The Association of Death Anxiety, Loneliness, and Hopelessness with Clinical Features and Qualityof Life in Palliative Radiotherapy Patients

Abstract

OBJECTIVE The incidence of adjustment disorder, anxiety, and depression in cancer patients is 40–50%. These disorders may lead to an impairment in quality of life (QoL). Radiotherapy is an essential part of palliative care that relieves symptoms in advanced cancer patients. The cancer patients may have the opportunity to be evaluated regarding psychosocial morbidity in radiation oncology departments (RODs). METHODS Advanced cancer patients treated in ROD in palliative intent were asked to fill out Templer’s death anxiety scale, Beck hopelessness scale, University of California, Los Angeles loneliness scale, and short-form 36. The correlations of scale results with each other and with sociodemographic and clinical characteristics of patients were investigated statistically. RESULTS Forty patients’ results were evaluated in the study. The rate of high death anxiety was 45%, moderate hopelessness 27.5%, mild hopelessness 32.5%, moderate loneliness 57.5%, and high loneliness 15%. There were negative significant correlations between physical functioning and loneliness, physical role limitations and death anxiety/loneliness, social functioning and death anxiety/loneliness, energy/fatigue and hopelessness/loneliness, bodily pain and hopelessness, general health perceptions/emotional wellbeing, and all three moods. The identified predisposing factors for death anxiety were male gender (p=0.030) and poor ECOG performance status (p=0.034). Higher educational attainment was associated with higher loneliness (p=0.026). Body mass index was negatively correlated with higher levels of death anxiety, loneliness, and hopelessness (p=0.007, 0.025, and 0.020). CONCLUSION Even more than 50% of the patients who underwent palliative radiotherapy suffer from hopelessness, loneliness, and death anxiety. This circumstance is related to poorer QoL. Advanced cancer patients must be evaluated about psychological symptoms and supported if needed to improve QoL.