Affiliation:
1. Department of Psychology Tulane University New Orleans Louisiana USA
2. Department of Medical Social Sciences Northwestern University Feinberg School of Medicine Chicago Illinois USA
3. Department of Psychology Central Michigan University Mount Pleasant Michigan USA
4. Department of Behavioral Science Markey Cancer Center Center for Health Equity Transformation University of Kentucky College of Medicine Lexington Kentucky USA
5. Department of Psychology Indiana University‐Purdue University Indianapolis Indianapolis Indiana USA
6. Departments of Psychiatry and Medicine Tulane Cancer Center Freeman School of Business Tulane University New Orleans Louisiana USA
Abstract
AbstractObjectiveAlthough palliative care can mitigate emotional distress, distressed patients may be less likely to engage in timely palliative care. This study aims to investigate the role of emotional distress in palliative care avoidance by examining the associations of anger, anxiety, and depression with palliative care attitudes.MethodsPatients (N = 454) with heterogeneous cancer diagnoses completed an online survey on emotional distress and palliative care attitudes. Emotional distress was measured using the Patient‐Reported Outcomes Measurement Information System anger, anxiety, and depression scales. The Palliative Care Attitudes Scale was used to measure palliative care attitudes. Regression models tested the impact of a composite emotional distress score calculated from all three symptom measures, as well as individual anger, anxiety, and depression scores, on palliative care attitudes. All models controlled for relevant demographic and clinical covariates.ResultsRegression results revealed that patients who were more emotionally distressed had less favorable attitudes toward palliative care (p < 0.001). In particular, patients who were angrier had less favorable attitudes toward palliative care (p = 0.013) while accounting for depression, anxiety, and covariates. Across analyses, women had more favorable attitudes toward palliative care than men, especially with regard to beliefs about palliative care effectiveness.ConclusionsAnger is a key element of emotional distress and may lead patients to be more reluctant toward timely utilization of palliative care. Although psycho‐oncology studies routinely assess depression or anxiety, more attention to anger is warranted. More research is needed on how best to address anger and increase timely utilization of palliative cancer care.
Funder
National Cancer Institute
National Institutes of Health
National Institute of General Medical Sciences
Subject
Psychiatry and Mental health,Oncology,Experimental and Cognitive Psychology