Open Communication With Oncologists Can Help Patients Feel Dignified

Patients felt less demoralized when communication with their oncologists improved, research showed.

Certain characteristics in patients with cancer were associated with a perceived loss of dignity throughout the treatment continuum, according to research published in the journal, Asian Nursing Research.

“Dignity is a basic human right that is related to psychosocial distress factors in patients with cancer, such as depression and demoralization,” the authors wrote.

The researchers analyzed data from 267 patients with cancer who filled out the Patient Dignity Inventory Mandarin version, which measures sources of dignity-related distress at the end of life; the Demoralization Scale Mandarin Version, which measures existential distress in patients with cancer; and the Patient Health Questionnaire-9, which is used to screen, diagnose, monitor and measure depression.

Findings showed that age, demoralization and depression all tended to have an impact on dignity. Specifically, patients aged 65 years or older had “significant dignity-related issues.” This was in line with prior research which showed that older patients may be more likely to perceive themselves as having little or nothing to contribute to society and are unvalued if they have serious health issues.

“It is therefore crucial to maintain the dignity of elderly patients with cancer in health care settings, be it through the health care professionals paying attention to their language, attitude and behaviors, or the environments and facilities,” the researchers wrote. “The key is to ensure that the elderly patients with cancer feel valued and recognized and see their life as meaningful.”

Prior research presented at the 2023 Annual American Psychosocial Oncology Society Conference found that predictors of anxiety and depression in older patients with metastatic cancer included:

• Concerns about body image and healthy lifestyle
• Intimacy and relationships
• Communication with the health care team

The data also showed that patients who were experiencing demoralization or depression were more likely to feel decreased dignity.

“We hope that the (Patient Dignity Inventory) can be used to detect early signs of dignity-related issues in patients with cancer and also be applied as a preventive screening tool for psychological distress,” the authors wrote.

READ MORE: Psychological Distress in Patients with Cancer Leads to Slower Time Until Treatment

According to the study authors, characteristics of being demoralized include feeling incapable, helpless, having a sense of failure or feeling like an outcast. They cited prior research published in the Journal of Pain Symptom Management which showed that approximately 10% to 18% of patients with cancer feel demoralized.

The researchers concluded that open patient-provider communication will not only help screen patients for feelings of decreased dignity and increased depression but can also help mitigate those issues as well. For example, not only can these discussions lead to patients getting the professional mental health help that they need, but open conversations can help patients better understand their disease, treatment and prognosis, thereby decreasing fear of the unknown — something that is a major source of anxiety, according to the researchers.

“Health care professionals could use the PDI-MV to routinely monitor dignity changes in patients with cancer, understand how they view dignity and dignity-related distress, encourage them to speak out regarding their personal views, and provide suitable care measures based on local backgrounds and cultural habits,” the authors wrote. “This will increase dignity in patients, alleviate dignity-related distress, and reduce adverse outcomes.”

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