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Psychosocial— spiritual correlates of death distress in patients with life-threatening medical conditions

Department of Psychiatry

Susan D Videen

Pastoral Care Department

Paul N Duckro

Department of Community and Family Medicine, Saint Louis University School of Medicine, St. Louis, Missouri

Douglas K Miller

Department of Internal Medicine, Saint Louis University School of Medicine, St. Louis, Missouri and Geriatric Research, Education and Clinical Center, Saint Louis Veterans Affairs Medical Center, St. Louis, Missouri

The purpose of this study was to identify demographic, disease, health care, and psychosocial spiritual factors associated with death distress (death-related depression and anxiety). Cross-sectional baseline data from a randomized controlled trial were used. Outpatients (n=70) were recruited from an urban academic medical centre and proprietary hospital. All patients had life-threatening medical conditions, including cancer; pulmonary, cardiac, liver, or kidney disease; HIV/AIDS; or geriatric frailty. Measures of death distress, physical symptom severity, depression and anxiety symptoms, spiritual well-being, social support, patient-perceived physician communication, and patient-perceived quality of health care experiences were administered. In a hierarchical multiple regression model, higher death distress was significantly associated with living alone, greater physical symptom severity, more severe depression symptoms, lower spiritual well-being, and less physician communication as perceived by the patient. Death distress as a unique experiential construct was discriminable among younger patients with specific, diagnosable life-threatening conditions, but less so among geriatric frailty patients. The findings suggest that the experience of death distress among patients with life-threatening medical conditions is associated with the psychosocial spiritual dimensions of the patient's life. Attention to these dimensions may buffer the negative affects of death distress.

Key Words: attitude to death • depression • palliative care • physician-patient relations • religion and medicine

Palliative Medicine, Vol. 16, No. 4, 331-338 (2002)
DOI: 10.1191/0269216302pm544oa


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