Assessment of the wish to hasten death in patients with advanced cancer: A comparison of 2 different approaches. Issue 6 (10th April 2018)

• Record Type: Journal Article
• Authors: Bellido‐Pérez, Mercedes; Crespo, Iris; Wilson, Keith G.; Porta‐Sales, Josep; Balaguer, Albert; Monforte‐Royo, Cristina
• Is Part Of: Psycho-oncology. Volume 27:Issue 6(2018)
• Page Start: 1538
• Page End: 1544
• Publication Date: 2018-04-10
• Subjects: advanced cancer -- assessment -- cancer -- desire to die -- oncology -- palliative care -- patient perspective -- wish to hasten death; Cancer -- Psychological aspects -- Periodicals; Cancer -- Social aspects -- Periodicals; Neoplasms -- psychology -- Periodicals; 616.9940019
• DOI: 10.1002/pon.4689
• Languages: English
• ISSNs: 1057-9249

Abstract

Abstract: Introduction: The Desire for Death Rating Scale (DDRS) and the short form of the Schedule of Attitudes toward Hastened Death (SAHD‐5) are different approaches to assessing the wish to hasten death (WTHD). Both have clinical threshold scores for identifying individuals with a meaningfully elevated WTHD. However, the agreement between the 2 measures and patient opinions about assessment of the WTHD are unknown. Objectives: To compare the DDRS and SAHD‐5 and to analyze patient opinions about assessment of the WTHD. Methods: The WTHD was assessed in 107 patients with advanced cancer using both the DDRS and SAHD‐5. Patients were subsequently asked their opinion about this assessment. Results: Correlation between scores on the SAHD‐5 and the DDRS was moderate, Spearman rho = 0.67 ( P < .01). The SAHD‐5 identified 13 patients (12.1%) at risk of the WTHD, and the DDRS identified 6 patients (5.6%) with a moderate‐high WTHD ( P > .05). Concordance between the DDRS and SAHD‐5 in identifying individuals with an elevated WTHD was poor when using recommended cut‐off scores, κ = 0.37 ( P < 0.01) but could be improved by using different thresholds. Only 4 patients (3.8%) regarded the assessment questions as bothersome, and 90.6% considered it important that health‐care professionals inquire about the WTHD. Conclusions: The SAHD‐5 and DDRS appear to be appropriate methods for assessing the WTHD and could provide complementary information in clinical practice: the SAHD‐5 to screen for risk of the WTHD and the DDRS as a clinical interview to explore it in greater detail. Assessment of the WTHD is well accepted by palliative care cancer patients.