Premium
Assessment of the wish to hasten death in patients with advanced cancer: A comparison of 2 different approaches
Author(s) -
BellidoPérez Mercedes,
Crespo Iris,
Wilson Keith G.,
PortaSales Josep,
Balaguer Albert,
MonforteRoyo Cristina
Publication year - 2018
Publication title -
psycho‐oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.41
H-Index - 137
eISSN - 1099-1611
pISSN - 1057-9249
DOI - 10.1002/pon.4689
Subject(s) - concordance , medicine , clinical practice , rating scale , family medicine , oncology , psychology , developmental psychology
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.