TY  - JOUR
PY  - 2016//
TI  - 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
JO  - Journal of pain and symptom management
A1  - Robinson, Sophie
A1  - Kissane, David W.
A1  - Brooker, Joanne
A1  - Hempton, Courtney
A1  - Burney, Susan
SP  - 243
EP  - 249
VL  - 53
IS  - 2
N2  - 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>
LA  - en
SN  - 0885-3924
UR  - http://dx.doi.org/10.1016/j.jpainsymman.2016.08.013
ID  - ref1
ER  -