Interpersonal factors predict increased desire for hastened death in late-stage cancer patients

Abstract

Background: Cancer patients at the end of life sometimes express a wish that death would come quickly, but this desire for hastened death (DHD) remains little understood. Relationships with spousal caregivers may play a role in patients' DHD. Purpose: This study examined factors that could predict an increase in the DHD in late-stage cancer patients over the course of 4 months, including marital and caregiving variables that have not previously been examined. Method: Patients completed the Schedule of Attitudes Toward Hastened Death and other measures, including the Dyadic Adjustment Scale. Caregivers were asked how many hours they spent weekly in caregiving activities and completed the Caregiver Demands Scale. Approximately 4 months later, DHD was reassessed in surviving patients. Results: Sixty caregiver/patient dyads completed all measures. Desire for hastened death was generally low at both assessments; however, more depression and greater dyadic adjustment reported by patients, and more hours spent in caregiving activities by spouses, each independently predicted increased DHD in patients at the Time 2 assessment. Conclusions: Findings suggest that issues related to spousal caregivers play an important role in the course of DHD in cancer patients at the end of life. © 2006 by The Society of Behavioral Medicine.