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Please use this identifier to cite or link to this item: http://hdl.handle.net/1959.3/192561
- The landscape of distress in the terminally ill
- Chochinov, Harvey Max; Hassard, Thomas Hassard; McClement, Susan; Hack, Thomas; Kristjanson, Linda J.; Harlos, Mike; Sinclair, Shane; Murray, Alison
- Understanding the complexities of distress and knowing who is most vulnerable is foundational to the provision of quality, palliative end-of-life care. Although prior studies have examined the prevalence of symptom distress among patients nearing death, these studies have tended to largely focus on physical and, to a lesser extent, psychological challenges. The aim of this study was to use the Patient Dignity Inventory (PDI), a novel, reliable, and validated measure of end-of-life distress, to describe a broad landscape of distress in patients who are terminally ill. The PDI, a 25-item self-report, was administered to 253 patients receiving palliative care. Each PDI item is rated by patients to indicate the degree to which they experience various kinds of end-of-life distress. Palliative care patients reported an average of 5.74 problems (standard deviation, 5.49; range, 0-24), including physical, psychological, existential, and spiritual challenges. Being an inpatient, being educated, and having a partner were associated with certain kinds of end-of-life problems, particularly existential distress. Spirituality, especially its existential or "sense of meaning and purpose" dimension, was associated with less distress for terminally ill patients. A better appreciation for the nature of distress is a critical step toward a fuller understanding of the challenges facing the terminally ill. A clear articulation of the landscape of distress, including insight regarding those who are most at risk, should pave the way toward more effective, dignity-conserving end-of-life care.
- Publication type
- Journal article
- Journal of Pain and Symptom Management, Vol. 38, no. 5 (Nov 2009), pp. 641-649
- Publication year
- FOR Code(s)
- 1117 Public Health and Health Services
- Distress; Palliative care; Patient dignity inventory; Terminal care; Terminal illness
- Publisher URL
- Copyright © 2009 U.S. Cancer Pain Relief Committee.
- Peer reviewed