Existential distress in cancer: Alleviating suffering from fundamental loss and change

A severe life threatening illness can challenge fundamental expectations about security, interrelatedness with others, justness, controllability, certainty, and hope for a long and fruitful life. That distress and suffering but also growth and mastery may arise from confrontation with an existential...

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Veröffentlicht in:Psycho-oncology (Chichester, England) Jg. 27; H. 11; S. 2525 - 2530
Hauptverfasser: Vehling, Sigrun, Kissane, David W.
Format: Journal Article
Sprache:Englisch
Veröffentlicht: England Wiley Subscription Services, Inc 01.11.2018
Schlagworte:
Adaptation, Psychological
Anxiety
Attitude to Death
Autonomy
Cancer
Clinical outcomes
Clinical significance
Comorbidity
Conflict
Coping
Death & dying
Death anxiety
demoralization
existential distress
existential suffering
existential therapy
Existentialism - psychology
Expectations
Fear
Fear & phobias
fear of cancer recurrence
Grief
Health services
Health status
Hopelessness
Human dignity
Humans
Life
Life threatening sickness
Loneliness
Mental health services
Meta-analysis
Neoplasms - mortality
Neoplasms - psychology
Palliative Care - psychology
Psychological distress
Recurrence
Regret
Right to die
Self Concept
sense of dignity
Shame
Stress, Psychological
Suffering
Treatment methods
existential distress
sense of dignity
existential therapy
fear of cancer recurrence
hopelessness
death anxiety
demoralization
cancer
existential suffering
ISSN:1057-9249, 1099-1611, 1099-1611
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Zusammenfassung:A severe life threatening illness can challenge fundamental expectations about security, interrelatedness with others, justness, controllability, certainty, and hope for a long and fruitful life. That distress and suffering but also growth and mastery may arise from confrontation with an existentially threatening stressor is a long‐standing idea. But only recently have researchers studied existential distress more rigorously and begun to identify its distinct impact on health care outcomes. Operationalizations of existential distress have included fear of cancer recurrence, death anxiety, demoralization, hopelessness, dignity‐related distress, and the desire for hastened death. These focus in varying emphasis on fear of death, concern about autonomy, suffering, or being a burden to others; a sense of profound loneliness, pointlessness or hopelessness; grief, regret, or embitterment about what has been missed in life; and shame if dignity is lost or expectations about coping are not met. We provide an overview of conceptual issues, diagnostic approaches, and treatments to alleviate existential distress. Although the two meta‐analyses featured in this special issue indicate the progress that has been made, many questions remain unresolved. We suggest how the field may move forward through defining a threshold for clinically significant existential distress, investigating its comorbidity with other psychiatric conditions, and inquiring into adjustment processes and mechanisms underlying change in existential interventions. We hope that this special issue may inspire progress in this promising area of research to improve recognition and management of a central psychological state in cancer care.
Bibliographie:SourceType-Scholarly Journals-1
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ObjectType-Editorial-2
ObjectType-Commentary-1
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ISSN:1057-9249
1099-1611
1099-1611
DOI:10.1002/pon.4872