Demoralization, Pain, and Hope as Predictors of Desire for Death in Cancer Patients: A Cross-Sectional Study.

Abstract

Context: The desire to hasten death is a critical issue in palliative and end-of-life care for patients with cancer, reflecting physical suffering, psychological distress, and existential concerns. Pain, demoralization, and hope are key factors shaping patients' perspectives on life and death. A deeper understanding of these factors is crucial for developing holistic interventions that address both physical and emotional needs.

Objectives: This study aimed to explore the relationships between pain, demoralization, and hope with the desire to hasten death among patients with cancer. Additionally, it sought to identify significant psychological and clinical predictors while adjusting for potential confounders.

Methods: A cross-sectional study was conducted with 112 patients with cancer receiving palliative care in Greece. Validated tools were used to assess pain, demoralization, hope, and the desire to hasten death. Various demographic and clinical factors were considered as confounders. Logistic regression analysis was performed to examine the influence of pain, demoralization, and hope on the desire for hastened death.

Results: Univariate analysis revealed significant associations between pain, demoralization, hope, and the desire to hasten death. In multivariable analysis, demoralization was positively associated with a greater desire to hasten death (adjusted OR = 1.184, P = 0.016), while hope was negatively associated (adjusted OR = 0.807, P = 0.027). Pain was not a significant predictor in the final model.

Conclusion: Demoralization and hope significantly influence the desire to hasten death in patients with cancer, with demoralization increasing and hope decreasing this desire. These findings highlight the need for psychological and existential interventions alongside physical symptom management.