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J Pain Symptom Manage · Oct 2016
Death-related anxiety in patients with advanced cancer: Validation of the German version of the Death and Dying Distress Scale (DADDS-G).
- Dorit Engelmann, Katharina Scheffold, Michael Friedrich, Tim J Hartung, Frank Schulz-Kindermann, Florian Lordick, Georgia Schilling, Chris Lo, Gary Rodin, and Anja Mehnert.
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany.
- J Pain Symptom Manage. 2016 Oct 1; 52 (4): 582-587.
ContextDistress and anxiety about issues related to death and dying is commonly experienced in patients with advanced disease and a limited life expectancy.ObjectivesTo evaluate the psychometric properties of the German version of the Death and Dying Distress Scale (DADDS-G) in advanced cancer patients.MethodsWe recruited advanced patients with mixed tumor entities (Union for International Cancer Control [UICC] Stage III/IV) treated in two German University Medical Centers during their outpatient treatment. After testing a preliminary version of the state-of-the-art translated original Death and Dying Distress Scale, we analyzed the psychometric properties of the shortened nine-item adapted DADDS-G using validated instruments measuring distress, anxiety, depression, fear of progression, and quality of life.ResultsWe obtained complete questionnaires from 77 of 93 patients with advanced cancer (response rate: 83%). Participants were mostly married or cohabiting (75%), well-educated, and both sexes were almost equally represented (52% men; mean age 58 years, SD = 12). The total mean DADDS-G score was 13.3 (SD = 8.5). Patients reported to be most distressed by the feeling of being a burden to others. The exploratory factor analysis led to one factor that accounted for more than 59% of the variance. The DADDS-G's internal consistency was excellent with Cronbach alpha = 0.91. The confirmatory factor analysis demonstrated a very good model fit. Death-related anxiety was significantly associated with distress, depression, anxiety, fear of progression, and lower quality of life (P < 0.001).ConclusionResults provide further evidence that the DADDS-G is a valid and reliable instrument of high clinical relevance for use in patients with advanced cancer.Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
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