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Affiliation
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School of Psychological Sciences, Monash University, Melbourne, Australia; Szalmuk Family Psycho-oncology Unit, Cabrini Health, Melbourne, Australia. |
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Abstract
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CONTEXT: The risk of suicide is elevated in palliative care patients compared to the general population. Various psychological factors, including depression, demoralization, loss of control, and low self-worth have been associated with a desire to hasten death.
OBJECTIVES: The aim of this study was to investigate whether depression, demoralization, loss of control, and low self-worth mediated the relationship between global quality of life and desire to hasten death.
METHODS: A sample of 162 palliative care patients completed measures of global quality of life, depression, demoralization, perceived control, self-worth, and desire to hasten death. A multiple mediation model with bootstrapping sampling tested the total (combined) indirect effect and individual indirect effects of depression, the two subscales of demoralization (Meaning and Purpose; Distress and Coping Ability), perceived control, and self-worth.
RESULTS: Depressive symptoms, loss of meaning and purpose, loss of control, and low self-worth mediated the direct effect of global quality of life on desire to hasten death. The Distress and Coping Ability component of demoralization was not a significant mediator.
CONCLUSION: Depression, loss of meaning and purpose, loss of control, and low self-worth are strong clinical markers for desire to hasten death. Targeting these symptoms through existentially-oriented therapies, such as meaning-centered therapy, may ameliorate suicidal thinking.
Copyright © 2016. Published by Elsevier Inc.
Language: en |