Effects of meaning in life and individual characteristics on dignity in patients with advanced cancer in China: a cross-
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ORIGINAL ARTICLE
Effects of meaning in life and individual characteristics on dignity in patients with advanced cancer in China: a cross-sectional study Xiaocheng Liu 1 & Zhili Liu 2 & Qinqin Cheng 3 & Nuo Xu 1 & Hui Liu 1 & Wenjuan Ying 2 Received: 6 April 2020 / Accepted: 1 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose This study was conducted to evaluate the effects of meaning in life and individual characteristics on dignity in patients with advanced cancer. Methods One hundred sixty-seven patients with advanced cancer participated in this study. Dignity was assessed with the Patient Dignity Inventory (PDI), meaning in life was assessed with the Meaning in Life Scale (MiLS), and performance status was defined as the Karnofsky Performance Status (KPS). Sociodemographic and clinical variables were also measured. Independent T tests and one-way ANOVA were performed for the PDI scores and sociodemographic and clinical variables. Relationships among the PDI, MiLS, and KPS scores were evaluated with bivariate analyses (Spearman rank correlation). A multiple linear regression analysis was conducted to determine the predictors the of PDI score. Results Patients reported a mean of 4.2 (SD 4.9) problems affecting their sense of dignity; 21.6% reported moderate to severe loss of their sense of dignity. Multivariable regression analyses revealed that a lower MiLS score, younger age, inpatient status, and a lower KPS score predicted the loss of dignity. Stepwise regression showed that 49.8% of dignity-related distress could be explained by the MiLS score, age, inpatient status, and the KPS score. Conclusion Self-perceived dignity is significantly negatively associated with meaning in life, age, inpatient status, and performance status. The early recognition of risk factors for the loss of dignity and interventions to enhance meaning in life may prevent the loss of dignity in patients with advanced cancer. Keywords Dignity . Meaning in life . Loss of dignity . Palliative care
Introduction Cancer is one of the primary causes of morbidity and mortality worldwide. The GLOBOCAN 2018 database indicated that there were 18.1 million new cases of cancers and 9.6 million deaths from cancer in 2018, among which 23.7% of new cases and 30.2% of cancer-related deaths were in China [1, 2]. Local reports indicate that the incidence and mortality rates of
* Wenjuan Ying [email protected] 1
Shantou University Medical College, Shantou People’s Republic of China
2
Nursing Department, The First Affiliated Hospital of Shantou University Medical College, Shantou 515000 People’s Republic of China
3
Pain Management Department, Hunan Cancer Hospital, Changsha People’s Republic of China
cancers will increase further because of the large population size and aging. Cancer is a life-threatening illness that may pose different challenges for patients and caregivers, who undoubtedly suffer worsening health conditions, physical symptoms, and psychological distress. For terminally ill cancer patient
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