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Detrimental social interactions predict loss of dignity among patients with cancer

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Abstract

Purpose

This prospective study aimed to determine the extent to which cancer patients experience loss of dignity during primary cancer care (baseline) and at 3-month follow-up and the contribution of positive social support and detrimental social interactions on loss of dignity at follow-up.

Methods

At baseline, we enrolled N = 270 cancer patients (advanced cancer 57 %) undergoing oncological treatment. At follow-up, n = 178 patients (72 %) participated. Patients completed the following questionnaires: sense of dignity item (SDI), physical problem list of the NCCN Distress Thermometer, Illness-Specific Social Support Scale (SSUK), Patient Health Questionnaire (PHQ-9), and Generalized Anxiety Disorder Questionnaire (GAD-7). We conducted ordinal regression analyses controlling for age, gender, tumor stage, number of physical symptoms, depression, and anxiety.

Results

At baseline, 18 % of the patients experienced moderate to extreme loss of dignity (follow-up 23 %, p = 0.27). Detrimental interactions significantly predicted loss of dignity (OR = 1.42, 95 % CI 1.06–1.90) in a model including positive support (OR = 1.10, 95 % CI 0.82–1.49), depression (OR = 1.55, 95 % CI 0.96–2.51), and anxiety (OR = 1.20, 95 % CI 0.83–1.74). Items in relation to detrimental interactions with significant others such as “made you feel like you couldn’t take care of yourself” (r = 0.29, p < 0.001) and “felt uncomfortable in illness conversations” (r = 0.24, p = 0.002) showed the highest associations with perceived loss of dignity.

Conclusion

Loss of dignity was a frequent problem in our mixed cancer patient sample. Detrimental interactions that weaken the sense of dignity may result from discrepancies with patients’ needs for autonomy and security. Tailoring social support to attachment-related patient needs may help to conserve patients’ sense of dignity.

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Acknowledgments

This research has been supported by a grant from the Barbara and Michael Hell Stiftung in Hamburg, Germany.

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Authors and Affiliations

  1. Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistr. 52-W26, 20246, Hamburg, Germany

    R. Philipp, C. Lehmann & S. Vehling

  2. Department of Medical Psychology and Medical Sociology, Division of Psychosocial Oncology, University Medical Center Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany

    A. Mehnert

  3. Department of Oncology, Hematology and Bone Marrow Transplantation with section of Pneumology, University Medical Center Hamburg-Eppendorf, Martinistr. 52-O24, 20246, Hamburg, Germany

    K. Oechsle & C. Bokemeyer

  4. University Cancer Center Hamburg (UCCH)—Hubertus Wald Tumor Center, University Medical Center Hamburg-Eppendorf, Martinistr. 52-O24, 20246, Hamburg, Germany

    K. Oechsle, C. Bokemeyer & A. Krüll

  5. Department of Radiotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52-O26, 20246, Hamburg, Germany

    A. Krüll

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  1. R. Philipp
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Correspondence to R. Philipp.

Ethics declarations

The study was approved by the local research ethics committee. All participating patients provided written informed consent.

Conflict of interest

The authors declare that they have no competing interests.

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Philipp, R., Mehnert, A., Lehmann, C. et al. Detrimental social interactions predict loss of dignity among patients with cancer. Support Care Cancer 24, 2751–2758 (2016). https://doi.org/10.1007/s00520-016-3090-9

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  • DOI: https://doi.org/10.1007/s00520-016-3090-9

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