Existential distress and associated factors in advanced cancer patients: A cross-sectional study

Background. Advanced cancer patients often experience existential distress (ED). However, the factors associated with ED remain unclear. This study investigated the current state of ED and identified the associated factors in Chinese patients with advanced cancer. Methods. A cross-sectional study was conducted among 352 advanced cancer patients from 3 tertiary hospitals in Fujian, China. Participants were invited to complete the Existential Distress Scale, Number Rating Scale, Self-Perceived Burden Scale, Quality of Life Concerns in the End-of-Life Questionnaire, and Hospital Anxiety and Depression Scale. Objectives. This study aimed to investigate the level of existential distress among advanced cancer patients in China and identify the associated factors. Results. A total of 352 advanced cancer patients were recruited for this study. The average score for ED was 8.48 +/- 7.12 among the advanced cancer patients. Multiple regression showed that the associated factors included depression (beta = 0.32, p = 0.000), self-perceived burden (SPB) (beta = 0.18, p = 0.001), the presence of a spouse (beta = -0.10, p = 0.050), and reception of government subsidies (beta = 0.17, p = 0.001). The factors accounted for 30.1% of the total variance in ED (F = 8.472, p < 0.001). Significance of results. Among the advanced cancer patients queried, ED was found to be positively influenced by depression, SPB, and reception of government subsidies and negatively influenced by the presence of a spouse. Depression was the most important risk factor, and thus future ED interventions should target depression.