Sarah Alonzi1, Laura M Perry1, Ashley B Lewson2, Brenna Mossman1, Madison W Silverstein3, Michael Hoerger1,4,5. 1. Department of Psychology, Tulane University, New Orleans, Louisiana, USA. 2. Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA. 3. Department of Psychology, Loyola University New Orleans, New Orleans, Louisiana, USA. 4. Department of Palliative Medicine and Supportive Care, University Medical Center, New Orleans, Louisiana, USA. 5. Departments of Psychiatry and Medicine, Tulane Cancer Center, and Freeman School of Business, Tulane University, New Orleans, Louisiana, USA.
Abstract
Background: Palliative care is underutilized due in part to fear and misunderstanding, and depression might explain variation in fear of palliative care. Objective: Informed by the socioemotional selectivity theory, we hypothesized that older adults with cancer would be less depressed than younger adults, and subsequently less fearful of utilizing palliative care. Setting/Subjects: Patients predominately located in the United States with heterogeneous cancer diagnoses (n = 1095) completed the Patient-Reported Outcomes Information System (PROMIS) Depression scale and rated their fear of palliative care using the Palliative Care Attitudes Scale (PCAS). We examined the hypothesized intercorrelations, followed by a bootstrapped analysis of indirect effects in the PROCESS macro for SPSS. Results: Participants ranged from 26 to 93 years old (mean [M] = 60.40, standard deviation = 11.45). The most common diagnoses were prostate (34.1%), breast (23.3%), colorectal (17.5%), skin (15.3%), and lung (13.5%) cancer. As hypothesized, older participants had lower depression severity (r = -0.20, p < 0.001) and were less fearful of palliative care (r = -0.11, p < 0.001). Participants who were more depressed were more fearful of palliative care (r = 0.21, p < 0.001). An indirect effect (β = -0.04, standard error = .01, 95% confidence interval: -0.06 to -0.02) suggested that depression severity may account for up to 40% of age-associated differences in fear of palliative care. Conclusions: Findings indicate that older adults with cancer are more likely to favor palliative care, with depression symptom severity accounting for age-related differences. Targeted interventions among younger patients with depressive symptoms may be helpful to reduce fear and misunderstanding and increase utilization of palliative care.
Background: Palliative care is underutilized due in part to fear and misunderstanding, and depression might explain variation in fear of palliative care. Objective: Informed by the socioemotional selectivity theory, we hypothesized that older adults with cancer would be less depressed than younger adults, and subsequently less fearful of utilizing palliative care. Setting/Subjects: Patients predominately located in the United States with heterogeneous cancer diagnoses (n = 1095) completed the Patient-Reported Outcomes Information System (PROMIS) Depression scale and rated their fear of palliative care using the Palliative Care Attitudes Scale (PCAS). We examined the hypothesized intercorrelations, followed by a bootstrapped analysis of indirect effects in the PROCESS macro for SPSS. Results: Participants ranged from 26 to 93 years old (mean [M] = 60.40, standard deviation = 11.45). The most common diagnoses were prostate (34.1%), breast (23.3%), colorectal (17.5%), skin (15.3%), and lung (13.5%) cancer. As hypothesized, older participants had lower depression severity (r = -0.20, p < 0.001) and were less fearful of palliative care (r = -0.11, p < 0.001). Participants who were more depressed were more fearful of palliative care (r = 0.21, p < 0.001). An indirect effect (β = -0.04, standard error = .01, 95% confidence interval: -0.06 to -0.02) suggested that depression severity may account for up to 40% of age-associated differences in fear of palliative care. Conclusions: Findings indicate that older adults with cancer are more likely to favor palliative care, with depression symptom severity accounting for age-related differences. Targeted interventions among younger patients with depressive symptoms may be helpful to reduce fear and misunderstanding and increase utilization of palliative care.
Entities:
Keywords:
aged; cancer; depressive symptoms; middle aged; oncology; palliative care
Authors: Laura M Perry; Oliver Sartor; Sonia Malhotra; Sarah Alonzi; Seowoo Kim; Hallie M Voss; James L Rogers; William Robinson; Kendra Harris; Jessica Shank; David G Morrison; Ashley B Lewson; Jyotsna Fuloria; Lucio Miele; Brian Lewis; Brenna Mossman; Michael Hoerger Journal: J Pain Symptom Manage Date: 2021-04-20 Impact factor: 3.612
Authors: Shaheen S Kurani; Rozalina G McCoy; Michelle A Lampman; Chyke A Doubeni; Lila J Finney Rutten; Jonathan W Inselman; Rachel E Giblon; Kari S Bunkers; Robert J Stroebel; David Rushlow; Sagar S Chawla; Nilay D Shah Journal: JAMA Netw Open Date: 2020-03-02