“I want to live, but …” the desire to live and its physical, psychological, spiritual, and social factors among advanced cancer patients: evidence from the APPROACH study in India
Abstract Background The limited access to palliative care resources along with the social stigma around cancer largely explains the poor quality of life (QoL) of Indian advanced cancer patients. As advanced cancer patients with poor QoL often harbour a desire for hastened death (DHD), it is imperati...
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| Format: | Article |
| Language: | English |
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BMC
2022-08-01
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| Series: | BMC Palliative Care |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12904-022-01041-z |
| _version_ | 1798032094386978816 |
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| author | Anjum S. Khan Joad Arati Hota Pratima Agarwal Krimal Patel Kinjal Patel Jyotika Puri Soye Shin |
| author_facet | Anjum S. Khan Joad Arati Hota Pratima Agarwal Krimal Patel Kinjal Patel Jyotika Puri Soye Shin |
| author_sort | Anjum S. Khan Joad |
| collection | DOAJ |
| description | Abstract Background The limited access to palliative care resources along with the social stigma around cancer largely explains the poor quality of life (QoL) of Indian advanced cancer patients. As advanced cancer patients with poor QoL often harbour a desire for hastened death (DHD), it is imperative to understand factors affecting DHD, or the desire to live (DTL) among advanced cancer patients in India. We aim to examine the relationship between DTL and physical, psychological, spiritual, and social factors measuring patients’ QoL alongside their awareness of their late cancer stage. Methods We surveyed 200 patients from a tertiary cancer hospital in India to collect their DTL, awareness of cancer stage, demographic characteristics, and standardized measures for patients’ QoL. We used a linear probability regression model to quantify the association between these factors and patients’ DTL among the final sample of 192 patients with no missing information for the variables of interest. Results Among the various domains affecting cancer patients’ QoL, we found that the pain severity score (ranging from 0 to 10) and psychological distress score (ranging from 0 to 42) are negatively associated with the DTL. One point increase in each score reduced the DTL by 2.2% (p < 0.05) and 0.7% (p < 0.05), respectively. Our results also showed that patients whose perceived socio-economic status (SES) is poor have a 16% (p < 0.05) lower probability of DTL, compared to those with higher SES (lower middle class, upper middle class, and wealthy). Controlling for caste, religion, gender, age, marital status and years of education, we found psychological distress is statistically higher among patients belonging to this bottom SES. Conclusions We found that pain severity, psychological distress and perceived low SES are negatively associated with the desire to live in advanced cancer patients. Future research should focus on developing interventions to improve physical pain and psychological distress, particularly for patients who are socially and economically disadvantaged. |
| first_indexed | 2024-04-11T20:08:25Z |
| format | Article |
| id | doaj.art-b57b3e1a6d34477690a0628a3fe1e887 |
| institution | Directory Open Access Journal |
| issn | 1472-684X |
| language | English |
| last_indexed | 2024-04-11T20:08:25Z |
| publishDate | 2022-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Palliative Care |
| spelling | doaj.art-b57b3e1a6d34477690a0628a3fe1e8872022-12-22T04:05:16ZengBMCBMC Palliative Care1472-684X2022-08-0121111110.1186/s12904-022-01041-z“I want to live, but …” the desire to live and its physical, psychological, spiritual, and social factors among advanced cancer patients: evidence from the APPROACH study in IndiaAnjum S. Khan Joad0Arati Hota1Pratima Agarwal2Krimal Patel3Kinjal Patel4Jyotika Puri5Soye Shin6Bhagwan Mahaveer Cancer Hospital and Research CentreBhagwan Mahaveer Cancer Hospital and Research CentreBhagwan Mahaveer Cancer Hospital and Research CentreBhagwan Mahaveer Cancer Hospital and Research CentreBhagwan Mahaveer Cancer Hospital and Research CentreProgram in Health Services and Systems Research, Duke-NUS Medical SchoolProgram in Health Services and Systems Research, Duke-NUS Medical SchoolAbstract Background The limited access to palliative care resources along with the social stigma around cancer largely explains the poor quality of life (QoL) of Indian advanced cancer patients. As advanced cancer patients with poor QoL often harbour a desire for hastened death (DHD), it is imperative to understand factors affecting DHD, or the desire to live (DTL) among advanced cancer patients in India. We aim to examine the relationship between DTL and physical, psychological, spiritual, and social factors measuring patients’ QoL alongside their awareness of their late cancer stage. Methods We surveyed 200 patients from a tertiary cancer hospital in India to collect their DTL, awareness of cancer stage, demographic characteristics, and standardized measures for patients’ QoL. We used a linear probability regression model to quantify the association between these factors and patients’ DTL among the final sample of 192 patients with no missing information for the variables of interest. Results Among the various domains affecting cancer patients’ QoL, we found that the pain severity score (ranging from 0 to 10) and psychological distress score (ranging from 0 to 42) are negatively associated with the DTL. One point increase in each score reduced the DTL by 2.2% (p < 0.05) and 0.7% (p < 0.05), respectively. Our results also showed that patients whose perceived socio-economic status (SES) is poor have a 16% (p < 0.05) lower probability of DTL, compared to those with higher SES (lower middle class, upper middle class, and wealthy). Controlling for caste, religion, gender, age, marital status and years of education, we found psychological distress is statistically higher among patients belonging to this bottom SES. Conclusions We found that pain severity, psychological distress and perceived low SES are negatively associated with the desire to live in advanced cancer patients. Future research should focus on developing interventions to improve physical pain and psychological distress, particularly for patients who are socially and economically disadvantaged.https://doi.org/10.1186/s12904-022-01041-zAdvanced cancer patientsPalliative careDesire to liveDesire for hastened deathIndiaSocio-economic status |
| spellingShingle | Anjum S. Khan Joad Arati Hota Pratima Agarwal Krimal Patel Kinjal Patel Jyotika Puri Soye Shin “I want to live, but …” the desire to live and its physical, psychological, spiritual, and social factors among advanced cancer patients: evidence from the APPROACH study in India BMC Palliative Care Advanced cancer patients Palliative care Desire to live Desire for hastened death India Socio-economic status |
| title | “I want to live, but …” the desire to live and its physical, psychological, spiritual, and social factors among advanced cancer patients: evidence from the APPROACH study in India |
| title_full | “I want to live, but …” the desire to live and its physical, psychological, spiritual, and social factors among advanced cancer patients: evidence from the APPROACH study in India |
| title_fullStr | “I want to live, but …” the desire to live and its physical, psychological, spiritual, and social factors among advanced cancer patients: evidence from the APPROACH study in India |
| title_full_unstemmed | “I want to live, but …” the desire to live and its physical, psychological, spiritual, and social factors among advanced cancer patients: evidence from the APPROACH study in India |
| title_short | “I want to live, but …” the desire to live and its physical, psychological, spiritual, and social factors among advanced cancer patients: evidence from the APPROACH study in India |
| title_sort | i want to live but the desire to live and its physical psychological spiritual and social factors among advanced cancer patients evidence from the approach study in india |
| topic | Advanced cancer patients Palliative care Desire to live Desire for hastened death India Socio-economic status |
| url | https://doi.org/10.1186/s12904-022-01041-z |
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