Death acceptance was assessed in 337 adult cancer patients who were starting to receive chemotherapy, and in 180 healthy controls. Although diagnosis of cancer and higher age are associated with a reduction of the average time left to live, these variables had differential associations with death acceptance. Higher age but not having cancer was associated with higher levels of death acceptance, and differences in death acceptance between patients and healthy control group members were stronger in younger than in older participants. Within the patient sample, stronger physical impairments, male gender, having no long-term goals, and religiosity were related to higher levels of death acceptance. Across a nine-month interval, no changes in the mean level of death acceptance appeared. Nonetheless, younger patients with stronger physical impairments at T1 showed a decline in death acceptance at T2. We conclude that reasons that make illness and mortality salient reduce death acceptance in younger patients, but not in older patients.
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References
1.
AikenL. S., & WestS. G. (1991). Multiple regression: Testing and interpreting interactions. Newbury Park, CA: Sage.
2.
American Cancer Society. (2005). Cancer: Facts and figures. Washington, DC: Author.
3.
BeckA. T.WeissmanA.LesterD., & TrexlerL. (1974). The measurement of pessimism. Journal of Consulting and Clinical Psychology, 42, 861–865.
4.
BrandtstädterJ.WenturaD., & SchmitzU. (1997). Veränderungen der Zeit- und Zukunftsperspektive im Übergang zum höheren Alter: Quer- und längsschnittliche Befunde [Cross-sectional and longitudinal results on the change of future perspective]. Zeitschrift für Psychologie, 205, 377–395.
5.
CellaD. F., & TrossS. (1987). Death anxiety in cancer survival: A preliminary cross-validation study. Journal of Personality Assessment, 51, 451–461.
6.
CohenJ. (1992). A power primer. Psychological Bulletin, 112, 155–159.
7.
DokaK., & MartinT. (2001). Take it like a man: Masculine response to loss. In LundD. (Ed.), Men coping with grief (pp. 37–47). Amityville, NY: Baywood.
8.
DoughertyK.TemplerD. I., & BrownR. (1986). Psychological states in terminal cancer patients as measured over time. Journal of Consulting Psvchology, 33, 357–359.
9.
EriksonE. (1963). Childhood and society (2nd ed.). New York: Norton.
10.
FortnerB. V., & NeimeyerR. A. (1999). Death anxiety in older adults: A quantitative study. Death Studies, 23, 387–411.
11.
GesserG.WongP. T., & RekerG. T. (1987–1988). Death attitudes across the life-span: The development and validation of the Death Attitudes Profile (DAP). Omega, 18, 109–124.
12.
GibbsH. W., & Achterberg-LawlisJ. (1978). Spiritual value and death anxiety: Implications for counselling with terminally ill cancer patients. Journal of Counselling Psychology, 25, 563–569.
13.
GotayC. C.ShimizuH.MuroakaM.IshiharaY.TsuboiK., & OgawaH. (2004). Cancer-related attitudes: A comparative study in Japan and the US. Psycho-Oncology, 13, 665–672.
14.
GreerS. (1991). Psychological response to cancer and survival. Psychological Medicine, 21, 43–49.
15.
HeidrichS. M.ForsthoffC. A., & WardS. E. (1999). Psychological adjustment in adults with cancer: The self as mediator. In SuinnR. M. & Van den BossG. R. (Eds.), Cancer patients and their families (pp. 81–95). Washington, DC: American Psychological Association.
16.
HintonJ. (1999). The progress of awareness and acceptance of dying assessed in cancer patients and their caring relatives. Palliative Medicine, 13, 19–35.
17.
HoS. M., & ShiuW. C. (1995). Death anxiety and coping mechanisms of Chinese cancer patients. Omega, 31, 59–65.
18.
JohnsonC. L., & BarerB. M. (1997). Life beyond 85 years: The aura of survivorship. New York: Springer.
19.
KalishR. A. (1976). Death and dying in a social context. In BinstockR. H. & ShanasG. (Eds.), Handbook of aging and the social sciences (pp. 483–507). New York: Van Nostrand Reinhold.
20.
KastenbaumR. (2000). The psychology of death (3rd ed.). New York: Springer.
21.
KeilA. (2000). Lebensqualität und Strahlentherapie [Quality of life and radiation therapy]. Marburg: Görich und Weiershäuser.
22.
KelleyB.BurnettP.BadgerS.PelusiD.VargheseF. T., & RobertsonM. (2003). Doctors and their patients: A context for understanding the wish to hasten death. Psycho-Oncology, 12, 375–384.
23.
KlugA. (1997). Einstellungen zu Streben, Tod und Danach [Attitudes toward death, dying, and afterlife]. Aachen: Mainz-Verlag.
24.
KrosnikJ. A., & AlwinD. L. (1989). Aging and susceptibility to attitude change. Journal of Personality and Social Psychology, 57, 416–425.
25.
Kübler-RossE. (1969). On death and dying. New York: Macmillan.
26.
LavoieJ., & DeVriesB. (2003–2004). Identity and death: An empirical investigation. Omega, 48, 223–243.
27.
LittleM., & SayersE. J. (2004). The skull beneath the skin: Cancer survival and awareness of death. Psycho-Oncology, 13, 190–198.
28.
LlewelynS. P., & MurrayA. K. (1999). Group therapy for metastatic cancer patients: Report of an intervention. Psychology, Health & Medicine, 4, 229–240.
29.
LongS. O. (2004). Cultural scripts for a good death in Japan and the United States: Similarities and differences. Social Science & Medicine, 58, 913–928.
30.
MahoneyF. I., & BarthelD. W. (1965). Functional evaluation: The Barthel Index. A simple index of independence useful in scoring improvement in the rehabilitation of the chronically ill. Maryland State Medical Journal, 14(2), 61–65.
31.
MehnertA., & KochU. (2001). Religiosität und psychische Befindlichkeit—Überprüfung von Instrumenten zur Erfassung von Religiosität [Religiousness and well-being: Evaluation of instruments for the assessment of religious attitudes]. Zeitschrift für Medizinische Psychologie, 10, 171–182.
32.
MeierP. (1992). Sinnsuche und Sinnfindung im Umfeld eines kritischen Lebenscreignisses [Searching and finding meaning when being confronted with a critical life event]. Regensburg: Roderer.
33.
MillerA. S., & NakamuraT. (1996). On the stability of church attendance patterns during a time of demographic change: 1965–1988. Journal for the Scientific Study of Religion, 35, 275–284.
34.
MitterW. (1990). Educational reform in West and East Germany in European perspective. Oxford Review of Education, 16, 333–341.
35.
NeimeyerR. A., & Van BruntD. (1995). Death anxiety. In WassH. & NeimeyerR. A. (Eds.), Dying: Facing the facts (3rd ed., pp. 49–88). Washington, DC: Hemisphere.
36.
NicholsJ., & RiegelB. (2002). The contribution of chronic illness to acceptance of death in hospitalized patients. Clinical Nursing Research, 11, 103–115.
37.
OwenC.TennantC.LevisJ., & JonesM. (1994). Cancer patients' attitudes to final events in life: Wish for death, attitudes to cessation of treatment, suicide and euthanasia. Psycho-Oncology, 3, 1–9.
38.
PinquartM.Nixdorf-HänchenJ. C., & SilbereisenR. K. (2005). Associations of age and cancer with individual goal commitment. Applied Developmental Science, 9, 54–66.
39.
RayJ. J., & NajmanJ. (1974). Death anxiety and death acceptance: A preliminary approach. Omega, 5, 311–315.
40.
RepettoL.FratinoL.AudisioR. A.VenturinoA.GianniW.VercelliM.ParodiS.Dal LagoD.GioiaF.MonfardiniS.AaproM. S.SerrainoD., & ZagonelV. (2002). Comprehensive geriatric assessment adds information to Eastern Cooperative Oncology Group Performance Status in elderly cancer patients: An Italian group for geriatric oncology study. Journal of Clinical Oncology, 20, 494–502.
41.
SmithE. D.StefanekM. E.JosephM. V.VerdieckM. J.ZaboraJ. R., & FettingJ. H. (1993). Spiritual awareness, personal perspective on death, and psychological distress among cancer patients: An initial investigation. Journal of Psychosocial Oncology, 11(3), 89–103.
42.
SpiegelD., & GlafkidesM. C. (1983). Effect of group confrontation with death and dying. International Journal of Group Therapy, 33, 433–447.
43.
TherasseP. (2002). Evaluation of response: New and standard criteria. Annals of Oncology, 13(Suppl. 4), 127–129.
44.
TobinS. (1996). A non-normative old-age contrast: Elderly parents caring for offspring with mental retardation. In BengtsonV. L. (Ed.), Adulthood and aging: Research on continuities and discontinuities (pp. 124–142). New York: Springer.
45.
TomerA. (1994). Death anxiety in adult life: Theoretical perspectives. In NeimeyerR. A. (Ed.), Death anxiety handbook (pp. 3–28). Washington, DC: Taylor & Francis.
46.
TomerA., & EliasonG. (2000). Beliefs about self, life, and death: Testing aspects of a comprehensive model of death anxiety and death attitudes. In TomerA. (Ed.), Death attitudes and the older adult (pp. 137–153). Philadelphia, PA: Brunner & Routledge.
47.
WittkowskiJ. (1990). Psychologie des Todes [Psychology of death]. Darmstadt: Wissenschaftliche Buchgesellschaft.
48.
WongP. T.RekerG. T., & GesserT. (1994). Death attitude profile-revised: A multidimensional measure of attitudes toward death. In NeimeyerR. A. (Ed.), Death anxiety handbook (pp. 121–148). Washington, DC: Taylor & Francis.
49.
ZagonelV.FratinoL.PiselliP.MilanI.La ConcaG.SerrainoD., & MonfardiniS. (2002). The comprehensive geriatric assessment (CGA) predicts mortality among elderly cancer patients (ECP). Proceedings of the American Society for Clinical Oncology, 21, 1458.
