Tan, R., & Hu, D. (2025) · Asia-Pacific Journal of Oncology Nursing · doi:10.1016/j.apjon.2025.100749 · Cited by 8 · see citing works
Demoralization in breast cancer survivors
Sender, A., Hinz, A., Broemer, L., Mehnert, A., Strauss, B. M., Briest, S., & Rosendahl, J. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1523164 · Cited by 9 · see citing works
Psychotherapie in der palliativen Versorgung
Mehnert, A. (2015) · PPmP - Psychotherapie · Psychosomatik · Medizinische Psychologie · doi:10.1055/s-0035-1552758 · Cited by 8 · see citing works
Jong, M. A.-D., DeJong, C. A. J., Hermens, R., Kissane, D. W., Massuger, L. F. A. G., Hoogerbrugge, N., Prins, J. B., & deHullu, J. A. (2017) · Journal of Psychosomatic Obstetrics & Gynecology · doi:10.1080/0167482x.2017.1296429 · Cited by 8 · see citing works
YuYu, L., Shan, Z., & JingJun, P. (2023) · Medicine · doi:10.1097/md.0000000000032719 · Cited by 7 · see citing works
Ramm, M., Jedamzik, J., Lenz, P., Jürgens, L., Heuft, G., & Conrad, R. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1389021 · Cited by 5 · see citing works
Psychoonkologische Unterstützung für Patienten mit begrenzter Lebenserwartung
Mehnert, A., & Schulz‐Kindermann, F. (2016) · Forum · doi:10.1007/s12312-016-0035-7 · Cited by 4 · see citing works
Shapiro, G. K., Mah, K., de Vries, F. E., Zimmermann, C., Li, M., Hales, S., & Rodin, G. (2022) · Journal of Psychosocial Oncology Research and Practice · doi:10.1097/or9.0000000000000076 · Cited by 4 · see citing works
Demoralisation in Cancer Patients: The Association with Distress, Depression and Positive Emotion
Thong, K. S. (2021) · Medicine & health · doi:10.17576/mh.2021.1601.10 · Cited by 4 · see citing works
Huang, Y., Zhuang, P., Guan, A., Ren, X., & Xu, L. (2024) · Nursing Open · doi:10.1002/nop2.70130 · Cited by 3 · see citing works
武, 奥. (2022) · Advances in Psychology · doi:10.12677/ap.2022.121026 · Cited by 3 · see citing works
Pollo, D. R., Rubiales, Á. S., Aragón, M. L. V., Canedo, J. A. M., Alonso‐Sardón, M., & Sagrado, M. G. (2018) · Medicina Paliativa · doi:10.1016/j.medipa.2017.05.006 · Cited by 3 · see citing works
Psycho-oncology and Palliative Care: Two Concepts That Fit into Comprehensive Cancer Care
Weber, D., Gründel, M., & Mehnert, A. (2015) · Springer eBooks · doi:10.1007/978-3-662-46202-7_14 · Cited by 2 · see citing works
Mousavi, N., Piryaei, M., Nooripour, R., Kissane, D. W., Hooshyari, Z., Effatpanah, M., & Ghanbari, N. (2024) · Brain and Behavior · doi:10.1002/brb3.3589 · Cited by 1 · see citing works
Death-related Distress in Advanced Cancer
An, E. (2018) · TSpace (University of Toronto) · Cited by 1 · see citing works
Arantes, A. C. D. L. Q. (2020) · Springer eBooks · doi:10.1007/978-3-030-57535-9_6
Panfilov, A. Y. (2024) · National Psychological Journal · doi:10.11621/npj.2024.0205
Kelberman, C., Schuttenberg, E. M., Buffie, M. L., & Blossom, J. B. (2025) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-025-10194-z
Use of NCCN distress thermometer in cancer genetics patients
Kennedy, A. M., Murad, A. M., Koeppe, E. S., Riba, M., Stoffel, E. M., & Jacobs, M. F. (2025) · Supportive Care in Cancer · doi:10.1007/s00520-025-09473-y
Research Progress on Depression Syndrome in Patients with Colorectal Cancer
吴, 迪. (2025) · Nursing Science · doi:10.12677/ns.2025.145116
Uncovering Relationships Between Demoralization, Attachment, and Social Support in Oncology Patients
Nikoloudi, M., Chatzigeorgiou, E., Galanis, P., Tsatsou, I., & Mystakidou, K. (2025) · Journal of Cancer Education · doi:10.1007/s13187-025-02740-w
Ramm, M., Jedamzik, J., Lenz, P., Poopana, A., Heuft, G., & Conrad, R. (2024) · Figshare · doi:10.6084/m9.figshare.26618638
Ramm, M., Jedamzik, J., Lenz, P., Poopana, A., Heuft, G., & Conrad, R. (2024) · Figshare · doi:10.6084/m9.figshare.26618641
Li, Y., Liu, X., & Yang, Q. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1560247
Baziliansky, S., & Sowan, W. (2026) · Frontiers in Psychology · doi:10.3389/fpsyg.2026.1812342
- Authors
- Vehling, S., Oechsle, K., Koch, U., & Mehnert, A.
- Affiliations
- University Medical Center Hamburg-Eppendorf (DE)
- Corresponding author
- Vehling, Sigrun
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2013-03-15
- Volume
- 8
- Issue
- 3
- Pages
- e59417
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC3598752
- OpenAlex
- W2075957394
- Cited by
- 58
- References
- 57
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 8 · 2023: 5 · 2022: 4 · 2021: 3 · 2020: 3 · 2019: 4 · 2018: 4 · 2017: 8 · 2016: 2 · 2015: 5 · 2014: 2 · 2013: 1
- FWCI
- 1.78
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Deutsche Krebshilfe (107465)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- 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
- Keywords
- demoralization, existential suffering, cancer patients, palliative care, curative treatment, age differences, gender differences, moderated effects, social support, somatic symptoms, psychosocial interventions
- MeSH terms
- Adolescent, Adult, Age Factors, Aged, Antineoplastic Agents, Depression, Female, Humans, Male, Middle Aged, Neoplasms, Palliative Care, Surveys and Questionnaires, Regression Analysis, Sex Factors, Stress, Psychological
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