Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-18T20:23:49.745Z Has data issue: false hasContentIssue false
  • English
  • Français

The schedule of attitudes toward hastened death: Validation analysis in terminally ill cancer patients

Published online by Cambridge University Press:  19 July 2005

KYRIAKI MYSTAKIDOU ,
BARRY ROSENFELD ,
EFI PARPA ,
ELENI TSILIKA ,
EMMANUELA KATSOUDA ,
ANTONIS GALANOS  and
LAMBROS VLAHOS
KYRIAKI MYSTAKIDOU
Affiliation:
Pain Relief and Palliative Care Unit, Department of Radiology, Areteion Hospital, School of Medicine, University of Athens, Athens, Greece
BARRY ROSENFELD
Affiliation:
Department of Psychology, Fordham University, Bronx, New York
EFI PARPA
Affiliation:
Pain Relief and Palliative Care Unit, Department of Radiology, Areteion Hospital, School of Medicine, University of Athens, Athens, Greece
ELENI TSILIKA
Affiliation:
Pain Relief and Palliative Care Unit, Department of Radiology, Areteion Hospital, School of Medicine, University of Athens, Athens, Greece
EMMANUELA KATSOUDA
Affiliation:
Pain Relief and Palliative Care Unit, Department of Radiology, Areteion Hospital, School of Medicine, University of Athens, Athens, Greece
ANTONIS GALANOS
Affiliation:
Pain Relief and Palliative Care Unit, Department of Radiology, Areteion Hospital, School of Medicine, University of Athens, Athens, Greece
LAMBROS VLAHOS
Affiliation:
Department of Radiology, Areteion Hospital, University of Athens, School of Medicine, Athens, Greece
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective: The faithful translation of the English version of the Schedule of Attitudes toward Hastened Death (SAHD) into Greek and its validation as an assessment tool in terminally ill cancer patients receiving palliative treatment.

Methods: 120 terminally ill cancer patients attending a Palliative Care Unit, at the University of Athens, Greece, between June 2003 and November 2003 for palliative treatment.

Results: SAHD would be a useful instrument for measuring desire for hastened death with valid psychometric properties in a Greek cancer population. The SAHD demonstrated high reliability. Desire for hastened death was significantly associated with Hospital Anxiety and Depression Scale (HAD) depression (r = 0.607, p < 0.0005) and substantially correlated with HAD anxiety (r = 0.502, p < 0.0005). “Pain intensity” had a moderate correlation with SAHD scores (r = 0.28, p = 0.01) and SAHD scores correlated significantly with “pain interference in mood” (r = 0.38, p = 0.01) and in “enjoyment of life” (r = 0.34, p = 0.03). SAHD correlation with quality of life was statistically significant (r = −0.38, p < 0.01) as was health status (r = −0.36, p < 0.01). Patients with a Poor Performance Status (from Eastern Cooperative Oncology Group scale) correlated significantly with high scores in SAHD (p = 0.038). Factor analysis supported the unidimentionality of the measurement.

Significance of results: SAHD could be a useful and valid instrument for measuring desire for hastened death in Greek terminally ill cancer patients.

Keywords

Palliative careHastened deathGreece
Type
Research Article
Information
Palliative & Supportive Care , Volume 2 , Issue 4 , December 2004 , pp. 395 - 402
Copyright
© 2004 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Aaronson, N.K., Ahmedzai, S., Bergman, B., et al. (1993). The European Organization for Research and Treatment of Cancer QLQ-C30; A quality-of-life instrument for use in international clinical trials in oncology. Journal of the National Cancer Institute, 85, 365–376.Google Scholar
Allebeck, P., Bolund, C., & Ringback, G. (1989). Increased suicide rate in cancer patients. A cohort study based on the Swedish Cancer-Environment Register. Journal of Clinical Epidemiology, 42, 611–616.Google Scholar
Back, A.L., Wallace, J.I., Starks, H.E., et al. (1996). Physician-assisted suicide and euthanasia in Washington State. Journal of the American Medical Association, 275, 919–925.Google Scholar
Bolund, C. (1985). Suicide and cancer: II. Medical and care factors in suicide by cancer patients in Sweden, 1973–1976. Journal of Psychosocial Oncology, 3, 17–30.Google Scholar
Breitbart, W. (1993). Suicide risk and pain in cancer and AIDS patients. In Current and emerging issues in cancer pain: Research and practice, Chapman, C.R. & Foley, K.M. (eds.), pp. 1–17, 49–65. New York: Raven Press.
Breitbart, W., Bruera, E., Chochinov, H., et al. (1995). Neuropsychiatric syndromes and psychiatric symptoms in patients with advanced cancer. Journal of Pain and Symptom Management, 10, 131–141.Google Scholar
Breitbart, W., Rosenfeld, B., Pessin, H., et al. (2000). Depression, hopelessness, and desire for hastened death in terminally ill patients with cancer. Journal of the American Medical Association, 284, 2907–2911.Google Scholar
Brown, J.H., Henteleff, P., Barakat, S., et al. (1986). Is it normal for terminally ill patients to desire death? American Journal of Psychiatry, 143, 208–211.Google Scholar
Chochinov, H.M., Wilson, K.G., Enns, M., et al. (1995a). Prevalence of depression in the terminally ill: Effects of diagnostic criteria and symptom threshold judgments. American Journal of Psychiatry, 151, 537–540.Google Scholar
Chochinov, H.M., Wilson, K.G., Enns, M., et al. (1995b). Desire for death in the terminally ill. American Journal of Psychiatry, 152, 1185–1191.Google Scholar
Conwell, Y., Caine, E.D., & Olsen, K. (1990). Suicide and cancer in late life. Hospital and Community Psychiatry, 41, 1334–1339.Google Scholar
Crocetti, E., Arniani, S., Accia, S., et al. (1998). High suicide mortality soon after diagnosis among cancer patients in central Italy. British Journal of Cancer, 77, 1194–1196.Google Scholar
Cronbach, L.J. (1951). Coefficient alpha and the internal structure of test. Psychometrica, 16, 297–334.Google Scholar
Derogatis, L.R., Marrow, G.R., Fetting, J., et al. (1983). The prevalence of psychiatric disorders among cancer patients. Journal of the American Journal Association, 249, 751–757.Google Scholar
Emanuel, J.E. (2002). Euthanasia and physician-assisted suicide: A review of the empirical data from the United States. Archives of Internal Medicine, 162, 142–152.Google Scholar
Emanuel, J.E., Fairclough, L.D., Daniels, E.R., et al. (1996). Euthanasia and physician-assisted suicide: Attitudes and experiences of oncology patients. Oncologists, and the public. Lancet, 347, 1805–1810.Google Scholar
Farberow, L., Ganzler, S., Cutter, F., et al. (1971). An eight years survey of hospital suicides. Suicide and Life Threatening Behavior, 1, 184–201.Google Scholar
Filiberti, A., Audisio, R.A., & Kaasa, S. (1998). Psychosocial issues in old cancer patients. Critical Reviews in Oncology and Hematology, 27, 132–133.Google Scholar
Foley, K. (1995). Pain, physician assisted suicide, and euthanasia. Pain Forum, 4, 163–178.Google Scholar
Fox, B.H., Stanek, E.J., Boyd, S.C., et al. (1982). Suicide rates among cancer patients in Connecticut. Journal of Chronic Disease, 35, 85–100.Google Scholar
Ganzini, L. & Block, S. (2002). Physician assisted death: A last resort? New England Journal of Medicine, 346, 1663–1665.Google Scholar
Ganzini, L., Johnston, W.S., McFarland, B.H., et al. (1998). Attitudes of patients with Amyotrophic Lateral Sclerosis and their care givers toward assisted suicide. New England Journal of Medicine, 339, 967–973.Google Scholar
Henderson, J.M. & Ord, R.A. (1997). Suicide and neck cancer patients. Journal of Oral Maxillofacial Surgery, 55, 1217–1221.Google Scholar
Herrmann, C. (1997). International experiences with the Hospital Anxiety and Depression Scale. A review of validation data and clinical results. Journal of Psychosomatic Research, 42, 17–41.Google Scholar
Kahn, J.M., Lazarus, J.C., & Owens, P.D. (2003). Allowing patients to die: Practical, ethical and religious concerns. Journal of Clinical Oncology, 21, 3000–3002.Google Scholar
Levi, F., Bulliard, J., & La Vecchia, C. (1991). Suicide risk among incident cases of cancer in the Swiss Canton of Vaud. Oncology, 48, 44–47.Google Scholar
Lloyd-Williams, M. (2002). How common are thoughts of self-harm in a UK palliative care population? Supportive Care in Cancer, 10, 422–424.Google Scholar
Louhivouori, K.A. & Hakama, J. (1979). Risk of suicide among cancer patients. American Journal of Epidemiology, 109, 59–65.Google Scholar
Meier, D.E., Emmons, C., Wallenstein, S., et al. (1998). A national survey of physician-assisted suicide and euthanasia in the United States. New England Journal of Medicine, 338, 1193–1201.Google Scholar
Moorey, S., Greer, S., Watson, M., et al. (1991). The factor structure and factor stability of the Hospital Anxiety and Depression Scale in patients with cancer. British Journal of Psychiatry, 158, 255–259.Google Scholar
Mystakidou, K., Mendoza, T., Tsilika, E., et al. (2001a). Greek Brief Pain Inventory: Validation and utility in cancer pain. Oncology, 60, 35–42.Google Scholar
Mystakidou, K., Tsilika, E., Parpa, E., et al. (2001b). The EORTC Core Quality of Life Questionnaire (QLQ-C30-c30, Version 3.0) in terminally ill cancer patients under palliative care: Validity and reliability in a Hellenic sample. International Journal of Cancer, 94, 135–139.Google Scholar
Mystakidou, K., Tsilika, E., Kouloulias, V., et al. (2004). The “Palliative Care Quality of Life Instrument (PQLI)” in terminal cancer patients. Health & Quality of Life Outcomes, 2, 8.Google Scholar
Nunnally, J. & Bernstein, I. (1994). Psychometric Theory. New York: McGraw-Hill.
Olafsen, O.M. (1981). Suicide among cancer patients in Norway. In Depression et Suicide. Aspects Medicaux Psychologiques et Socio-Culturels, Soubrier, J.P. & Vedrinne, J. (eds.), pp. 587–591. Oxford, UK: Pergamon Press.
Owen, C., Tennant, C., Levi, J., et al. (1992). Suicide and euthanasia: Patient attitudes in the context of cancer. Psychooncology, 1, 79–88.Google Scholar
Pessin, H., Rosenfeld, B., & Breitbart, W. (2002). Assessing psychological distress near the end of life. American Behavioral Science, 46, 357–372.Google Scholar
Rosenfeld, B. (2000). Assisted suicide, depression and the right to die. Psychology, Public Policy and Law, 6, 467–488.Google Scholar
Rosenfeld, B., Breitbart, W., Galietta, M., et al. (2000). The schedule of attitudes toward hastened death. Cancer, 88, 2868–2875.Google Scholar
Rosenfeld, B., Breitbart, W., Stein, K., et al. (1999). Measuring desire for death among patients with HIV/AIDS: The schedule of attitudes toward hastened death. American Journal of Psychiatry, 156, 94–99.Google Scholar
Seale, C. & Addington-Hall, J. (1994). Euthanasia: Why people want to die earlier. Social Science of Medicine, 39, 647–654.Google Scholar
Snaith, R.P. (2003). The Hospital Anxiety and Depression Scale. Health and Quality of Life Outcomes, 1, 29.Google Scholar
Spinhoven, P.H., Ormel, J., Sloekers, P.P.A., et al. (1997). A validation study of the Hospital Anxiety and Depression Scale (HAD) in different groups of Dutch subjects. Psychological Medicine, 27, 363–370.Google Scholar
Suarez-Almazor, M.E., Newman, C., Hanson, J., et al. (2002). Attitudes of terminally ill cancer patients about euthanasia and assisted suicide: Predominance of psychosocial determinants and beliefs over symptom distress and subsequent survival. Journal of Clinical Oncology, 20, 2134–2141.Google Scholar
Van Houdenhove, B. & Onghena, P. (1997). Pain and depression. In Depression and Physical Illness, Robertson, M.M. & Katona, C.L.E. (eds.), pp. 465–497. Chichester, UK: Wiley & Sons Ltd.
Weisman, A. (1976). Coping with behavior and suicide in cancer. In Cancer: The Behavioral Dimension, Cullen, G., Fox, B. & Ison, R. (eds.), pp. 321–341. New York: Raven Press.
Wolfe, J., Fairclough, D.L., Clarridge, B., et al. (1999). Stability of attitudes regarding physician-assisted suicide and euthanasia among oncology patients, physicians, and the general public. Journal of Clinical Oncology, 17, 1274–1279.Google Scholar
Zigmond, A.S. & Snaith, R.P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361–370.Google Scholar