Loss of Personal Autonomy and Dignity-Related Distress in End-Of-Life Cancer Patients

Am J Hosp Palliat Care. 2024 Feb;41(2):179-186. doi: 10.1177/10499091231166373. Epub 2023 Mar 28.

Abstract

The objective of this cross-sectional study is to investigate Dignity-Related Loss of Personal Autonomy (DR-LPA) intended as loss of relational independence causing dignity-related distress. Moreover, it analyzes its possible relationships with demoralization, spirituality, quality of life, hope, and coping styles in a sample composed of 207 end-of-life cancer patients. These variables have been assessed through the following rating scales: Patient Dignity Inventory - Italian version, Demoralization Scale - Italian version, Functional Assessment of Cancer Therapy Scale - General Measure, Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being, Brief Coping Orientation to Problem Experienced, and Herth Hope Index. The results have shown that most of the DR-LPA items were considered a problem by most patients. Functional, social, emotional, and spiritual wellbeing, disheartenment, age, and sex emerged as significant predictors of DR-LPA. In conclusion, this study showed that DR-LPA can be a relevant concern for patients at the end-of-life and for this reason it becomes necessary for psychosocial provides to consider it to deliver better dignity conserving care.

Keywords: autonomy; cancer; dignity; end of life; self-determination.

MeSH terms

  • Cross-Sectional Studies
  • Death
  • Humans
  • Neoplasms* / psychology
  • Palliative Care* / psychology
  • Personal Autonomy
  • Quality of Life
  • Respect
  • Surveys and Questionnaires