Health-related quality of life in patients with advanced cancer who express a wish to hasten death: A comparative study.

Abstract

Some evidence suggests the wish to hasten death is related to poor health-related quality of life. Deficits in perceived dignity and self-efficacy are risk factors for wish to hasten death that also impact health-related quality of life. To compare perceived health-related quality of life, dignity and self-efficacy in patients with advanced cancer who either do (case group) or do not (control group) express a wish to hasten death. Cases and controls were matched on sociodemographic and functional characteristics. A comparative cross-sectional study. A total of 153 adult patients with advanced cancer were assessed for wish to hasten death using the Desire for Death Rating Scale. Scores ⩾1 indicate some degree of wish to hasten death (case group, <i>n</i> = 51), and score = 0 implies no wish to hasten death (control group, <i>n</i> = 102). Assessments included health-related quality of life using the European Organization for Research and Treatment of Cancer Quality-of-Life Core 15-Item Palliative Questionnaire, perceived loss of dignity using the Patient Dignity Inventory and self-efficacy using the General Self-Efficacy Scale. Patients with a wish to hasten death had worse emotional functioning (<i>p</i> < 0.001), greater perceived loss of dignity (<i>p</i> < 0.001) and lower self-efficacy (<i>p</i> = 0.001). There was no difference in most physical symptoms. Perceived overall health-related quality of life was significantly worse for those with a clinically relevant wish to hasten death (<i>p</i> = 0.023) and marginally worse for the case group than the control group (<i>p</i> = 0.052). Patients with wish to hasten death showed lower perceived dignity, self-efficacy and emotional quality of life than patients without wish to hasten death without necessarily perceiving worse physical symptoms.