Skip header and navigation

Refine By

6 records – page 1 of 1.

Burden to others and the terminally ill.

https://arctichealth.org/en/permalink/ahliterature162607
Source
J Pain Symptom Manage. 2007 Nov;34(5):463-71
Publication Type
Article
Date
Nov-2007
Author
Harvey Max Chochinov
Linda J Kristjanson
Thomas F Hack
Thomas Hassard
Susan McClement
Mike Harlos
Author Affiliation
Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada. harvey.chochinov@cancercare.mb.ca
Source
J Pain Symptom Manage. 2007 Nov;34(5):463-71
Date
Nov-2007
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Adaptation, Psychological
Aged
Cost of Illness
Female
Humans
Male
Manitoba
Neoplasms - complications
Neuropsychological Tests
Palliative Care
Stress, Psychological - etiology - psychology
Terminal Care - psychology
Abstract
Studies of patients who are terminally ill consistently identify strong associations between "sense of burden to others" and marked end-of-life distress. However, little research has addressed the issue of burden to others among patients nearing death. The aim of this study was to carefully examine "burden to others" and clarify its relationship with various psychosocial, physical, and existential issues arising in patients who are terminally ill. A cohort of 211 patients with end-stage cancer was assessed, using an assortment of validated psychometrics to document psychosocial, physical, and existential aspects of their end-of-life experience. This included an assessment of their sense of "burden to others." Forty percent of participants indicated a negligible sense of burden to others, scoring within the lowest quarter on an ordinal measure of "burden to others;" 25% scored within the second lowest quarter; 12% within the third quarter; and 23% within the highest or most severe range. The most highly correlated variables with "sense of burden to others" included depression (r=0.460; df=201, P
PubMed ID
17616329 View in PubMed
Less detail

Dignity in the terminally ill: a cross-sectional, cohort study.

https://arctichealth.org/en/permalink/ahliterature187218
Source
Lancet. 2002 Dec 21-28;360(9350):2026-30
Publication Type
Article
Author
Harvey Max Chochinov
Thomas Hack
Thomas Hassard
Linda J Kristjanson
Susan McClement
Mike Harlos
Author Affiliation
Department of Psychiatry, University of Manitoba, Winnipeg, Canada. chochin@cc.UManitoba.CA
Source
Lancet. 2002 Dec 21-28;360(9350):2026-30
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Cohort Studies
Cross-Sectional Studies
Educational Status
Female
Humans
Male
Manitoba
Neoplasms
Palliative Care
Quality of Life
Questionnaires
Right to Die
Abstract
Considerations of dignity are often raised in reference to the care of dying patients. However, little research that addresses this issue has been done. Our aim was to identify the extent to which dying patients perceive they are able to maintain a sense of dignity, and to ascertain how demographic and disease-specific variables relate to the issue of dignity in these individuals.
We did a cross-sectional study of a cohort of terminally ill patients with cancer, who had a life expectancy of less than 6 months. We enrolled 213 patients from two palliative care units in Winnipeg, Canada, and asked them to rate their sense of dignity. Our main outcome measures included: a 7-point sense of dignity item; the symptom distress scale; the McGill pain questionnaire; the index of independence in activities of daily living (IADL); a quality of life scale; a brief battery of self-report measures, including screening for desire for death, anxiety, hopelessness, and will to live; burden to others; and requirement for social support.
16 of 213 patients (7.5%; 95% CI 4-11) indicated that loss of dignity was a great concern. These patients were far more than likely than the rest of the cohort to report psychological distress and symptom distress, heightened dependency needs, and loss of will to live.
Loss of dignity is closely associated with certain types of distress often seen among the terminally ill. Preservation of dignity should be an overall aim of treatment and care in patients who are nearing death.
Notes
Comment In: Lancet. 2002 Dec 21-28;360(9350):1997-812504390
Comment In: Lancet. 2003 Mar 1;361(9359):78312620760
PubMed ID
12504398 View in PubMed
Less detail

Dignity therapy: a novel psychotherapeutic intervention for patients near the end of life.

https://arctichealth.org/en/permalink/ahliterature173271
Source
J Clin Oncol. 2005 Aug 20;23(24):5520-5
Publication Type
Article
Date
Aug-20-2005
Author
Harvey Max Chochinov
Thomas Hack
Thomas Hassard
Linda J Kristjanson
Susan McClement
Mike Harlos
Author Affiliation
Department of Psychiatry, Family Medicine, Community Health Sciences, and Faculty of Nursing, University of Manitoba, Canada. harvey.chochinov@cancercare.mb.ca
Source
J Clin Oncol. 2005 Aug 20;23(24):5520-5
Date
Aug-20-2005
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Adult
Aged
Attitude to Death
Australia
Cost of Illness
Family Relations
Humans
Manitoba
Middle Aged
Neoplasms - psychology
Patient satisfaction
Quality of Life
Right to Die
Spirituality
Statistics, nonparametric
Stress, Psychological
Terminal Care - methods
Terminally Ill - psychology
Abstract
This study examined a novel intervention, dignity therapy, designed to address psychosocial and existential distress among terminally ill patients. Dignity therapy invites patients to discuss issues that matter most or that they would most want remembered. Sessions are transcribed and edited, with a returned final version that they can bequeath to a friend or family member. The objective of this study was to establish the feasibility of dignity therapy and determine its impact on various measures of psychosocial and existential distress.
Terminally ill inpatients and those receiving home-based palliative care services in Winnipeg, Canada, and Perth, Australia, were asked to complete pre- and post-intervention measures of sense of dignity, depression, suffering, and hopelessness; sense of purpose, sense of meaning, desire for death, will to live, and suicidality; and a post-intervention satisfaction survey.
Ninety-one percent of participants reported being satisfied with dignity therapy; 76% reported a heightened sense of dignity; 68% reported an increased sense of purpose; 67% reported a heightened sense of meaning; 47% reported an increased will to live; and 81% reported that it had been or would be of help to their family. Post-intervention measures of suffering showed significant improvement (P = .023) and reduced depressive symptoms (P = .05). Finding dignity therapy helpful to their family correlated with life feeling more meaningful (r = 0.480; P = .000) and having a sense of purpose (r = 0.562; P = .000), accompanied by a lessened sense of suffering (r = 0.327; P = .001) and increased will to live (r = 0.387; P = .000).
Dignity therapy shows promise as a novel therapeutic intervention for suffering and distress at the end of life.
Notes
Comment In: J Clin Oncol. 2005 Aug 20;23(24):5427-816110001
PubMed ID
16110012 View in PubMed
Less detail

The patient dignity inventory: a novel way of measuring dignity-related distress in palliative care.

https://arctichealth.org/en/permalink/ahliterature156482
Source
J Pain Symptom Manage. 2008 Dec;36(6):559-71
Publication Type
Article
Date
Dec-2008
Author
Harvey Max Chochinov
Thomas Hassard
Susan McClement
Thomas Hack
Linda J Kristjanson
Mike Harlos
Shane Sinclair
Alison Murray
Author Affiliation
Department of Psychiatry, University of Manitoba, Winnipeg, Canada. harvey.chochinov@cancercare.mb.ca
Source
J Pain Symptom Manage. 2008 Dec;36(6):559-71
Date
Dec-2008
Language
English
Publication Type
Article
Keywords
Aged
Attitude to Death
Canada - epidemiology
Female
Humans
Male
Palliative Care - psychology
Psychometrics - methods
Questionnaires
Reproducibility of Results
Right to Die
Self-Assessment
Sensitivity and specificity
Spirituality
Stress, Psychological - diagnosis - epidemiology - psychology
Terminally Ill - psychology
Abstract
Quality palliative care depends on a deep understanding of distress facing patients nearing death. Yet, many aspects of psychosocial, existential and spiritual distress are often overlooked. The aim of this study was to test a novel psychometric--the Patient Dignity Inventory (PDI)--designed to measure various sources of dignity-related distress among patients nearing the end of life. Using standard instrument development techniques, this study examined the face validity, internal consistency, test-retest reliability, factor structure and concurrent validity of the PDI. The 25-items of the PDI derive from a model of dignity in the terminally ill. To establish its basic psychometric properties, the PDI was administered to 253 patients receiving palliative care, along with other measures addressing issues identified within the Dignity Model in the Terminally Ill. Cronbach's coefficient alpha for the PDI was 0.93; the test-retest reliability was r = 0.85. Factor analysis resulted in a five-factor solution; factor labels include Symptom Distress, Existential Distress, Dependency, Peace of Mind, and Social Support, accounting for 58% of the overall variance. Evidence for concurrent validity was reported by way of significant associations between PDI factors and concurrent measures of distress. The PDI is a valid and reliable new instrument, which could assist clinicians to routinely detect end-of-life dignity-related distress. Identifying these sources of distress is a critical step toward understanding human suffering and should help clinicians deliver quality, dignity-conserving end-of-life care.
PubMed ID
18579340 View in PubMed
Less detail

Personality, neuroticism, and coping towards the end of life.

https://arctichealth.org/en/permalink/ahliterature167333
Source
J Pain Symptom Manage. 2006 Oct;32(4):332-41
Publication Type
Article
Date
Oct-2006
Author
Harvey Max Chochinov
Linda J Kristjanson
Thomas F Hack
Thomas Hassard
Susan McClement
Mike Harlos
Author Affiliation
Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada. harvey.chochinov@cancercare.mb.ca
Source
J Pain Symptom Manage. 2006 Oct;32(4):332-41
Date
Oct-2006
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Aged
Female
Humans
Male
Manitoba - epidemiology
Neoplasms - epidemiology - psychology
Neurotic Disorders - epidemiology - psychology
Personality
Risk Assessment - methods
Terminally Ill - psychology - statistics & numerical data
Abstract
The influence of personality characteristics on how patients cope with various challenges at the end of life has not been extensively studied. In order to examine the association between end-of-life experience and neuroticism (defined within the personality literature as a trait tendency to experience psychological distress), a measure of neuroticism was administered to a cohort of dying cancer patients. Various other measures of physical, psychological, and existential distress were also measured to explore their possible connection to patient personality style. The personality characteristic neuroticism demonstrated a significant relationship with several end-of-life sources of distress, including depression, anxiety, sense of dignity, quality of life (rating and satisfaction), hopelessness, concentration, and outlook on the future. Neuroticism appears to have a significant association with the dying experience. This association is expressed across the psychological, existential and, to a lesser extent, physical and social domains of end-of-life distress. This may help clinicians identify vulnerable individuals who are most likely to have poorer adjustments and may benefit from earlier targeted interventional approaches. Exploring the relationship between various facets of personality and end-of-life distress, and mapping this information against optimal therapeutic responses, remains the challenge for future research broaching this intriguing and largely ignored area of palliative care.
PubMed ID
17000350 View in PubMed
Less detail

The relation between perceived need for mental health treatment, DSM diagnosis, and quality of life: a Canadian population-based survey.

https://arctichealth.org/en/permalink/ahliterature175440
Source
Can J Psychiatry. 2005 Feb;50(2):87-94
Publication Type
Article
Date
Feb-2005
Author
Jitender Sareen
Murray B Stein
Darren W Campbell
Thomas Hassard
Verena Menec
Author Affiliation
Department of Psychiatry, University of Manitoba, Winnipeg. sareen@cc.umanitoba.ca
Source
Can J Psychiatry. 2005 Feb;50(2):87-94
Date
Feb-2005
Language
English
Publication Type
Article
Keywords
Activities of Daily Living - classification - psychology
Adolescent
Adult
Alcoholism - diagnosis - epidemiology - psychology
Anxiety Disorders - diagnosis - epidemiology - psychology
Bulimia - diagnosis - epidemiology - psychology
Cross-Sectional Studies
Diagnostic and Statistical Manual of Mental Disorders
Female
Health Services Needs and Demand - statistics & numerical data
Humans
Incidence
Male
Mental Disorders - diagnosis - epidemiology - psychology
Middle Aged
Mood Disorders - diagnosis - epidemiology - psychology
Ontario
Patient Acceptance of Health Care - psychology - statistics & numerical data
Population Surveillance
Quality of Life - psychology
Retreatment - statistics & numerical data
Sick Role
Substance-Related Disorders - diagnosis - epidemiology - psychology
Suicide - prevention & control - psychology
Abstract
Prevalence estimates of mental disorders were designed to provide an indirect estimate of the need for mental health services in the community. However, recent studies have demonstrated that meeting criteria for a DSM-based disorder does not necessarily equate with need for treatment. The current investigation examined the relation between self-perceived need for mental health treatment and DSM diagnosis, with respect to quality of life (QoL) and suicidal ideation.
Data came from an Ontario population-based sample of 8116 residents (aged 15 to 64 years). The University of Michigan Composite International Diagnostic Interview was used to diagnose mood, anxiety, substance use, and bulimia disorder according to DSM-III-R criteria. We categorized past-year help seeking for emotional symptoms and (or) perceiving a need for treatment without seeking care as self-perceived need for treatment. We used a range of variables to measure QoL: self-perception of mental health status, a validated instrument that measured well-being, and restriction of activities (current, past 30 days, and long-term).
Independent of subjects' meeting criteria for a DSM-III-R diagnosis, self-perceived need for treatment was significantly associated with poor QoL (on all measures) and past-year suicidal ideation.
Self-perceived need for mental health treatment, in addition to DSM diagnosis, may provide valuable information for estimating the number of people in the population who need mental health services. The relation between self-perceived need for treatment and objective measures of treatment need requires future study.
PubMed ID
15807224 View in PubMed
Less detail

6 records – page 1 of 1.