Death-related anxiety in patients with advanced cancer: validation of the German version of the Death and Dying Distress Scale

Journal Publication ResearchOnline@JCU
Engelmann, Dorit;Scheffold, Katharina;Friedrich, Michael;Hartung, Tim J.;Schulz-Kindermann, Frank;Lordick, Florian;Schilling, Georgia;Lo, Chris;Rodin, Gary;Mehnert, Anja
Abstract

Context: Distress and anxiety about issues related to death and dying is commonly experienced in patients with advanced disease and a limited life expectancy. Objectives: To evaluate the psychometric properties of the German version of the Death and Dying Distress Scale (DADDS-G) in advanced cancer patients. Methods: We recruited advanced patients with mixed tumor entities (Union for International Cancer Control [UICC] Stage III/IV) treated in two German University Medical Centers during their outpatient treatment. After testing a preliminary version of the state-of-the-art translated original Death and Dying Distress Scale, we analyzed the psychometric properties of the shortened nine-item adapted DADDS-G using validated instruments measuring distress, anxiety, depression, fear of progression, and quality of life. Results: We obtained complete questionnaires from 77 of 93 patients with advanced cancer (response rate: 83%). Participants were mostly married or cohabiting (75%), well-educated, and both sexes were almost equally represented (52% men; mean age 58 years, SD = 12). The total mean DADDS-G score was 13.3 (SD = 8.5). Patients reported to be most distressed by the feeling of being a burden to others. The exploratory factor analysis led to one factor that accounted for more than 59% of the variance. The DADDS-G's internal consistency was excellent with Cronbach alpha = 0.91. The confirmatory factor analysis demonstrated a very good model fit. Death-related anxiety was significantly associated with distress, depression, anxiety, fear of progression, and lower quality of life (P < 0.001). Conclusion: Results provide further evidence that the DADDS-G is a valid and reliable instrument of high clinical relevance for use in patients with advanced cancer.

Journal

Journal of Pain and Symptom Management

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52

ISBN/ISSN

1873-6513

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Issue

4

Pages Count

6

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Publisher

Elsevier Science Inc

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DOI

10.1016/j.jpainsymman.2016.07.002