The landscape of distress in the terminally ill

Understanding the complexities of distress and knowing who is most vulnerable isfoundational to the provision of quality, palliative end-of-life care. Although prior studieshave examined the prevalence of symptom distress among patients nearing death, thesestudies have tended to largely focus on phy...

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Main Authors: Chochinov, H., McClement, S., Hack, T., Kristjanson, Linda, Harlos, M., Sinclair, S., Murray, A.
Format: Journal Article
Published: Elsevier 2009
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/16214
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author Chochinov, H.
McClement, S.
Hack, T.
Kristjanson, Linda
Harlos, M.
Sinclair, S.
Murray, A.
author_facet Chochinov, H.
McClement, S.
Hack, T.
Kristjanson, Linda
Harlos, M.
Sinclair, S.
Murray, A.
author_sort Chochinov, H.
building Curtin Institutional Repository
collection Online Access
description Understanding the complexities of distress and knowing who is most vulnerable isfoundational to the provision of quality, palliative end-of-life care. Although prior studieshave examined the prevalence of symptom distress among patients nearing death, thesestudies have tended to largely focus on physical and to a lesser extent, psychologicalchallenges. 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 distressin patients who are terminally ill. The PDI, a 25-item self-report, was administered to 253patients receiving palliative care. Each PDI item is rated by patients to indicate the degree towhich they experience various kinds of end-of-life distress. Palliative care patients reported anaverage of 5.74 problems (standard deviation, 5.49; range, 0e24), including physical,psychological, existential, and spiritual challenges. Being an inpatient, being educated, andhaving a partner were associated with certain kinds of end-of-life problems, particularlyexistential distress. Spirituality, especially its existential or ??sense of meaning and purpose??dimension was associated with less distress for terminally ill patients. A better appreciationfor the nature of distress is a critical step toward a fuller understanding of the challengesfacing the terminally ill. A clear articulation of the landscape of distress, including insightregarding those who are most at risk, should pave the way toward more effective, dignityconservingend-of-life care.
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spelling curtin-20.500.11937-162142017-09-13T15:53:16Z The landscape of distress in the terminally ill Chochinov, H. McClement, S. Hack, T. Kristjanson, Linda Harlos, M. Sinclair, S. Murray, A. Patient Dignity Inventory Palliative Care Distress Understanding the complexities of distress and knowing who is most vulnerable isfoundational to the provision of quality, palliative end-of-life care. Although prior studieshave examined the prevalence of symptom distress among patients nearing death, thesestudies have tended to largely focus on physical and to a lesser extent, psychologicalchallenges. 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 distressin patients who are terminally ill. The PDI, a 25-item self-report, was administered to 253patients receiving palliative care. Each PDI item is rated by patients to indicate the degree towhich they experience various kinds of end-of-life distress. Palliative care patients reported anaverage of 5.74 problems (standard deviation, 5.49; range, 0e24), including physical,psychological, existential, and spiritual challenges. Being an inpatient, being educated, andhaving a partner were associated with certain kinds of end-of-life problems, particularlyexistential distress. Spirituality, especially its existential or ??sense of meaning and purpose??dimension was associated with less distress for terminally ill patients. A better appreciationfor the nature of distress is a critical step toward a fuller understanding of the challengesfacing the terminally ill. A clear articulation of the landscape of distress, including insightregarding those who are most at risk, should pave the way toward more effective, dignityconservingend-of-life care. 2009 Journal Article http://hdl.handle.net/20.500.11937/16214 10.1016/j.jpainsymman.2009.04.021 Elsevier fulltext
spellingShingle Patient Dignity Inventory
Palliative Care
Distress
Chochinov, H.
McClement, S.
Hack, T.
Kristjanson, Linda
Harlos, M.
Sinclair, S.
Murray, A.
The landscape of distress in the terminally ill
title The landscape of distress in the terminally ill
title_full The landscape of distress in the terminally ill
title_fullStr The landscape of distress in the terminally ill
title_full_unstemmed The landscape of distress in the terminally ill
title_short The landscape of distress in the terminally ill
title_sort landscape of distress in the terminally ill
topic Patient Dignity Inventory
Palliative Care
Distress
url http://hdl.handle.net/20.500.11937/16214