Dignity and its influencing factors in patients with cancer in North China: a cross-sectional study.

Abstract

Patients with cancer experience various levels of loss of dignity. Exploring levels of loss of dignity and the factors that influence such losses for patients with cancer is rare, but important in palliative care in China. Participants were cancer patients with early and advanced cancer recruited from a tertiary cancer hospital in North China. Patients were surveyed to assess their level of loss of dignity and potentially relevant factors. Data were collected using the Patient Dignity Inventory, the MD Anderson Symptom Inventory-Chinese, the distress thermometer, the Hospital Anxiety and Depression Scale, and the 30-question core Quality of Life Questionnaire from the European Organisation for Research and Treatment of Cancer, and were analyzed using quantitative methods. The study included 202 cancer patients, 143 of whom experienced mild loss of dignity (71%); 37, moderate loss of dignity (18%); and 10, severe loss of dignity (5%). The problems with dignity were slightly different in patients with early-stage disease than in those with advanced-stage disease. Loss of dignity in the patients was significantly correlated with psychological distress, symptom burden, and quality of life (p < 0.05). Logistic regression showed that age, Karnofsky performance status, anxiety, and symptom burden were significant predictors of loss of dignity. Most patients with early and advanced cancer experienced some level of loss of dignity. Loss of dignity was more likely for patients of younger age, high Karnofsky performance status, high symptom burden, and anxiety. Understanding the dignity of cancer patients and potentially relevant factors is of great value for implementing comprehensive palliative care in China.