Fear of Palliative Care: Roles of Age and Depression Severity.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
  • Additional Information
    • Source:
      Publisher: Mary Ann Liebert, Inc Country of Publication: United States NLM ID: 9808462 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1557-7740 (Electronic) Linking ISSN: 15577740 NLM ISO Abbreviation: J Palliat Med Subsets: MEDLINE
    • Publication Information:
      Original Publication: Larchmont, NY : Mary Ann Liebert, Inc., c1998-
    • Subject Terms:
    • Abstract:
      Background: Palliative care is underutilized due in part to fear and misunderstanding, and depression might explain variation in fear of palliative care. Objective: Informed by the socioemotional selectivity theory, we hypothesized that older adults with cancer would be less depressed than younger adults, and subsequently less fearful of utilizing palliative care. Setting/Subjects: Patients predominately located in the United States with heterogeneous cancer diagnoses ( n  = 1095) completed the Patient-Reported Outcomes Information System (PROMIS) Depression scale and rated their fear of palliative care using the Palliative Care Attitudes Scale (PCAS). We examined the hypothesized intercorrelations, followed by a bootstrapped analysis of indirect effects in the PROCESS macro for SPSS. Results: Participants ranged from 26 to 93 years old (mean [M] = 60.40, standard deviation = 11.45). The most common diagnoses were prostate (34.1%), breast (23.3%), colorectal (17.5%), skin (15.3%), and lung (13.5%) cancer. As hypothesized, older participants had lower depression severity ( r  = -0.20, p  < 0.001) and were less fearful of palliative care ( r  = -0.11, p  < 0.001). Participants who were more depressed were more fearful of palliative care ( r  = 0.21, p  < 0.001). An indirect effect ( β  = -0.04, standard error = .01, 95% confidence interval: -0.06 to -0.02) suggested that depression severity may account for up to 40% of age-associated differences in fear of palliative care. Conclusions: Findings indicate that older adults with cancer are more likely to favor palliative care, with depression symptom severity accounting for age-related differences. Targeted interventions among younger patients with depressive symptoms may be helpful to reduce fear and misunderstanding and increase utilization of palliative care.
    • References:
      Am J Geriatr Psychiatry. 2007 Jan;15(1):28-41. (PMID: 17194813)
      J Psychosom Res. 2003 Nov;55(5):403-9. (PMID: 14581094)
      Int J Psychiatry Med. 2010;40(1):109-24. (PMID: 20565049)
      J Pain Symptom Manage. 2020 Feb;59(2):293-301.e8. (PMID: 31539604)
      Science. 2006 Jun 30;312(5782):1913-5. (PMID: 16809530)
      Ann Behav Med. 2019 Jun 4;53(7):674-685. (PMID: 30265282)
      Acad Med. 2012 Jan;87(1):66-73. (PMID: 22104055)
      Med Care. 1992 Jun;30(6):473-83. (PMID: 1593914)
      Am Psychol. 1994 Jan;49(1):15-24. (PMID: 8122813)
      Psychooncology. 2020 Jul;29(7):1232-1234. (PMID: 32323415)
      J Palliat Med. 2013 Nov;16(11):1329-34. (PMID: 24073685)
      J Am Heart Assoc. 2014 Jan 02;3(1):e000544. (PMID: 24385453)
      Rehabil Psychol. 2014 May;59(2):220-229. (PMID: 24661030)
      Death Stud. 2007 Jul;31(6):549-61. (PMID: 17726829)
      J Clin Oncol. 2015 May 1;33(13):1438-45. (PMID: 25800768)
      J Pain Symptom Manage. 2021 Nov;62(5):987-996. (PMID: 33864847)
      J Affect Disord. 2020 Apr 15;267:63-66. (PMID: 32063574)
      JAMA Netw Open. 2020 Mar 2;3(3):e200618. (PMID: 32150271)
      J Pediatr Hematol Oncol. 2011 Oct;33 Suppl 2:S126-31. (PMID: 21952569)
      Br J Cancer. 2007 Mar 26;96(6):868-74. (PMID: 17311020)
      Health Psychol. 2017 Jun;36(6):538-548. (PMID: 28277698)
      J Gen Intern Med. 2020 Jul;35(7):2059-2064. (PMID: 32157652)
      Behav Res Methods Instrum Comput. 2004 Nov;36(4):717-31. (PMID: 15641418)
      J Clin Oncol. 2017 Mar 10;35(8):834-841. (PMID: 28029308)
      Value Health. 2019 May;22(5):537-544. (PMID: 31104731)
      J Aging Health. 2008;20(8):972-96. (PMID: 18791184)
      J Palliat Med. 2018 Apr;21(4):428-437. (PMID: 29100002)
      J Palliat Med. 2016 Jan;19(1):69-75. (PMID: 26618636)
      Contemp Clin Trials. 2009 Nov;30(6):552-9. (PMID: 19580887)
      JAMA. 2010 Mar 17;303(11):1054-61. (PMID: 20233823)
      J Natl Compr Canc Netw. 2016 Apr;14(4):439-45. (PMID: 27059192)
      Soc Sci Med. 2009 Feb;68(3):562-9. (PMID: 19059687)
      Psychol Aging. 1992 Sep;7(3):331-8. (PMID: 1388852)
      CMAJ. 2016 Jul 12;188(10):E217-E227. (PMID: 27091801)
      J Clin Oncol. 1993 Mar;11(3):570-9. (PMID: 8445433)
      J Pain Symptom Manage. 2018 Jul;56(1):1-6.e1. (PMID: 29581034)
      J Cancer Surviv. 2015 Dec;9(4):620-9. (PMID: 25708515)
      Assessment. 2011 Sep;18(3):263-83. (PMID: 21697139)
      J Pers Soc Psychol. 2015 Jun;108(6):900-16. (PMID: 25984789)
      Psychooncology. 2016 Jan;25(1):91-6. (PMID: 25899740)
      J Psychosom Res. 2020 Feb 11;131:109958. (PMID: 32120145)
      Int J Aging Hum Dev. 2020 Jan;90(1):28-49. (PMID: 30612437)
      Breast Cancer Res Treat. 2017 Nov;166(1):267-275. (PMID: 28726159)
    • Grant Information:
      U54 GM104940 United States GM NIGMS NIH HHS
    • Contributed Indexing:
      Keywords: aged; cancer; depressive symptoms; middle aged; oncology; palliative care
    • Publication Date:
      Date Created: 20211111 Date Completed: 20220504 Latest Revision: 20230916
    • Publication Date:
      20240105
    • Accession Number:
      PMC9081062
    • Accession Number:
      10.1089/jpm.2021.0359
    • Accession Number:
      34762507