@article{ref1,
title="The relationship between poor quality of life and desire to hasten death: a multiple mediation model examining the contributions of depression, demoralization, loss of control, and low self-worth",
journal="Journal of pain and symptom management",
year="2016",
author="Robinson, Sophie and Kissane, David W. and Brooker, Joanne and Hempton, Courtney and Burney, Susan",
volume="53",
number="2",
pages="243-249",
abstract="CONTEXT: The risk of suicide is elevated in palliative care patients compared to the general population. Various psychological factors, including depression, demoralization, loss of control, and low self-worth have been associated with a desire to hasten death. <br><br>OBJECTIVES: The aim of this study was to investigate whether depression, demoralization, loss of control, and low self-worth mediated the relationship between global quality of life and desire to hasten death. <br><br>METHODS: A sample of 162 palliative care patients completed measures of global quality of life, depression, demoralization, perceived control, self-worth, and desire to hasten death. A multiple mediation model with bootstrapping sampling tested the total (combined) indirect effect and individual indirect effects of depression, the two subscales of demoralization (Meaning and Purpose; Distress and Coping Ability), perceived control, and self-worth. <br><br>RESULTS: Depressive symptoms, loss of meaning and purpose, loss of control, and low self-worth mediated the direct effect of global quality of life on desire to hasten death. The Distress and Coping Ability component of demoralization was not a significant mediator. <br><br>CONCLUSION: Depression, loss of meaning and purpose, loss of control, and low self-worth are strong clinical markers for desire to hasten death. Targeting these symptoms through existentially-oriented therapies, such as meaning-centered therapy, may ameliorate suicidal thinking.<br><br>Copyright © 2016. Published by Elsevier Inc.<p /> <p>Language: en</p>",
language="en",
issn="0885-3924",
doi="10.1016/j.jpainsymman.2016.08.013",
url="http://dx.doi.org/10.1016/j.jpainsymman.2016.08.013"
}