[This corrects the article DOI: 10.1016/j.apjon.2021.12.017.].

This study aimed to investigate death anxiety in advanced cancer patients and identify associated factors in the context of Chinese culture. Participants (N = 270) with advanced cancer in a tertiary cancer hospital completed anonymous questionnaire surveys. Measures included the Chinese version of a Likert-type Templer-Death Anxiety Scale, Rosenberg’s Self-esteem Scale, Medical Coping Modes Questionnaire, the Social Support Rating Scale, and Connor-Davidson Resilience Scale. Data were analyzed in SPSS using descriptive statistics, Student’s t test, Pearson correlation test, and linear regression. Respondents returned 252 (93.33%) of the 270 questionnaires. The total CL-TDAS score was 39.56 ± 10.20. The top three items were “I fear dying a painful death” (3.59 ± 1.41), “I often think about how shortly life really is” (3.11 ± 1.33), and “1 am not particularly afraid of getting cancer” (3.09 ± 1.35). Associated factors of death anxiety (R2 = .333, F = 15.756, p < .001) were the medical coping mode (resignation, confronce), self-esteem, the participants’ adult children, the patient-primary caregivers’ relationship, resilience, and the level of activity of daily living. Our results demonstrate high levels of death anxiety in advanced cancer patients. Generally, patients with adult children, high self-esteem and resilience had low death anxiety. Conversely, patients with low levels of activity of daily living and high coping mode (resignation, confrontation) reported high death anxiety. We determined that associated factors contributed to reduce death anxiety. Social interventions are recommended to improve the end-of-life transition for patients and caregivers.

Objective:The aim of this study was to evaluate the effects of whole process management model interventions based on information system benefits reported by patients with cancer pain. Methods:We performed a quantitative, prospective nonrandomized controlled design from June to October 2020. A total of 124 cancer patients with pain were enrolled. Patients in the experimental group received a whole process management model intervention based on an information system compared to the control group who received routine cancer pain management. Data were collected at baseline and after a four-week follow-up, acting as a test-retest control. The primary outcome was pain management quality, which was measured using the American Pain Society Patient Outcome Questionnaire-Chinese version (APS-POQ-C). Secondary outcomes were patient-related attitudinal barriers and analgesic adherence. The Barrier Questionnaire (BQ) and a single-item questionnaire were used. Chi-square tests were used to compare the pain intensity and analgesic adherence, independent sample t-test and Mann-Whitney U test were performed to test the differences in the pain management quality and patient-related attitudinal barriers between control and experimental groups. Results:Baseline characteristics and outcomes of the participants did not differ significantly (P ​> ​0.05). Primary outcomes were changes in four aspect of the quality of pain management (APS-POQ-C) between the two groups (P ​< ​0.05). Patients in the whole process management group reported significantly better pain control and perception of care than the control group. With respect to secondary endpoints, a significant difference in favor of the experimental group was found for barriers (P ​< ​0.05) and medication adherence (60.0% vs. 40.0%; P ​< ​0.05) after the interventions. Conclusions:The whole process management of patients with cancer pain effectively improves patient-reported quality of pain management, reduces patient-perceived barriers, enhances patient adherence to analgesic drugs and is worthy of clinical application.

Objective:To explore the mediating effect of medical coping style on psychological resilience and death anxiety in cancer patients.Methods:Using the convenient sampling method, a total of 330 inpatients from 2 cancer hospitals in Beijing were selected as the research objects from June to August 2020. The general information questionnaire, Chinese Version of Templer 's Death Anxiety Scale (C-T-DAS) , Medical Coping Modes Questionnaire (MCMQ) and the Connor-Davidson Resilience Scale (CD-RISC) were used to investigate them. Pearson correlation analysis and multiple linear regression were used to analyze the relationship between death anxiety, medical coping style and psychological resilience in cancer patients. AMOS 21.0 was used to establish the structural equation model and verify the mediation effect. A total of 330 questionnaires were sent out in this study, and 302 were effectively received, with the effective recovery of 91.5%. Results:The score of Chinese Version of Templer's Death Anxiety Scale for 302 cancer patients was (40.12±10.23) , the score of Connor-Davidson Resilience Scale was (70.97±13.43) and the scores of confrontation, avoidance and resighation dimension of Medical Coping Modes Questionnaire were (18.80 ±3.65) , (15.64±3.16) and (8.75±2.84) . The psychological resilience of cancer patients was negatively correlated with death anxiety and the resignation dimension in medical coping styles ( P<0.01) , and positively correlated with the facing and avoiding dimensions in medical coping styles ( P<0.05) . The face and yield dimensions in the medical coping style of cancer patients were positively correlated with death anxiety ( P<0.05) . Medical coping styles played a partial mediating role between psychological resilience and death anxiety, and the mediating effect accounted for 32.47% of the total effect. Conclusions:Clinical medical staff should pay attention to the death anxiety of cancer patients, improve their psychological resilience and encourage patients to actively cope with the disease, so as to reduce their death anxiety level and promote mental health.

This study aimed to develop a model that specifies the predictive effects of factors on death anxiety among Chinese patients with cancer using structural equation modeling. Using convenience sampling, data were collected from 353 cancer patients. Self-administered questionnaires included Social Support Rating Scale, Rosenberg Self-Esteem Scale, Connor Davidson Resilience Scale, Templer’s Death Anxiety Scale, and socio-demographic factors. The results showed that social support, self-esteem, and resilience significantly impacted death anxiety. The final model fitted the data acceptably (χ2 = 37.319, df =31, p = 0.201). Social support mediated death anxiety through self-esteem and resilience. Resilience mediated the buffer effect of self-esteem on death anxiety as an intermediary factor. Findings suggest the need for further studies to explore effective interventions to provide social support and improve self-esteem and resilience among patients with cancer to alleviate death anxiety.

目的:探讨晚期肿瘤患者心理弹性水平并分析其与应对方式、社会支持的相关性,为探讨提高晚期肿瘤患者心理弹性的干预措施提供依据.方法:采用横断面、便利抽样的设计方法,采用一般资料调查表、心理弹性量表(CD-RISC)、医学应对问卷(MCMQ)、社会支持量表对244例晚期肿瘤患者进行问卷调查.结果:晚期肿瘤患者CD-RISC总分为(71.23±13.64)分,处于较高水平;在应对方式中面对维度、回避维度与心理弹性呈正相关(r=0.153,r=0.242,P<0.05),屈服维度与心理弹性呈负相关(r=-0.375,P<0.01);社会支持3个维度均与心理弹性呈正相关(P<0.05).多元线性回归结果显示,在控制人口学资料的情况下,晚期肿瘤患者应对中回避维度和屈服维度是心理弹性的主要影响因素,共解释变异变量的22.7％(F=17.558,P<0.001).结论:临床医护人员应关注晚期肿瘤患者的医学应对方式、社会支持对其心理弹性水平的影响,提高社会支持与积极应对的能力,进一步提高晚期肿瘤患者的心理弹性.