Demoralization Syndrome in End-Of-Life Cancer Patients: A Qualitative Study.

Objectives: In our previous study we analyzed the prevalence of demoralization in a sample of 235 end-of-life cancer patients using the Demoralization Scale (DS). The findings revealed that 50.2% of the participants reported experiencing a moderate level of demoralization. The main sub-dimensions observed from the original DS were Helplessness, Disheartenment, and Sense of Failure, which we have categorized as "Emotional Distress and Inability to Cope". The aim of this study was to qualitatively investigate the subjective experience of this factor among a group of terminal cancer patients.

Method: A sample of 30 patients was interviewed using seven open-ended questions, divided into 3 categories: helplessness, disheartenment and sense of failure. Content analysis was performed.

Results: Faith and prayer, social support and preserving autonomy were the principal coping strategies used by the sample and have been classed as sources of hope. Sadness, anger, death anxiety, fear, and sickness were the most commonly expressed emotions. Faith, social support, autonomy, and fighting spirit were identified as the primary coping strategies.

Conclusions: This study allowed a better understanding of the patient's subjective experience of the demoralization sub-dimension. The deepening of the topic can increase personalized clinical interventions, according to the patient's needs.