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- Title
End-of-Life Care, Symptom Burden, and Quality of Life in Couples Facing Stage IV Lung Cancer: The Role of Patient and Spousal Psychospirituality and Discussions Around Fear of Death and Disease Progression.
- Authors
Kroll, Juliet L.; Jones, Morgan; Chen, Aileen B.; Yang, Chunyi Claire; Carmack, Cindy L.; Cohen, Lorenzo; Bruera, Eduardo; Milbury, Kathrin
- Abstract
Background: As patients live longer with stage IV nonsmall cell lung cancer, correlates of end-of-life (EOL) care and experience are increasingly relevant. Methods: We, therefore, prospectively examined associations among psychospirituality (Center for Epidemiologic Studies Depression Scale, Functional Assessment of Chronic Illness Therapy–Spiritual Well-Being), discussions around fear of death and disease progression, and hospital-based EOL care in patients and caregivers. Patients additionally reported symptom burden (MD Anderson Symptom Inventory–Lung Cancer total) and quality of life (QOL) (quality-of-life at EOL). Results: Of the baseline patients (n = 75), 32% were alive at time of the analyses (mean = 4.6 years postbaseline). Deceased patients (n = 51) were middle aged (mean = 65.3 years) and non-Hispanic White (81%). Caregiver spiritual well-being (r = 0.34, p = 0.02) and depression (r = −0.31, p = 0.03) were associated with EOL care metrics. Patients who "held back" more of their fear of death or disease progression experienced greater symptom burden (r = 0.41, p < 0.001) and poorer QOL (r = −0.44, p < 0.001). Conclusion: For couples facing prolonged metastatic disease, psychospirituality is highly relevant to EOL care with potential sequelae of withholding one's fear regarding death or disease progression.
- Subjects
TUMOR diagnosis; LUNG cancer; DISEASE progression; WELL-being; TERMINAL care; SPIRITUALITY; SPOUSES; SYMPTOMS; QUALITY of life; PSYCHOLOGY of caregivers; MENTAL depression; ANXIETY; PSYCHOLOGICAL distress; ATTITUDES toward death; LONGITUDINAL method; PSYCHOSOCIAL factors
- Publication
Journal of Palliative Medicine, 2023, Vol 26, Issue 5, p690
- ISSN
1096-6218
- Publication type
Article
- DOI
10.1089/jpm.2022.0376