Defining dignity in terminally ill cancer patients: A factor-analytic approach
Article first published online: 8 JAN 2004
Copyright © 2004 John Wiley & Sons, Ltd.
Volume 13, Issue 10, pages 700–708, October 2004
How to Cite
Hack, T. F., Chochinov, H. M., Hassard, T., Kristjanson, L. J., McClement, S. and Harlos, M. (2004), Defining dignity in terminally ill cancer patients: A factor-analytic approach. Psycho-Oncology, 13: 700–708. doi: 10.1002/pon.786
- Issue published online: 24 SEP 2004
- Article first published online: 8 JAN 2004
- Manuscript Accepted: 23 OCT 2003
- Manuscript Received: 11 APR 2003
The construct of ‘dignity’ is frequently raised in discussions about quality end of life care for terminal cancer patients, and is invoked by parties on both sides of the euthanasia debate. Lacking in this general debate has been an empirical explication of ‘dignity’ from the viewpoint of cancer patients themselves. The purpose of the present study was to use factor-analytic and regression methods to analyze dignity data gathered from 213 cancer patients having less than 6 months to live. Patients rated their sense of dignity, and completed measures of symptom distress and psychological well-being. The results showed that although the majority of patients had an intact sense of dignity, there were 99 (46%) patients who reported at least some, or occasional loss of dignity, and 16 (7.5%) patients who indicated that loss of dignity was a significant problem. The exploratory factor analysis yielded six primary factors: (1) Pain; (2) Intimate Dependency; (3) Hopelessness/Depression; (4) Informal Support Network; (5) Formal Support Network; and (6) Quality of Life. Subsequent regression analyses of modifiable factors produced a final two-factor (Hopelessness/Depression and Intimate Dependency) model of statistical significance. These results provide empirical support for the dignity model, and suggest that the provision of end of life care should include methods for treating depression, fostering hope, and facilitating functional independence. Copyright © 2004 John Wiley & Sons, Ltd.