Background
Methods
Design
Study population
Measurement instrument: State-of-Suffering-V
Analysis of relationship between intensity of symptoms and unbearable suffering
Analysis of longitudinal data
Analysis of subjective descriptions of unbearable suffering
Category of suffering | Indications for assigning category |
---|---|
Physical | Medical morbidity, the physical symptom itself, physical symptoms which result in physical experienced suffering |
Loss of meaning | Loss of: identity, capacity of self-fulfillment, communication, social role, social interaction, intimacy |
Loss of autonomy | Suffering acknowledged to be caused by: loss of autonomous functioning or occurrence of dependency (presence itself of loss of autonomy or of dependency is not sufficient to assign the category) |
Loss of dignity | Socially embarrassing symptoms, shame, body image concerns, not being taken seriously, worthlessness |
Loss of sexual role | Loss of capability of sexual functioning; loss of sexual role |
Fear of future suffering | Fear caused by awareness of potential suffering related to progress of disease |
Anxiety | Anxiety |
Death anxiety | Anxiety related to awareness of the process of dying and what will go along with that, and anxiety related to the actual dying process |
Depressiveness | Suffering caused by the presence of depressive thoughts |
Worrying | Negative thoughts which cannot be turned off |
Feeling tensed | Feeling tensed in mind or body |
Hopelessness | Loss of possibility of meaning |
Pointlessness | Total loss of meaning; nothing left |
Results
Study sample
Symptom prevalence and unbearable suffering
Symptom present % *(n) | Symptom high intensity % *(n) | High intensity and unbearable % *(n) | Percentage unbearable when high intensity % | Symptom low intensity % *(n) | Low intensity and unbearable %(n) | Percentage unbearable when low intensity % | Symptom unbearable % *(n) | |
---|---|---|---|---|---|---|---|---|
Domain I: Medical symptoms
| ||||||||
Weakness | 93 (56) | 51 (31) | 43 (26) | 84 | 42 (25) | 14 (8) | 32 | 57 (34) |
Tiredness | 87 (52) | 48 (29) | 28 (17) | 59 | 39 (23) | 7 (4) | 17 | 35 (21) |
General discomfort | 80 (48) | 27 (16) | 17 (10) | 63 | 53 (32) | 20 (12) | 38 | 37 (22) |
Changed appearance | 78 (47) | 40 (24) | 20 (12) | 50 | 38 (23) | 2 (1) | 4 | 22 (13) |
Pain | 72 (43) | 20 (12) | 18 (11) | 92 | 52 (31) | 7 (4) | 13 | 25 (15) |
Loss of appetite | 62 (37) | 24 (14) | 10 (6) | 43 | 38 (23) | 15 (9) | 39 | 25 (15) |
Shortness of breath | 59 (35) | 17 (10) | 14 (8) | 80 | 42 (25) | 5 (3) | 12 | 19 (11) |
Impaired co-ordination | 57 (34) | 17 (10) | 13 (8) | 80 | 40 (24) | 5 (3) | 13 | 18 (11) |
Not sleeping well | 47 (28) | 12 (7) | 10 (6) | 86 | 35 (21) | 15 (9) | 43 | 25 (15) |
Thirst | 45 (27) | 18 (11) | 10 (6) | 55 | 27 (16) | 2 (1) | 6 | 12 (7) |
Feeling tensed | 44 (26) | 12 (7) | 10 (6) | 86 | 32 (19) | 2 (1) | 5 | 12 (7) |
Memory loss | 43 (26) | 12 (7) | 7 (4) | 57 | 32 (19) | 8 (5) | 26 | 15 (9) |
Impaired sight | 42 (25) | 5 (3) | 3 (2) | 67 | 37 (22) | 4 (2) | 9 | 7 (4) |
Impaired mental clarity | 42 (25) | 10 (6) | 5 (3) | 50 | 32 (19) | 7 (4) | 21 | 12 (7) |
Loss of concentration | 40 (24) | 13 (8) | 12 (7) | 88 | 27 (16) | 5 (3) | 19 | 17 (10) |
Coughing | 38 (23) | 2 (1) | 2 (1) | 100 | 36 (22) | 3 (2) | 9 | 5 (3) |
Swallow food impaired | 35 (21) | 7 (4) | 7 (4) | 100 | 28 (17) | 5 (3) | 18 | 12 (7) |
Smelling unpleasant | 35 (21) | 8 (5) | 8 (5) | 100 | 27 (16) | 3 (3) | 19 | 13 (8) |
Feeling depressed | 34 (20) | 3 (2) | 2 (1) | 50 | 31 (18) | 10 (6) | 33 | 12 (7) |
Impaired hearing | 33 (20) | 8 (5) | 7 (4) | 80 | 25 (15) | 8 (4) | 27 | 13 (8) |
Incomprehensible speech | 32 (19) | 14 (8) | 12 (7) | 88 | 18 (11) | 3 (2) | 18 | 15 (9) |
Itch | 32 (19) | 8 (5) | 5 (3) | 60 | 24 (14) | 2 (1) | 7 | 7 (4) |
Constipation | 30 (18) | 8 (5) | 8 (5) | 100 | 22 (13) | 4 (2) | 15 | 12 (7) |
Nausea | 28 (17) | 12 (7) | 8 (5) | 71 | 16 (10) | 5 (3) | 30 | 13 (8) |
Dizziness | 27 (16) | 5 (3) | 5 (3) | 100 | 22 (13) | 7 (4) | 31 | 12 (7) |
Vomiting | 27 (16) | 9 (5) | 7 (4) | 80 | 18 (11) | 13 (8) | 73 | 20 (12) |
Feeling anxious | 27 (16) | 5 (3) | 3 (2) | 67 | 22 (13) | 4 (2) | 15 | 7 (4) |
Swallowing fluid impaired | 23 (14) | 5 (3) | 5 (3) | 100 | 18 (11) | 2 (1) | 9 | 7 (4) |
Hiccups | 22 (13) | 7 (4) | 5 (3) | 75 | 15 (9) | 5 (3) | 33 | 10 (6) |
Intestinal cramps | 22 (13) | 5 (3) | 3 (2) | 67 | 17 (10) | 5 (3) | 30 | 8 (5) |
Diarrhea | 20 (12) | 3 (2) | 3 (2) | 100 | 17 (10) | 4 (2) | 20 | 7 (4) |
Incontinence of urine | 10 (6) | 0 (0) | 0 (0) | 0 | 10 (6) | 0 (0) | 0 | 0 (0) |
Incontinence of feces | 8 (5) | 2 (1) | 2 (1) | 100 | 6 (4) | 5 (3) | 75 | 7 (4) |
Pressure ulcers | 8 (5) | 2 (1) | 2 (1) | 100 | 6 (4) | 1 (1) | 25 | 3 (2) |
Impaired comprehension of speech | 7 (4) | 2 (1) | 2 (1) | 100 | 5 (3) | 1 (1) | 33 | 3 (2) |
Paralyzed limbs | 5 (3) | 2 (1) | 2 (1) | 100 | 3 (2) | 0 (0) | 0 | 2 (1) |
Skin metastasis | 3 (2) | 3 (2) | 2 (1) | 50 | 0 (0) | 0 (0) | 0 | 2 (1) |
Symptom present %*(n) | Symptom high intensity %* (n) | High intensity and unbearable %*(n) | Percentage unbearable when high intensity % | symptom low intensity %*(n) | Low intensity and unbearable %*(n) | Percentage unbearable when low intensity % | Symptom unbearable %*(n) | |
---|---|---|---|---|---|---|---|---|
Domain II: Loss of function
| ||||||||
Impaired routine daily activities | 83 (50) | 58 (35) | 48 (29) | 83 | 25 (15) | 7 (4) | 27 | 55 (33) |
Impaired leisure activities | 82 (49) | 60 (36) | 48 (29) | 81 | 22 (13) | 2 (1) | 8 | 50 (30) |
Help needed with housekeeping | 71 (42) | 54 (32) | 39 (23) | 72 | 17 (10) | 3 (2) | 20 | 42 (25) |
Help needed with self-care | 60 (36) | 27 (16) | 15 (9) | 56 | 33 (20) | 7 (4) | 20 | 22 (13) |
Bedridden | 56 (33) | 32 (19) | 24 (14) | 74 | 24 (14) | 8 (5) | 36 | 32 (19) |
Impaired working capacity | 17 (10) | 17 (10) | 12 (7) | 70 | 0 (0) | 0 (0) | 0 | 12 (7) |
Impaired sexual functioning | 14 (8) | 12 (7) | 5 (3) | 43 | 2 (1) | 0 (0) | 0 | 5 (3) |
Domain III: Personal aspects
| ||||||||
Feeling dependent on others | 80 (48) | 50 (30) | 37 (22) | 73 | 30 (18) | 8 (5) | 28 | 45 (27) |
Not able to do things you consider important | 63 (36) | 26 (15) | 23 (13) | 87 | 37 (21) | 19 (11) | 52 | 42 (24) |
Trouble accepting the present situation | 60 (36) | 30 (18) | 25 (15) | 83 | 30 (18) | 8 (5) | 28 | 33 (20) |
Feeling a nuisance to others | 38 (23) | 5 (3) | 3 (2) | 67 | 33 (20) | 10 (6) | 30 | 13 (8) |
Negative thoughts or worrying | 32 (19) | 12 (7) | 8 (5) | 71 | 20 (12) | 7 (4) | 33 | 15 (9) |
Loss of control over your own life | 30 (18) | 22 (13) | 20 (12) | 92 | 8 (5) | 7 (4) | 80 | 27 (16) |
Feeling not any longer being the same person | 28 (17) | 8 (5) | 8 (5) | 100 | 20 (12) | 2 (1) | 8 | 10 (6) |
Hopelessness | 28 (17) | 7 (4) | 7 (4) | 100 | 21 (13) | 6 (4) | 31 | 13 (8) |
Experienced little happiness with family/friends | 22 (13) | 5 (3) | 0 (0) | 0 | 17 (10) | 8 (5) | 50 | 8 (5) |
Feelings of worthlessness | 22 (13) | 10 (6) | 8 (5) | 83 | 12 (7) | 2 (1) | 14 | 10 (6) |
Feeling lonely (intrapersonal) | 20 (12) | 5 (3) | 3 (2) | 67 | 15 (9) | 7 (4) | 44 | 10 (6) |
Feeling of no longer being important to others | 18 (11) | 5 (3) | 5 (3) | 100 | 13 (8) | 3 (2) | 25 | 8 (5) |
Feeling tired of life | 17 (10) | 5 (3) | 5 (3) | 100 | 12 (7) | 4 (2) | 29 | 9 (5) |
Not satisfied with own self | 12 (7) | 5 (3) | 5 (3) | 100 | 7 (4) | 2 (1) | 25 | 7 (4) |
Feelings of guilt | 12 (7) | 2 (1) | 2 (1) | 100 | 10 (6) | 3 (2) | 33 | 5 (3) |
Experienced little success in life | 10 (6) | 2 (1) | 0 (0) | 0 | 8 (5) | 2 (1) | 20 | 2 (1) |
Lived a life with little purpose | 8 (5) | 0 (0) | 0 (0) | 0 | 8 (5) | 2 (2) | 40 | 3 (2) |
Domain IV: Environment
| ||||||||
Relatives consider your suffering too severe | 33 (19) | 10 (6) | 9 (5) | 83 | 23 (13) | 7 (4) | 31 | 16 (9) |
Practical loneliness (no one present for you) | 15 (9) | 8 (5) | 8 (5) | 100 | 7 (4) | 4 (2) | 50 | 12 (7) |
Insufficient availability of care | 12 (7) | 2 (1) | 0 (0) | 0 | 10 (6) | 8 (5) | 83 | 8 (5) |
Unsatisfactory social contacts | 8 (5) | 2 (1) | 2 (1) | 100 | 6 (4) | 1 (1) | 25 | 3 (2) |
Insufficient support (family, relatives) | 5 (3) | 0 (0) | 0 (0) | 0 | 5 (3) | 2 (1) | 33 | 2 (1) |
Shame | 2 (1) | 0 (0) | 0 (0) | 0 | 2 (1) | 2 (1) | 100 | 2 (1) |
Domain V: Nature and prognosis of disease
| ||||||||
Fear of future suffering | 40 (24) | 15 (9) | 14 (8) | 89 | 25 (15) | 3 (2) | 13 | 17 (10) |
Fear of future failing strength to bear suffering | 25 (15) | 8 (5) | 8 (5) | 100 | 17 (10) | 2 (1) | 10 | 10 (6) |
Intensity of symptoms in relationship to unbearability
Intensity of symptoms and unbearable suffering longitudinally
Symptom in high intensity† | Symptom unbearable† | |||||
---|---|---|---|---|---|---|
Pre-final interview % (n) | Final interview % (n) | Difference pre-final and final interview % (95% CI) ‡ | Pre-final interview % (n) | Final interview % (n) | Difference pre-final and final interview % (95% CI) ‡ | |
Domain I: Medical symptoms
| ||||||
Weakness | 36 (12) | 55(18) | −18 (−29 to 3) | 33 (11) | 64(21) |
−30 (−41 to −6)
|
General discomfort | 9 (3) | 27(9) |
−18 (−19 to −1)
| 25 (8) | 42(14) | - 16 (−33 to 9) |
Tiredness | 39 (13) | 55(18) | −15 (−29 to 7) | 42 (14) | 42(14) | 0 (−16 to 16) |
Loss of appetite | 27 (9) | 18(6) | 9 (−11 to 23) | 27 (9) | 36(12) | −9 (−26 to 13) |
Pain | 24 (8) | 21(7) | 3 (−11 to 14) | 24 (8) | 27(9) | −3 (−20 to 16) |
Not sleeping well | 12 (4) | 6(2) | 6 (−10 to 17) | 9 (3) | 24(8) | −15 (−26 to 5) |
Changed appearance | 30 (10) | 42(14) | −12 (−29 to 11) | 30 (10) | 24(8) | 6 (−12 to20) |
Shortness of breath | 6 (2) | 21(7) | −15 (−15 to 0) | 12 (4) | 21(7) | −9 (−23 to 11) |
Vomiting | 3 (1) | 12(4) | −9 (−9 to 4) | 9 (3) | 18(6) | −9 (−15 to 7) |
Impaired co-ordination | 12 (4) | 12(4) | 0 (−14 to 14) | 24 (8) | 18(6) | 6 (−16 to 25) |
Loss of concentration | 21 (7) | 9(3) | 12 (−5 to 18) | 16 (5) | 18(6) | −3 (−18 to 14) |
Memory loss | 15 (5) | 9(3) | 6 (−7 to 12) | 19 (6) | 18(6) | 0 (−11 to 11) |
Incomprehensible speech | 3 (1) | 12(4) | −9 (−15 to 7) | 9 (3) | 9(3) | 0 (−11 to 11) |
Domain II: Loss of function
| ||||||
Impaired routine daily activities | 49 (16) | 67(22) | −18 (−35 to 7) | 55 (18) | 61(20) | −6 (−27 to 18) |
Impaired leisure activities | 49 (16) | 64(21) | −15 (−26 to 5) | 42 (14) | 52(17) | −9 (−15 to 6) |
Help needed with housekeeping | 39 (13) | 55(18) | −15 (−29 to 7) | 42 (14) | 39(13) | 3 (−16 to 10) |
Bedridden | 12 (4) | 36(12) |
−24 (−30 to −5)
| 18 (6) | 36(12) | −18 (−24 to 1) |
Help needed with self-care | 6 (2) | 27(9) |
−21 (−27 to −1)
| 15 (5) | 30(10) | −15 (−25 to 5) |
Domain III: Personal aspects
| ||||||
Not able to do important things | 39 (13) | 31(10) | 9 (−11 to 24) | 39 (13) | 55(18) | −15 (−26 to 5) |
Feeling dependant on others | 33 (11) | 55(18) | −21 (−32 to 1) | 39 (13) | 52(17) | −11 (−23 to 8) |
Trouble accepting situation | 21 (7) | 36(12) | −15 (−26 to 5) | 27 (9) | 39(13) | −12 (−26 to 9) |
Loss of control over own life | 9 (3) | 21(7) | −12 (−23 to 7) | 16 (5) | 30(10) | −13 (−23 to 8) |
Negative thoughts or worrying | 12 (4) | 16(5) | −3 (−14 to 11) | 18 (6) | 18(6) | 0 (−17 to 17) |
Domain IV: Environment
| ||||||
Relatives: suffering to severe | 9 (3) | 9(3) | 0** | 12 (4) | 15(5) | −3 (−9 to 7) |
Domain V: Nature and prognosis of disease
| ||||||
Fear of future suffering | 9 (3) | 12(4) | −3 (−14 to 11) | 13 (4) | 12(4) | 0 (−11 to 11) |
Overall unbearable suffering | 13 (4) | 33(11) | −20 (−27 to 1) |
The nature of suffering: analysis of the qualitative data
General discomfort: | You just feel miserable, it feels like a sort of flue, you don’t fancy doing anything, you only want to lie in bed |
Tired: | I hardly can do anything, it is nearly impossible to explain it in words, I never imagined a person could be so tired |
Weakness: | My right leg is to weakened, it is not safe to stand and so for weeks I lie in my bed all the time and only come out for the latrine chair |
Not sleeping well: | There is the noise at night on the streets, ambulances passing by, and this screaming neighbor woman, who keeps the whole neighborhood awake |
Pain: | I have pain all day, it occupies my mind, there is little distraction |
Loss of appetite: | I can hardly any more enjoy the taste of food, I long for the flavor of a fine stew |
Thirst: | My mouth is dry, I need to drink, but this makes me nauseous |
Smelling unpleasant: | I hate this urine smell |
Changed appearance: | I used to be vain, now I have become so thin, I find it ugly looking at my neck |
Impaired mental clarity: | I think about something, and then it’s gone, I find that stupid, for instance when I am one my way to fetch something |
Concentration loss: | My mind loses its way, I find this unpleasant |
Memory loss: | I used to remember all by mind, because I am illiterate |
Feel tense: | I try to control it, for the children |
Feel depressed: | This depressed mood in itself is unpleasant; at the same time it grows, because my daughter is doing less well |
Feel anxious: | I feel afraid for what will come and worry about how things will go on for my wife |
Shortness of breath: | Even with only slight activity I have a sort of hyperventilation, which makes me anxious |
Coughing: | When in public, than this phlegm comes out in my handkerchief, it’s very annoying |
Obstruction to swallow food: | I need to feed myself to prevent becoming even more weakened, but the passage of food is deranged |
Obstruction to swallow fluid: | I swallow, but it doesn’t pass, it makes me retch |
Nausea | I am nauseous continuously, I feel completely fed up with it |
Vomiting: | When I sit at the table, it suddenly comes up and I need to run for the bathroom |
Constipation: | It hurts and is strenuous |
Diarrhea: | You are dining out in a hotel and then you continuously need to go to the toilet |
Intestinal cramps: | These cramps are painful, it is very unpleasant |
Incontinence of urine: | X (no high scores in ultimate interview) |
Incontinence of feces: | It is filthy |
Hiccups: | It comes sudden and unexpected, it makes me feel uncivilized and ashamed |
Pressure ulcers: | It is annoying |
Itch: | You keep on scratching |
Skin metastasis: | In my neck, after radiotherapy it turned yellow, with an unpleasant look, it smells |
Paralyzed limbs: | I can’t do anything, my left leg is paralyzed and my arm is forceless |
Impaired coordination: | These unpredictable cramps and shaking of an arm or a leg, I cannot stop it |
Incomprehensible speech: | I cannot communicate by telephone, people don’t understand what I am saying |
Impaired comprehension of speech: | It makes me feel stupid |
Dizziness: | Sometimes it is frightening, one time it happened when my alarm-button was out of reach and it took a whole long time before anybody entered and took notice |
Impaired sight: | It annoys me so much, it is caused by the medication |
Impaired hearing: | If some people talk at the same time I cannot differentiate what is being said |
Impaired working capacity: | I am already counted out in society |
Impaired in routine daily activities: | I am not the crying type, but this week I suddenly started crying |
Impaired leisure activities: | I used to go out, make bus trips, I miss it, but absolutely can’t do it anymore. And I can’t any more receive people at my home, I am to exhausted |
Need help with housekeeping: | Being young and not capable to function independently, it feels so unnatural |
Need help with self-care: | I don’t want these young maidens of the home care service, it makes me feel ashamed |
Pedridden: | More and more you are drawn to that bed, it makes you realize you are deteriorating |
Restricted sexual functioning: | Widower: I feel rejected by my present partner, there is no intimacy, it is so cold |
Not satisfied with own self: | I just left my wife, she had done nothing wrong, life than takes a course, leaving impossible to restore the situation |
Lived a life with little purpose: | With my first wife everything was fine, the last years I miss love and tenderness |
Experienced little success in life: | I would have liked to be at a somewhat higher level in society, for instance I would have liked to study, I would do it differently if I could do it again |
Little happiness with family/close ones: | I would have preferred things to be different, I haven’t seen my children for 18 years |
Trouble accepting situation: | I can no longer play Chopin, or make a drawing |
Negative thoughts or worrying: | I would have liked to do things differently, at night it appears in my dreams |
Feelings of guilt: | I feel guilt I wanted to divorce from my wife the other year, she is the one who makes I am still living now, she does everything for me |
Feel worthless: | There is no more appreciation, people talk about you and not with you |
Feel lonely: | One has cancer, it is not contagious, but people pass by less frequently |
Feel hopeless: | This is not what I want |
No longer feel the same person: | Is this the same body? Yet I have to manage with it, which causes me trouble |
Feel tired of life: | I prefer it to be over as soon as possible, I used to be very active and independent and now I am totally passive and dependant |
Feel dependant of others: | Ones individuality is lost, one has no more privacy |
Feeling loss of control of life: | Tears in the eyes, gives no answer |
Feeling a nuisance to others: | In relation to being so dependant I now easily tend to think “Oh, just leave it” |
Feel unimportant to others: | My daughter, she is very sick and I can’t do anything for her |
Impossible to do important things: | I used to daily visit my wife in a nursing-home, I can’t do it any longer |
Not supported sufficiently by close ones: | The physical support is O.K., but there is emotional shortage |
Lonely (important people absent): | I have one son, he does not visit me |
Feelings of shame: | I have these outburst directed at my own person, which I find alarming, than this tic of my jaw appears and I wonder whether I can appear this way in church |
Relatives consider your suffering severe: | It makes it difficult to start a conversation |
Unsatisfactory contact with close ones: | They don’t keep stand up to their promises, for instance my daughter promises to visit me next week, I look forward to see her and then she shows up 1,5 years later |
Insufficient availability of care: | I find the home care miserable |
Fear of future suffering: | I feel short of breath, I am afraid to suffocate |
Fear losing strength to bear the suffering: | To die, would it be painful? |
Personal additions of missing aspects: | The hospice refused me last week, they considered me too good and advised a nursing home |
Symptom | Description of unbearability by patient | Rated category |
---|---|---|
Tired? | I hardly can do anything, it is nearly impossible to explain it in words. I never imagined a person could be so tired | Physical |
Lonely (important people absent)? | I have one son, he does not visit me | Loss of meaning |
Feel dependant on others? | I used to be very independent, and do all myself. Now I need to ask for everything, or wait. | Loss of autonomy |
Hiccups? | It comes sudden and unexpected, it makes me feel uncivilized and ashamed | Loss of dignity |
Feel to be a burden to others? | My husband, he needs to care for me continuously | Burden to others |
Restricted sexual functioning? | It is gone, it is in pieces, not only for myself, but also for my wife | Loss of sexual role |
Fear of future suffering? | I am in fear of suffering pain, that the pain will be unbearable | Fear of suffering |
Nausea? | I feel panic. Am I going to vomit? Is it going to be difficult to breathe? Is it going to happen when I am eating? | Anxiety |
Fear of future suffering? | I am frightened to suffocate | Death anxiety |
Feel depressed? | This depressed mood in itself is unpleasant, at the same time it grows, because my daughter is doing less well | Depressive thoughts |
Negative thoughts, worrying? | It haunts my mind all day: dissemination of cancer to my liver, 2 to 3 months to live. An operation? Other possibilities? | Worrying |
Feel tensed? | To be able to be more relaxed would help me; now it makes me lose much energy | Feeling tensed |
Hopelessness? | To take up a piece of paper , I can’t manage it, I cannot stand it | Hopelessness |
Trouble accepting present situation? | The fact that it is as it is, to look it in the face. It is over, I am just waiting | Pointlessness |
Overall unbearable suffering (n = 16) | Overall bearable suffering (n = 41) | ||||
---|---|---|---|---|---|
Categories of suffering | Category present in patients % (n) | Mean number in which category is present per patient Mean (stdev) | Category present in patients % (n) | Mean number in which category is present per patient Mean (stdev) | p-value of t-test for means |
Physical suffering | 100 (16) | 4.0 (2.1) | 61 (25) | 2.1 (2.4) | 0.008 |
Loss of meaning | 88 (14) | 3.6 (3.3) | 63 (26) | 2.0 (2.1) | 0.027 |
Loss of autonomy | 88 (14) | 3.1 (2.2) | 44 (18) | 2.2 (1.6) | 0.003 |
Loss of dignity | 56 (9) | 1.1 (1.5) | 32 (13) | 0,5 (0.9) | 0.064 |
Experience to be a burden to others | 56 (9) | 0.7 (0.7) | 17 (7) | 0.2 (0.5) | 0.025 |
Loss of sexual role | 6 (1) | 0.1 (0.3) | 2 (1) | 0.02 (0.2) | 0.491 |
Fear of future suffering | 44 (7) | 0.8 (0.9) | 5 (2) | 0.04 (0.2) | 0.009 |
Anxiety | 31 (5) | 0.6 (1.2) | 7 (3) | 0.1 (1.3) | 0.089 |
Death anxiety | 6 (1) | 0.1 (0.5) | 0 (0) | 0.0 (0.0 | 0.333 |
Depressive thoughts | 19 (3) | 0.2 (0.4) | 2 (1) | 0.02 (0.2) | 0.134 |
Worrying | 44 (7) | 0.5 (0.6) | 5 (2) | 0.1 (0.3) | 0.020 |
Feeling tensed | 13 (2) | 0.1 (0.3) | 5 (2) | 0.05 (0.2) | 0.417 |
Hopelessness | 19 (3) | 0.2 (0.4) | 2 (1) | 0.02 (0.2) | 0.134 |
Pointlessness | 13 (2) | 0.4 (1.1) | 2 (1) | 0.4 (0.5) | 0.299 |
Emotional symptoms | 75 (12) | 2.1 (2.6) | 20 (8) | 0.3 (0.8) | 0.014 |