How patients with less-advanced and more-advanced cancer deal with three death-related fears: an exploratory study.

The means used by cancer patients to cope with each of three death anxieties (i.e., fear of pain and suffering, loneliness, and the unknown) that contribute to their psychological distress have rarely been examined. Differences between cancer patients with Stage I or II disease (Group 1) and Stage III or IV disease (Group 2) were explored. T-tests revealed no difference between the groups. Age-controlled Pearson correlations were used to determine the relationship between all three death anxieties, and some recognized coping devices used by cancer patients, namely, coping styles, optimism, and religiosity/spirituality. Results showed that, for Group 1, avoidant coping correlated positively with fear of the unknown, and social diversion correlated positively with fear of pain and suffering. As for similarities between groups, with the exception of fear of pain and suffering for Group 2, emotion-focused coping correlated positively with all three death anxieties, and optimism correlated negatively with fear of the unknown. The advantage for researchers and clinicians of including measures or evaluation of the death anxieties in their considerations of the psychological distress of cancer patients is discussed.