Effects of Perception of Prognosis on Existential Well-Being and Ego-Integrity Among Advanced Cancer Patients
Journal Title: Palliative Medicine & Hospice Care – Open Journal - Year 2017, Vol 0, Issue 1
Abstract
Background: Based on literature review, advanced stage cancer patients hold over-optimistic perception of their prognosis. This phenomenon is presumed to be an implication of defense and coping mechanisms, aiming to alienate the proximity of death. At such circumstances, existential issues arise and when adaptive, serve as powerful psychological resources against distress and despair. The first purpose of the study was to investigate the influence of advanced stage Israeli cancer patients’ perception of prognosis on their existential well-being. The second purpose of the study was to explore the role of ego-integrity as a mediator within the equation of perception of prognosis and existential well-being. Methods: Two hundred and ten Israeli stage 4 cancer patients completed self-report measures of their perception of prognosis, ego-integrity and aspects of existential well-being: personal meaning, inter-personal meaning, death and dying anxiety, satisfaction with life and will-tolive. Results: Positive correlations were demonstrated between perception of prognosis with personal meaning, interpersonal meaning, total meaning satisfaction with life, will-to-live and egointegrity. In addition, negative correlations were demonstrated between perception of prognosis with death-anxiety and dying-anxiety. Perception of prognosis was found to be a predictor of existential well-being, so that the better the perception of prognosis the higher were satisfaction with life (β=0.39, p<0.01), will-to-live (β=0.12, p<0.05), total meaning (β=0.22, p<0.01), personal meaning (β=0.24, p<0.01), interpersonal meaning (β=0.13, p<0.05) and ego integrity (β=0.24, p<0.01). Furthermore, the better the perception of prognosis the lower was death anxiety (β =-.24, p<0.01). Moderating analyses revealed that only among patients low in egointegrity a positive association existed between perception of prognosis and personal meaning (β=0.30, p<0.05). Conclusions: The study highlights the significant effect of the perception of prognosis on existential well-being in advanced stage cancer patients. When death is imminent, an overestimation of prognosis has a role of preserving existential well-being. Also, ego integrity was found to be attributing for preserving existential well-being of people with terminal illnesses. In addition, the moderating effect of ego-integrity emphasizes its virtue as a source of resilience for the wholeness of the self at times of threat. A possible influence of cultural – ethnic attributes on results is discussed, thereby emphasizing the complexity of the argument, whether acknowledging one’s death has a positive or rather negative effect on one’s existential well-being.
Authors and Affiliations
Shirly Alon
Keywords
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- EP ID EP560850
- DOI 10.17140/PMHCOJ-SE-1-113
- Views 118
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