Understanding psychosocial wellbeing and concern for death and dying: Insights from a psycho-oncology clinic.

Abstract

11105 Background: Patients with cancer face burden of mental health symptoms and an ongoing concern for death and dying. The psycho-oncology clinic aims to address these concerns by integrating mental health services into cancer care. This study evaluates key domains of psychosocial health and their relationship with mortality salience. Methods: Data from 60 patients treated at a psycho-oncology clinic were analyzed. Demographics, cancer site, disease stage (localized vs. metastatic), treatment status, and psychiatric diagnoses were collected. Outcomes were assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS) Short Forms, including measures of Emotional Distress (Anxiety, Depression, Social Isolation), Meaning and Purpose, Psychosocial Illness Impact (Negative and Positive), and Concern for Death and Dying. Descriptive and univariate regression analyses explored cohort trends. Results: Among the 60 patients, the mean age was 63 years (SD=14.8), with 52.2% identifying as female, 45.5% as male, and 2.3% as non-binary. The most common primary cancer sites were lung (20.5%), breast (18.2%), and multiple myeloma (9.1%). Of the patients, 61.4% had localized disease, while 38.6% had metastatic disease. A significant proportion (79.6%) were undergoing active treatment. Calculated t-scores demonstrate that concern for death and dying was more than two standard deviations above the population mean while meaning and purpose was lower. Metastatic disease, higher levels of anxiety, depression, negative psychosocial illness impact, and a lower sense of meaning and purpose were all associated with greater concern for death and dying. Conclusions: This study highlights the high prevalence of concern for death and dying in patients who are referred to a psychosocial oncology clinic and its association with key psychological variables for which there are standard treatments. PROMIS measures offer valuable insights, underscoring the importance of comprehensive psychosocial assessments. Tailored interventions targeting emotional distress, meaning, and end-of-life concerns may improve patient outcomes. Variables Mean (SD) Calculated t-score* [SE] Regression Death & Dying Concern 25.2 (8.5) 71 [3.5] 95% CI p-value Age 63 (14.8) - (-0.1-0.22) .48 Localized vs Metastatic - - (2.0-11.3) .006 Anxiety 20.5 (6.7) 58.4 [2.0] (0.31-0.91) <.001 Depression 17.0 (7.3) 54.5 [3.1] (0.31-0.84) <.001 Meaning & Purpose 27.8 (7.6) 44.6 [2.9] (-0.64—0.1) .008 Negative Illness Impact 16.3 (5.6) 66.4 [2.9] (0.21-0.93) .003 Positive Illness Impact 35.6 (9.0) 50.5 [3.2] (-0.16-0.06) .14 Social Isolation 16.5 (6.6) 50.0 [1.8] (-0.16-0.5) .3 *Population t-score = 50.0 (10.0).