Reference Main aim(s) Design Sample Main results (ressaltar factors morir en pau)

Country (qualitative/quantita (N total; n Groups, disease, mean age, %

Quality tive/mixed; gender,% marital status, % main ethnic
Long./CS; group, % religion)
exploratory/interven
tion)
Cohen (2000) To examine the quality of dying Mixed, CS, N=79. Renal failure. 70 (1.6) years. Pain was the major symptom related to suffering. Older women
USA following dialysis termination. Descriptive Female (68%). Married/partner (46%). had better quality of dying. No association between quality of
*** White (76%). Catholic (41%). FALTAnG, dying and ethnicity, education, religion and marital status.
McMillan To identify aspects of QoL in patients Quantitative; CS; N=231. Cancer. Age 71.1. Female (52%). The absence of functional WB was explained with the presence of
(2000) receiving EoL care that are most and Exploratory. Married (47%). Caucasian (73%). fatigue. Pyschophysiologic WB was related to not feeling sad,
USA. least problematic for patients, Religion NR. Falta nG, angry or painful, but feeling hopeful. Social/spiritual WB was
related to having good relationship with God, the physical and
emotional care, and support from family and friends.
Steinhauser, K; To describe the attributes of a good Qualitative, CS, Total N=75. Nurses n=27, patients N=14, Pain and symptom management were reduced through empathic
et al 2000. USA. death, as understood by various exploratory social workers n= 10, chaplains n=6, communication and clear decision making with physicians. Deep
participants in EoL care. hospice volunteers n=8, physicians n=6, importance of spirituality and meaningfulness. Life review,
family members n= 4. Age 46.8 (26-77) resolving conflicts, spending time with family and contributing to
years. Female (64%). White (70%). WB of others.
Catholic (18%), Protestant (61%).
Steinhauser, et To determine the factors considered Quantitative; CS; N=1462. Groups: seriously ill patients Freedom of pain; at Peace with God; presence of family; Mentally
al. 2000. important at the end of life by Exploratory. (n=340; variety Advanced chronic aware; Treatment choices followed; Finances in order; Feel life
USA patients and care providers. diseases (cancer, renal, obstructive was meaningful; Resolve conflicts; Die at home.
**** pulmonary, heart failure); 68 years;
78.2% male, 47.9% married; 69% White;
60.3% Protestant); family members
(n=332; 62 years; 21.3 male, 77.8%
White); physicians (n=361; 52 years;
gender NR; 80.4% White; religion NR),
other care providers (n=429).
Chibnall (2002) Psychosocial- spiritual correlates of Quantitative, N=34. Liver/kidney disease (34%); Demographic characteristics not related to presence/absence of
USA death distress in patients with life- exploratory. Cancer (24%); HIV/AIDS (18%); cardiac distress. Perceived quality of health care negatively related to
threatening medical conditions. (15%), pulmonary (4%). Age 61 (17.9). distress. SWB, EWB, RWB and social support significant factors for
Female (66%). White (66%). Catholic a good death.
(36%), Protestant (45%).
Colleen Afterlife beliefs in a group of Quantitative 276 palliative care patients (41 belief in there was no significant difference in anxiety or depression across
McClain- terminally ill cancer patients and descriptive by a an afterlife, 47 don’t believe in afterlife the three afterlife
Jacobson MA et analyzed whether these beliefs were cross-sectional and 54 were unsure regarding their groups; A v2 test indicated that those who do believe in
al. 2004 associated with design beliefs. an afterlife were more likely than those in the non-belief and
**** psychological distress and end-of-life 183 Caucasian (66%), 158 female (57%) unsure groups to report that their beliefs were comforting to
despair and 135 Catholics (49%) falta estado them (v2=115.4, Pb.001
civil y edadmedia there was no significant
difference in anxiety or depression across the three afterlife
groups;
patients who reported belief in an afterlife were less
hopeless, had less desire for hastened death and less suicidal
ideation than those who did not believe in an afterlife or
those who were unsure about their beliefs
Gessert C, Pilot study: to refine the Randomized trial: Small sample that no shows significant In this pilot study the number of EW subjects was too small to test
Baines BK, methodologies control arm who results. the efficacy of the EW in reducing suffering. However, before-and-
Kuross SA, Clark to be used in studying Ethical Will were encourage to 42 patients were enrolled, but only 24 after comparisons of the responses of the EW subjects revealed
C, Haller I. (EW) as a statement capturing one’s write after sessions finished (10 EW, 14 control) falta sexo, trends toward reduced suffering for several of the scales for
(2004) values, wisdom, hopes and advice. , in about symptom grupos, enfermedad, etnia, EC, religion, specific suffering domains:
** preparation Treatment arm were In the EW group decreasing overall suffering, fear of the future,
for future studies that will examine encouraged to write unfinished business, concern for loved ones, and enjoyment of
the efficacy after sessions about life.
of EWs. lessons for life, with
the intention of
transmitting their
values to their
survivors
Morita T. 2004 prevalence and the characteristics of Retrospective The prevalence of continuous deep sedation for refractory
*** patients who received palliative descriptive study: a 81 physicians participated (response rat psycho-existential suffering was estimated as 1.0%
sedation questionnaire was 80%). 29 physicians (36%) reported The common sources of suffering requiring sedation were sense of
therapy for psycho-existential sent to 105 clinical experience in continuous deep meaninglessness/worthlessness 61% (28), burden on
suffering responsible sedation for psycho-existential others/dependency/inability to take care of oneself 48% (22),
physicians at all suffering. 52 reported no experience in death anxiety/fear/panic 33% (15), desire to control the time of
certified palliative continuous deep sedation, 18 (35%) and death by oneself 24% 811), and isolation/lack of social support
care units in Japan 32 (62%) reported clinical experience in 22% (10) and economic burden 8.7% (4)
intermittent deep sedation and
intolerable psycho-existential suffering Decision making process included: explicit patient request 100%,
unresolved until death, respectively, repeated patient request 95%, consent from family 100%, consent
falta sexo, etnia, raza, EC, religion, from nurses 98%, consent from multiple physicians 44%, consent
at multidisciplinary conference 54% and consent from
psychiatrists 17%
Morita T, The aim of this study was to clarify Retrospective 500 bereaved family members who Of 290 bereaved family members, 62 (21%) families reported that
Yukihiro S, Hirai the bereaved family-reported descriptive study: a gave written informed consent for this the patients had expressed a desire for death to family members
K, Tsuneto S, incidence and questionnaire was study, 322 (64%) returned the or physicians/nurses and requests
Shima Y. reasons for desiring death and sent to 500 bereaved questionnaire to hasten death (10%) in a nationwide sample of Japanese
2004 requests to hasten death during the family members. 290 terminally ill cancer patients receiving specialized inpatient
*** whole course of Responses were ultimately analysed palliative care
terminally ill cancer patients receiving (effective response rate, 62%, 290/468),
specialized palliative care in Japan falta grupos, etnia, EC, religion, The patients who desired early death and requested
enfermedad, edad media, that death be hastened were significantly
younger than those who did not (64 _ 13 vs. 68 _ 13, P _ 0.047; 62
_ 12 vs. 67 _ 13, P _ 0.047, respectively)

Burden on others, general malaise, dependency, and pain were

reported as the major reasons for desiring death in 39% or more
patients.

The major reasons for requesting to hasten death reported in 38%

or more were general malaise, concerns about future distress,
being a burden on others, and pain. Fewer than 15% and 4% of
families listed economic burden and dissatisfaction with care as
major reasons for desiring death and request to hasten death,
respectively. “Other physical symptoms” identified by the family
as major or minor reasons for desiring death were appetite los (n
_ 3), nausea (n _ 3), dysphasia (n _ 2), increased sputum, edema,
ascites, constipation, aphasia, dizziness, and convulsion

In 30% of the patients, physical symptoms were not major factors

in the development of desire for death and requests to hasten
death.
Vig EK, Primary goal of this study was to learn qualitative study 13 men with cancer and 13 with heart
Pearlman RA. how a group of terminally ill men involving disease. Only men sample. Mean age 71 Participants did not hold a uniform view of a good
EEUU (2004) described good and bad deaths. And one-on-one years, and white men. Of the eligible or bad death. Main results:
**** how components from these interviews with potential participants, 26 (79% of the Components of Good Deaths: “in my sleep (quietly in my sleep)”
descriptions contributed to a good or terminally ill men eligible subjects) agreed to participate (n=14); Quick (heart attack) (n=11); Painless (n=11); Without
bad death. to determine the Exclusion criteria: failure to suffering (n=5); Peace with Good (n=3); Peaceful (naturally, (n=3);
components of a acknowledge that they were seriously without knowledge of impending death (go quietly in sleep) (n=3)
good and a ill. Falta todo
bad death Components of Bad Deaths: Painful (n=12); Prolonged (n=11);
 Score the different Dependent (n=8); Suffering (n=7); Burdening others (n=5);
components in a Drowning or shortness of breath (n=4); not right with God (n=3)
Likert scale 1-5
points Importance ratings of end-of-life issues as very important:
Family/friends in current life (n=20), Presence family/friends at
the very EOL (n=10), Religion/spirituality in current life (n=16),
Presence of religious/spiritual leaders at the very EOL (n=8); dying
at home (n=6); Dying at hospital (n=2), Physical contact with loved
ones at the very EOL (n=8)
Williams BR examine how a sociological Qualitative analyse a convenience sample of 33 outpatients demographic characteristics of the sample: is overwhelmingly
EEUU framework can provide insights on semi-structured patients recruited for a study of coping black (70%), female (70%), and poor with a mean age of 52 years
(2004) existential suffering at the end of life interviews carried strategies for dealing with terminal
*** out of the clinic only 8 patients were > of 60 years old 2 main findings:
during the patients (young sample), but the cancer start on One: the process of becoming a terminally ill person involved
scheduled doctor their 50s), falta. Edad media, sexo, changes in both the inner reality of the self and the outer reality
visits religion, EC, grupos, etnia, of interaction with others. Anticipation of a shortened life,
diminished
by pain and distress, exacerbated their
suffering
Second: around patients’ use of emotional labour to deal with
their pain and suffering: in an attempt to cope with their own
feelings and manage the emotional economy of their social
setting, patients became preoccupied with the affective dimension
of their illness experience. Rears of eroding the positive sentiment
of others and becoming a non-person whose affective life and
personal biography are irrelevant intensified the participants’’
pain and suffering.
Hills J, Paice JA, explore the relationship between Pilot study, 31 inpatients referred to the palliative the group was moderately distressed as measured by the NCCN
Cameron J, spirituality, religious coping, and quantitative care consult service met the eligibly Distress Thermometer, with a mean distress score of 5.8 + 2.7
Shott S. symptoms of distress among a group prospective criteria and were able to participate (range, 1–10)
(2005) of inpatients referred to the palliative 17 (55%) males, mean age 60.7 + 16.5 Problems with mobility (“getting around”), pain, swelling, fatigue,
*** care consult service (range 26-80). and constipation were cited by more than 70% of patients.
Marital status 39% married, 29% Distress was not related to demographics
divorced Distress was positively correlated with all scales of POMS: the
Majority were white (68%) anxiety (p 0.04), confusion (p 0.03), depression (p 0.01), fatigue
ECOG performance status was 2.0 + 0.7 (p 0.01), and hostility (p 0.04) subscales
falta religion, The negative religious coping subscale (I felt punished by Good for
my lack of devotion…)was positively correlated with distress
 (p=0.01) and with the confusion and depression subscales of the
POMS
The positive religious coping subscale was not correlated with any
of the FACT-G (a part of the Functional Assessment of Cancer
Therapy—General) total or subscale scores as well as the FACT-G
total score

Jaw-Shiun Tsai, Focused on death fear in two groups Quantitative 224 consecutive patients with terminal N=224, 129 men/95 women, mean age 62.13
Chih-Hsun Wu, (young and elder) palliative care descriptive cancer admitted to palliative care unit in Pathology: lung cancer 21%, liver cancer 17%, head and neck
Tai-Yuan Chiu patients, and it relationship between Taiwan. cancer 11.6%
and Ching-Yu death fear and good death in two The cut-off point was 65 years according 2 groups: non elderly (<65 years old): 114 patients, elderly (> 65
Chen groups the definition of elderly proposed by years old): 110 pt
Taiwan WHO falta grupos, edad media, sexo, the death
(2005) EC, etnia, religion The fear score of the elderly group was significantly
**** higher than the non-elderly group at the time
of “two days before death”. No significant differences between
age groups “on admission time” and “a week after admission”
Negative significant correlation between fear death and the
“acceptance” subscale of the good death scale in non-elderly
group at “a week after admission”. At “two days before death”
time, there were negative significant correlation between fear
death and “acceptance” and “awareness” subscales
M. Nakashima, the views of older adults who qualitative research 16 participants: 9 female/ 7 male. 15
E.R. Canda / experienced psychosocial and was designed from Caucasian/1 Mexican-American
Journal of Aging spiritual well-being during their final the social Range of age 65-103 (mean 81).
Studies 19 months constructionists’ 4 married, 9 widowed, 2 divorced, 1
(2005) 109–125 viewpoint according single
**** to the paradigm of Personal and environmental resources:
naturalistic inquiry *11 caregiver–recipient pairs in the
proposed by study, their close relationships
Erlandson, Harris, supported the elder’s resilience. These
Skipper, and Allen close dyads were characterized by a
(1993) and high level of commitment,
Lincoln and Guba communication,
(1985). interviews involvement, and mutual care
with 16 terminally ill *Spirituality. 13 had strong spiritual
older adults who propensity, 6 benefits from nonreligious
experienced filiated spiritual beliefs and social
psychosocial and supports (such as Alcoholics
spiritual well-being anonymous)
and each person’s *confronting mortality and death with
primary caregiver. open awareness and a willingness to
Were nominated by discuss it without hesitation. 14 derived
hospice staff (social comfort about death from their spiritual
workers, nurses and beliefs. 3 were consciously preparing for
chaplains) their coming death.
A semistructured Psychological processes of resilience:
open-ended *Crating life narratives: patients used
interview method storytelling (the study interview) in a
was used to uncover manner to generate self-reflection and
the participants’ insights that helped their adaptation to
perspective on the their illnesses
subject through *engaging in generative-dialectical
stories, descriptions, tension: all patients (16) feel
and examples. comfortable with two seemingly
The older adult and opposite intentions: to fight against the
his/her primary negative impacts of their terminal
caregiver were illnesses AND recognizing their
interviewed both limitations decided to surrender to the
separately and divine will or inevitable mortality and
jointly expressed trust and a sense of peace
*Growth through the adversity of dying:
4 were able to cultivate new qualities
(eg developing computer skills), 4
described their recent investments in
future generations (eg sponsoring
younger members in organisation) 9
fortified relationships with loved ones,
11 stated that they had developed a
sense of spiritual self-transcendence
and created existential meaning in life.
It seems that when they were able to
respond proactively to the challenges of
living their dying, enriched their lives by
optimizing their resources and insights.
provides a model of resilience in
 older adults facing death

O’Mahony S. et The main objectives are: 1) the impact Experimental 64 newly referred to PC service, The major findings of this research are that improvement in
alt. of improvements in cancer pain longitudinal experiencing daily pain “at worst” >3 in depression was significantly predictive of improvement in desire
USA severity and pain’s interference with observational study the brief pain inventory, >18 years old. for hastened death and that desire for hastened death was
(2005) daily functioning and depression on Sexo, edad media, grupos, enfermedad, remarkably stable over the study period.
*** DHD, and 2) the role of factors such etnia, religion, estado civl, Cancer pain severity and the degree to which pain interferes in
as social and spiritual well-being, physical functioning, depression, perceived absence of social
educational level, and patient age in support, and lower levels of physical functioning were correlated
moderating the impact of pain and with desire for hastened death
depression on DHD. Contrary to the authors’ expectation, the significant decline in
pain intensity levels and pain interference levels over one month
in patients who completed follow-up questionnaires was not
predictive of improvement in desire for hastened death
Goldsteen M, This article aims to offer insight in Qualitative study and N= 13, life expectancy less than 3 5 categories of normative expectations around death and dying
Houtepen R, how terminally ill patients define their interviewed months who lived at home, being appeared to be prominent in the interview:
Proot IM, Abu- dying trajectory and how they use terminally ill patients competent and > 18 years old.  awareness and acceptance: open acceptance, other people
Saad HH, current normative ideas and The interview was a Patients were recruited October 1999 shows resistance that could be interpreted as a matter of will
Spreeuwenberg expectations about dying in their version of an open- till November 2000 rather than a matter of failing cognition or denial
C and stories ended interview 10 male/ 3 women  Open communication: Patients seem to have a varying
Widdershoven guide from other Ranging in age 39-83 years old (M= attitude to discuss issues around death and dying. For some
G. (2006) The research question how terminally studies. The revised 64.6) talking about death is very
Netherlands ill patients version was tested in All were Dutch, roman catholic and important; it brings satisfaction and rest. Others do not wish
*** talk about death and dying; what they a pilot study resided in the province of Limburg to talk about death, or at least not too long, not too much,
think about a ‘good Hermeneutical (South of Netherlands) and not with everyone. They rather talk about other things
death’ method was used All were cancer patients.  Living one’s life till the end: The normative expectation ‘to
Survival: 70% time between interview deal actively with one’s situation’ is expressed in terms of
and death was < 3 months (M= 12.6 staying active or trying to go on with one’s life, despite the
weeks, range= 1-36 weeks) illness
Falta edad media,  Taking care of one’s final responsibilities: The issue of taking
care of one’s final responsibilities is expressed in several
ways. Patients refer to very practical responsibilities but also
feel responsible for the lives of their family after their death
 Dealing adequately with emotions: they can be confronted
with feelings of anxiety, despair or fear to be left alone or to
die in pain. The ideas of patients about dealing adequately
with emotions might differ from the opinions of their
environment (some describes their loneliness in their
 emotions and doesn’t feel free to express his feelings, other
think that express their emotions is a part of their personality
etc.)
 Dealing with normative expectations: describes different
ways to deal with expectations: opposite with open
communication, internal process of acceptance of life
limitation, focused in present, be occupied most of time,
attitude “wait and see”, the capacity to talk about death was
described as a learning process
In CONCLUSION: existing normative frameworks are tailored to
the individual situation. What should be considered as a good
death is something that cannot be defined in general terms and is
not the same for everyone.

Hirai et al. 2006 Explore the components of a Qualitative 2 types of participants of 5 Japanese Identified 58 attributes and 17 categories as common components
Journal of Pain Japanese “good death”. descriptive research. cancer institutes: of “good death” or “quality of death and dying” in Japan. The
and Symptom 4 population were explored: patient, Exploratory  Nonmedical population (13 common components most often identified in Western literatures
management family, physicians and nurses preliminary study. patients and 10 family were: pain and symptom control, family relationship, burden to
Japan members) others, the sense of control, dignity, environmental well-geing,
 Medical (20 physicians and 10 preparation, hope, faith and spirituality, contribution to others,
*** nurses) completion, good relationship with medical staff and
Faltan todo menos N total inappropriate prolongation of life
Johansson CM, The aim of this study was to describe Qualitative 5 advanced cancer patients, living at  Valuing Ordinariness in daily life: appreciate normal things
Axelsson B, patients’ perceptions of QUALITY of descriptive. Focus home with support from relatives and (satisfaction with life when patients were able to carry out
Danielson E. LIFE in incurable cancer at the end of Group palliative homecare team. activities throughout the day) and to “feel functional” (being
Cancer Nursing life Most of them had metastasis free from pain and fatigue as possible and being able to
2006 Falta todo menos n total y enfermedad balance rest and physical activity like gardening)
Switzerland  Alleviated suffering, described as being free from physical
**** symptoms, psychological well-being and personal strategies
to relieve pain (such diverted attention from the pain,
keeping oneself occupied…)
 Maintaining a positive life
 Significant relations: essential networks and resonance in
communication ( the significance that there was a mutual
understanding in the relation)
 Managing life when ill: be in charge of the situation and to be
reflective (ex: material things are not matter)
63- The purpose of this study was to Descriptive cross- Patients were recruited from 2 medical  With the exception of age, the notion of being “at peace”
Steinhauser KE, examine correlations with other sectional sample of centres of Durham (Great Britain) was not explained by demographic variables. Subjects who
Voils CI, Clipp assessments of spirituality and quality patients with From a total of 320 potential subjects, had <50 years old with advanced serious illness report lower
EC, Bosworth of life to identify constructs advanced 248 patients completed the interview. levels of peacefulness.
HB, Chistakis associated serious illness Participants had at least 1 of 4 life-  Peacefulness was most strongly associated with the
NA, Tulsky JA. with the experience of being at peace threatening conditions (stage IV cancer, emotional and spiritual well-being subscales: small and
Arch Intern congestive heart failure, end-stage renal moderately significant relationships with other dimensions of
Med. disease and chronic obstructive quality of life: physical well-being (r=0.28), functional well-
2006;166:101- pulmonary disease) being (r=0.35), and social well-being. Correlations between
105 59% male, 59% white and 34% black, peacefulness and the 2 dimensions within the FACIT
Great Britain majority were married (62%) and the spirituality subscale: faith and purpose
median age was 61 years (range 28-88)
****
completo
76- The relationship between places of Descriptive factors 374 consecutive patients with terminal  Three hundred and seven patients (82.1%) died in the
Chien-An Yao et death and good death helping to a good Cancer admitted to the hospice and hospital (the hospital death group), while 67 patients (17.9%)
al. Journal of cross-sectional sample of patients death reported by palliative care unit in Taiwan. Divided died at home (the home-death group)
Pain and with advanced professional care into a hospital-death and home-death  proportion of elderly patients (>65 years old) was 61.2% in
Symptom serious illness workers of 374 group according to the place of death. the home-death group and 53.4% in the hospital-death group
Management. terminal cancer  the total good-death score in the home death group was
34 patients Falta todo menos N total, enfermedad. significantly higher than that in the hospital-death group
(5( November Team of caregivers except the item “comfort”
2007 answer a designed  Concerning the audit scale for good-death services, the item
Taiwan questionnaire about “bereavement support had the most significant correlation
three areas explored with the item ‘‘satisfaction
*** of patients and families to physical care
 The item scores in the home-death group including “respect
for dignity,’’ ‘‘respect for decision-making participation,’’
‘‘alleviation of anxiety,’’ ‘‘resolution of depression,’’ and
‘‘fulfilment of last wish’’ were significantly higher than that in
the hospital-
death group
77- The primary aim of this study was to Pre-post A total of 30 patients with incurable The most important finding is beneficial effect of the short-term
Ando M, Morita assess the efficacy of the Short-Term effectiveness of a cancer; (2) patients without cognitive life review on spiritual wellbeing. There were significant
T, Okamoto T, Life short therapy. impairment; (3) patients 20 years of age differences between pre- and post-intervention scores for anxiety,
Ninosaka Y. Review on the spiritual well-being, as or older; and (4) patients for whom the depression, suffering and happiness
Psycho- well as anxiety, depression, suffering, The interview primary physicians agreed would
Oncology and happiness of procedure was based benefit from the psychological
17:885-890 terminally ill cancer patients on a structured life interventions completed all sessions
(2008) review interview that
was conducted Falta etnia, religion, Ec, sexo,edad
Japan individually, and the media,
patient was asked to
**** re-evaluate both
good and bad
memories.
80- This study investigates the good Descriptive cross- 366 hospitalized patients with terminal The scores of good death scale on admission and before death
Cheng SY, Hu death status of elderly patients with sectional method. cancers admitted to the palliative care increased in both groups, and the sum of all items of the good
WY, Liu WJ, Yao terminal cancer, comparing the Compare 2 age unit in National Taiwan University death scale both in elderly and younger groups were elevated
CA, Chiu TY. differences in the degree of good groups: elderly (>65) Hospital during the period from July from 10.94 and 10.84 to 13.52 and 14.17 (p<0.01, respectively)
Palliative death among elderly and younger and younger 2004 through June 2005. The subdomains were reconstructed to 2 factors “patient care”
Medicine 2008; groups, and exploring the factors Sex: 183 men and 183 women. Mean and “social well-being”.
22:626-632 related to good death score. age 65 (+16.49) years, and only 3pt Reflecting the high level of satisfaction in both patients and family
Taiwan younger than 18 years. toward the services in the hospice.
Young group: 160pt, 89 men/ 71
*** women However, in the category of ‘autonomy’, the elderly groups had
Elder group: 206pt, 94 men/ 112 significantly lower score than the nonelderly group (P < 0.01)
women including both items of respect for autonomy’ and decision
making participation’.
Falta, etnia, EC, religion, Of all the potential correlates of good death score in the elderly
group, we found there was a significantly positive correlation
between respect for autonomy and good death (odds ratio =
1.215, 95% confidence interval, CI = 0.758 ~ 1.672). In addition,
‘verbal support’ was‘ significantly correlated with good death
88- The main aim is to identify and to Descriptive cross- 25 self-answered questionnaires 72% of the nursing team and 64% of the main caregivers were
¿a qué se describe the factors that contribute to sectional method. distributed among the main caregivers completely or close to total agreement that patients had died
atribuye que a peaceful death not only from the and 25 questionnaires distributed peacefully. However, while the nursing team tended to focus on
los enfermos perception of the nursing team among the nursing team who cared for somatic aspects such as good control of symptoms (69.5%) to
oncológicos de involved in the patient’s care but also those 25 patients with far advanced conclude that patients had died peacefully, main caregivers
una unidad de from their main caregivers’ point of cancer disease that died in the Palliative attributed the peaceful death to psycho-social factors (81.8%).
cuidados view. Care Unit la familia (18,18%) o el poder despedirse
paliativos (18,18%). Family members highlight be unconscious (27,27%), be
mueran en paz? falta Ec, religion, sexo, etnia, edad surrounded by family (18.18%) or be able to say good (18.18%)
Maté J, Bayés media,
R, González-
Barboteo J,
Moreno F,
Gómez-Batiste
X.
Psicooncologia.
5(2-3) 2008
pp303-321
Spain

Melin-joansson The objective of this qualitative study qualitative content data were collected from narrative Three main themes were found: being in intense suffering, having
C, Odling G, was to elucidate the meaning of analysis interviews with eight patients in their breathing space in suffering, and being at home. Living with
Axelsson B et quality of life as narrated by patients homes in 2004-2006. incurable cancer at the end of life was experienced as living in
al. 2008 with incurable cancer approaching physical distress as the body became incapacitated by unexpected
*** death in palliative home care in Falta todo physical complications. This incapacity had consequences on
Sweden. patients' psychological, social, and existential well-being.
Michiyo A, The present study investigated (1) Descriptive mixed 10 patients were individually  3 types of transformation were identified: 1)peaceful mind 2)
Morita T, Lee V, what methods interviewed by a clinical psychologist positive attitude and uneasy feelings 3) uneasy feelings
Okamoto T. types of transformation terminally ill Preliminary study During the 3-month study period, 10  5 categories of meaning of cancer were identified: 1) positive
Palliative and cancer patients Patients were patients were recruited meaning 2) natural acceptance 3) negative acceptance 4)
supportive Care experienced, (2) what kind of separated into 2 search for meaning 5) regret and sorrow
(2008), 6, 335- meanings terminally ill groups by the Falta todo menos n total  Relationship between spiritual wellbeing and positive
340 cancer patients attributed to the median of the FACIT- meaning. The low spiritual wellbeing group: main attributed
illness experience, Sp scores to analyse meanings to the illness, patients in the high spiritual well-
Japan and (3) patients who attributed the qualitative being group attributed positive meanings or a natural
positive meaning to content acceptance to the illness. On the other hand, those in the low
*** the illness achieved the high spiritual The interview spiritual well-being group attributed “regret and sorrow,”
well-being involved 2 questions: and “search for meaning” to the illness
1. Please recall how
your mood or
psychological status
has changed from
the diagnosis until
now, 2. What does
having cancer mean
to you.
The interview were
writing down,
because the negative
to recorded from
patients
Canada To assess the relationship between
2008 spirituality and hopelessness, desire
Canadian family for hastened death, and clinical and
physician disease-related characteristics among
Medecin de patients with advanced cancer, and to
famille investigate predictors of spirituality.
canadien Spiritual well-being is thought to have
** a beneficial effect on patients'
response to illness.
NovoaGomez20 This study evaluated the quality of life
08 and psychological well-being of
Bogotá cancer patients diagnosed with the
* advanced stages of the disease and
who, at the time of evaluation, were
in palliative care in Bogotá.
CASTELLO, 128, Objectives: to study the subjective
1O, 28006 perception of the passing of time
MADRID, SPAIN among patients hospitalized in a
2008 Palliative Care Unit (PCU) and their
*** primary caregivers. To find out
agreement extent between perceived
time in both. To explore personal,
clinical, and psychosocial factors that
may be related to this perception.
Sesterhenn The objective of this study was to
2008 describe end-stage disease in patients
United States suffering from advanced head and
** neck cancer (hnc). It is one of the
most unpleasant and agonizing way a
person may die and is a challenging
problem for all involved with its
treatment.
White2008 This study proposed to develop a
US valid and reliable instrument, the
*** White Peaceful Death Measure
(WPDM), to measure the concept of
peaceful death. The purpose was
twofold: (a) to estimate the content
A total of 91 patients with advanced Statistically significant associations were found between
cancer. spirituality and sex of patients (P = .001) and spirituality and
stronger hopelessness (r = 0.252, P = .016). In multivariate
Falta todo menos n total y enfermedad analyses, stronger hopelessness, male sex, younger age, and
receiving chemotherapy were found to be the strongest
predictors of being spiritual.
The sample consisted of 83 older adults
of both sexes, with different types of
advanced cancer.
Falta todo menos n total, y enfermedad.
 a descriptive study Ninety-six terminally ill patients and in 41.7% of patients the subjective perception of the passage of
carried out in the their primary caregivers took part in the time was described as "long" or "very long", while 28.1%
Palliative Care Unit survey. considered it "short" or "very short." Time perception in patients
at Hospital Santa was related to age and quality of the relationship with primary
Caterina in Girona Falta todo menosn total y enfermedad caregivers, with older people and those having a good relationship
with their caregiver experiencing a faster passage of time.
The design of this The charts of 16 patients suffering from The short survival time in hospice indicates that incurable patients
study was a cohort end-stage hnc were evaluated. may be referred to terminal care institutions too late in their dying
sample. trajectory.
Falta todo enos n total y enfermedad
methodological a sample of 107 hospice and palliative Results, therefore, are based on the combined vignette scores.
study care nurses The WPDM was reduced from 25 to 19 items. Cronbach's alpha
was high (σ = .93), stability was moderate (r = .61), and content
falta todo menos n total validity was high (CVI = .84). Four clear underlying dimensions
were identified: (a) Assistance the patient received from others,
(b) Resolution, (c) Condition and comfort of the patient, and (d)
 validity, internal consistency and Pain control. 
stability of the WPDM and (b) to
determine if underlying dimensions of
peaceful death exist within the
WPDM. 
Yong2008 The purpose of this study was to 257 cancer patients The results of factor analysis revealed five subconstructs: love and
Canada develop a scale assessing the spiritual connection, hope and peace, meaning and purpose, relationship
** needs of Korean patients with cancer. Falta todo menos n total y enfermedad with God, and acceptance of dying.

Ando2009  The aim of this study was to
349 investigate the primary concerns of
** terminally ill cancer patients in a
Short-Term Life Review among
Japanese, Koreans, and Americans to
develop intervention programs to be
tailored to patients in other countries.
Bonin- The study aimed at making a theory-
Scaon2009 driven inventory of end-of-life
United States preferences. 
* Falta todo menos n total
Twenty Japanese, 16 Korean, and 7 We clarify the differences among the primary concerns from the
American terminally ill cancer patients Short-Term Life Reviews, arguing that we can improve the
who were in the hospice wards of spiritual well-being of terminally ill cancer patients by focusing on
general Christian hospitals in each the primary concerns within each country.
country participated in this study
Falta religion, EC, edad media, sexo,
81 persons suffering from a terminal Ten factors were evidenced; they were easily interpretable in the
illness  AMT framework. 

Duggleby2009 The purpose of this study was to  10 home-care palliative patients The results of this study provide a foundation for future research
Building, 107 describe, using a grounded theory and the development of interventions to engender hope in older
Wiggins Road, approach, the processes by which Falta todo menos n total palliative patients.
Saskatoon, SK, palliative patients live with hope. 
Canada, S7N
5E5,
**
CASTELLO, 128, to examine the role played by disease  89 patients with advanced or terminal  the final model showed that disease awareness was determinant
1O, 28006 awareness and emotions in the pain Cancer for anxiety (gamma = -0.27) and depression (gamma = -0.19).
MADRID, SPAIN and suffering experience in a sample Falta todo menos n total Anxiety had a significant effect on pain intensity (beta = 0.30), and
2009 of patients with advanced Cancer.  pain intensity was determinant for sadness (beta = 0.10). Patient
** suffering was inñuenced by pain severity (beta = 0.15) and general
condition (beta = 0.24). Conclusions: emotional reactions to pain
are crucial to explain the relationship between pain and suffering.
A suitable explanation about the diagnosis and prognosis will
contribute to reduce the anxiety associated with pain, and to a
 better control of pain. 
Kongsuwan200 To explore the ways that ICU nurses ICU nurses ICU nurses promote peaceful death through a three-dimensional
9a in Thailand could promote peaceful Falta todo process: awareness of dying; creating a caring environment; and
Kongsuwan, death and to attempt a definition of promoting end-of-life care.
W.: Christine E. the concept of 'peaceful death'.
Lynn College of
Nursing, Florida
Atlantic
University,
Boca Raton, FL,
US, 33431,
wkongsuw
*
Murakawa Achieving a 'good death' is the This exploratory  Participants included doctors, palliative Medical staff had largely similar views on the percentage of
2009 ultimate goal for medical staff caring study investigates and non-palliative ward nurses working patients for which a component of 'good death' was achieved. All
Japan for terminally ill cancer patients, but the differences in in Miyagi Cancer Center, Natori, Japan.  the achievement ratings determined in the present study were
*** the exact definition of a 'good death' how Japanese cancer considerably lower than the necessity ratings given by non-
is subject to interpretation. care staff perceive a Falta todo menos enfermedad y etnia medical staff in a previous study. There were differences among
'good death' by using medical staff with respect to their contribution to achieving a
factor analysis. component of 'good death' and the concrete means they would
use to achieve a 'good death'.
Olden2009a The purpose of this study was to
US investigate the phenomena of
posttraumatic growth and benefit-
finding in patients with terminal
cancer 
Rodin2009 using structural 406 patients with metastatic The results supported the model. High disease burden, insecure
Rodin, Gary: equation modeling gastrointestinal or lung cancer recruited attachment, low self-esteem, and younger age were risk factors
Department of at outpatient clinics of a Toronto cancer for depression.
Psychosocial hospital
Oncology and
Palliative Care, Falta todo menos n total y enfermedad
Princess
Margaret
Hospital,
University
Health
Network, 16th
Floor, Room
724, 610
University
Avenue,
Toronto, ON,
Canada
**
Song2009 The objective of the study was to Fifty-one African Americans with end- The subjects were stratified by end-of-life treatment preferences
Song, Mi- examine whether psychosocial and stage renal disease and by acceptance of life-sustaining treatment outcomes, and
Kyung: School spiritual well-being is associated with compared for psychosocial and spiritual well-being, as well as
of Nursing, African American dialysis patients' Falta todo menos n total, etnia y sociodemographic and clinical characteristics.
University of end-of-life treatment preferences and enfermedad
North Carolina acceptance of potential outcomes of
at Chapel Hill, life-sustaining treatment.
Carrington Hall,
CB# 7460,
Chapel Hill, NC,
US, 27599-
7460,
songm@email.
unc.edu
**

Ando2010 The primary aim of the study was to
Fukuoka, Japan examine the efficacy of a one-week
*** Short-Term Life Review for the
enhancement of spiritual well-being,
using a randomized controlled trial.
Bussing2010 For many patients confronted with
England chronic diseases,
** spirituality/religiosity is a relevant
resource to cope. While most studies
on patients' spiritual needs refer to
the care of patients at the end of life,
our intention was to develop an
68 terminally ill cancer patients
randomly allocated to a Short-Term
Life-Review interview group or a control
group
Falta todo menos n total, enfermedad.
210 patients
Falta todo menos n total
The FACIT-Sp, Hope, Life Completion, and Preparation scores in
the intervention group showed significantly greater improvement
compared with those of the control group (FACIT-Sp, P < 0.001;
Hope, P < 0.001; Life Completion, P < 0.001; and Preparation, P <
0.001). HADS, Burden, and Suffering scores in the intervention
group also had suggested greater alleviation of suffering
compared with the control group (HADS, P < 0.001; Burden, P <
0.007; Suffering, P < 0.001). 
Factor analysis of the 19-item instrument (Cronbach's alpha +/- .
93) pointed to 4 factors which explain 67% of variance: Religious
Needs, Need for Inner Peace, Existentialistic Needs (Reflection /
Meaning), and Actively Giving.
 instrument to measure spiritual,
existential and psychosocial need of
patients with chronic diseases.
Grudzen2010 The objective was to identify the A convenience sample of 50 functionally Mean (±SD) age was 74.3 (±6.5) years and cancer was the most
United States palliative care needs of seriously ill, impaired adults  common diagnosis. Mean (±SD) QOL on the MQOL was 3.6 (±2.9).
** older adults in the emergency Over half of the patients exceeded intratest severity-of-needs
department (ED) Falta todo menos n total cutoffs in four categories of the NEST: physical symptoms (47/50,
94%), finances (36/50, 72%), mental health (31/50, 62%), and
access to care (29/50, 58%). The majority of patients reported
moderate to severe fatigue, pain, dyspnea, and depression on the
ESAS.
EAST PARK This study sought to hear what 13 people dying of cancer shared their Participants' recollections of experiences with doctors showed
SHANNON, CO, patients approaching death had to say experiences and perspectives on care that genuine demonstration of care begins with doctors seeking
CLARE, 00000, about doctor-patient interactions and within the patient-doctor relationship common ground with the patient as a fellow human being and
IRELAND care in order that doctors can learn individual. The psychological and physical suffering that results
2010 how to demonstrate care more Falta todo menos n total y enfermedad from allowing stereotypical assumptions and behaviours to shape
** effectively so that each patient feels doctor-patient interaction was clear. 
cared for as an individual.
Leung2010 This study was designed to evaluate Patient demography, cancer sites, A total of 281 patients (52% women) were admitted and died in
Medicine, the change of quality of life and Eastern Cooperative Oncology Group the study period. One hundred forty-five patients (51.6%) died
National quality of death over time and (ECOG) status were collected at within 3 weeks. Although those with short survival (<3 weeks) had
Taiwan between patients of long and short admission. Quality of life, including more physical symptoms during the first week, there was no
University survival in a palliative care unit. physical and psychological symptoms, difference in quality of life dimensions at admission, at 1 week,
Hospital and social support, and spirituality was and at 2 days before death between survival groups. Physical
College of assessed daily after admission. conditions deteriorated with time but other dimensions continued
Medicine, No. 7 to improve until death. GDS and subdimensions continued to
Chung-Shan Falta todo menos enfermedad improve until death. Although those with long survival (≥3 weeks)
South Road, have better scores for awareness, acceptance, timeliness,
Taipei, Taiwan, comfort, and GDS at admission, there was no difference between
100, the two groups at 2 days before death. 
chency@nhri.or
g.tw
**
Oechsle et al. To evaluate the impact of symptom Cross-sectional study 61 patients were recruited through a - Dignity total score correlated highest with lack of energy (P <
(2014) burden, distress, overall condition, palliative care inpatient ward within 48 0.001), anxiety (P < 0.001), sadness (P = 0.002), pain (P = 0.009),
Germany and individual patient characteristics hours after admission. shortness of breath (P = 0.019), irritability (P = 0.023), thirst (P =
on self-perceived dignity in terminally 0.029), and tiredness (P = 0.041).
ill cancer patients. - Gender: n(%) - Psychological symptoms showed more consistent associations

Rosenfeld This study examined DHD* over time
(2014) in a sample of terminally ill cancer
England patients admitted to a palliative care
hospital.
* “desire for hastened death”
- Este estudio representa uno de los
primeros análisis sistemáticos de
cambio a lo largo del tiempo en el
deseo de una muerte acelerada entre
los enfermos terminales de cáncer.
Female 36 (59) with the different dignity dimensions than physical symptoms
Male 25 (41) except for the dependency dimension.
- Malignant disease - Psychological distress correlated with all dignity dimensions:
Lung cancer 15 (25) symptom distress (P < 0.001), existential distress (P < 0.001),
Urogenital cancer 10 (16) dependency (P ¼ 0.020), peace of mind (P < 0.001), and social
Gastrointestinal cancer 9 (15) support (P = 0.024).
Gynecologic cancer 7 (11) - Overall condition was significantly associated with existential
Hematologic diseases 7 (11) distress (P = 0.013), but not with symptom distress, dependency,
Pancreatic cancer 7 (11) peace of mind, or social support. Performance status showed
Other 6 (10) significant association with dependency (P = 0.001).
- Conclusion. Self-perceived dignity in terminally ill cancer
Falta Ec, etnia, religion, edad media, patients is significantly associated with physical as well as
psychological symptoms, distress, overall condition,
performance status, and comorbidities. Knowledge of these
specific interactions is essential for adequate, comprehensive
palliative
Quantitative: - A random sample of 128 patients - Overall, there appears to be a relatively high frequency of
Although initial completed the Schedule of Attitudes change in DHD, even in the last weeks of life.
univariate analyses toward Hastened Death (SAHD). - Among patients who were low at T1, several variables
(chi-square test of - All participants were 21 years of age or distinguished between those who developed DHD and those who
association and older did not: physical symptom distress, depression symptom severity,
ANOVA) could - The study sample was 52.3% female (n hopelessness, spiritual well-being, baseline DHD, and a history of
certainly identify ¼ 67), had an average age of 66.0 years mental health treatment. However, these same medical and
variables that old (SD ¼ 13.87, range: 30e90) and 13.3 clinical variables did not distinguish between the falling and high
distinguished years of education (SD ¼ 3.1, range: trajectories.
these four groups 6e23 years). The most common cancer - Importantly, the lack of a significant relationship between
(one of which e the diagnoses were lung cancer (n ¼ 25; changes in depression and DHD trajectories in our sample
Low trajectory e was 19.5%), followed by gastro-intestinal (n suggests that treatment may need to focus on reducing
much larger than the ¼ 13; 10.2%), prostate (n ¼ 12; 9.4%), hopelessness rather than depression per se, since depressive
others), a and breast cancers (n ¼ 9; 7.0%). The symptoms decreased (on average) for all four trajectories, yet was
multivariate majority (n ¼ 87, 68.0%) of participants not associated with changes in DHD.
prediction model were white and identified themselves as
would be Catholic (n ¼ 64, 50.4%).
far less easily
interpreted and even Falta etnia, EC,
gleaning the
important pairwise
effects from 4-group
 analyses is much
harder. Thus, we
used univariate tests
(chi-square and t-
tests) to identify
variables that
distinguished
between two
subgroups of
patients based on
baseline DHD (e.g.,
those who had low
and high DHD at
baseline).
Villavicencio- This quantitative study explores the Cross-sectional study 101 advanced cancer patients admitted The Spanish adaptation of SAHD showed good psychometric
Chávez et al. relationship to an acute Palliative Care Unit (PCU) properties (Cronbach’s alpha 0.92; similar concurrent /
(2014) between the WTHD and psychological and followed-up for survival. discriminant validity to the original). The mean total score on
Spain and physical factors, including - 62 hombres (61,4%); 39 mujeres SAHD was 4.9 (standard deviation [SD] = 5.3). SAHD scores were
survival, in patients with advanced (38,6%). positively correlated with HADS-Total (r = 0.332, p < 0.01), HADS-
cancer. - Media edad 61,7 Depression (r = 0.397, p < 0.01), Performance Status (r = 0.276, p <
- 10,9% solteros (11); 80,2% casados 0.01), and Palliative Prognostic score (r = 0.248, p < 0.05) and
(81); y 8,9% separados (9). negatively correlated with the Barthel Index (r = 0.324, p < 0.01).
- 8,9% (9) vivían solos; 5,9% (7) en Women scored higher than men on SAHD (6.2, SD = 5.9 vs. 4.2, SD
institución. = 4.8, p < 0.01). No association was found between WTHD and
- 63% con educación secundaria; 17,7% survival (r = 0.12, p > 0.05).
estudios superiores. Conclusions: Both psychological and physical impairment (as
- Dx. Pulmón 22 (21,8%); Colon 14 well as poorer prognosis) are associated with higher scores on
(13,9%); Gástrico 11 (10,9%); Páncreas 9 SAHD, supporting the idea that WTHD emerges in response to
(8,9%); otros 45 (44,5%). overall suffering. Although we observed a direct relationship
between physical status and survival, the latter was not related to
Falta etnia, any of the psychological factors or WTHD.
Abeyta et al. Hacen una revisión de 5 estudios Cuantitativos. Across five studies we examined Taken together, the current studies demonstrated that people
(2015) propios sobre el Sentido, y sacan whether emotional clarity contributes with higher emotional clarity experience greater
USA conclusiones generales to perceptions of meaning by meaning in life and are better at maintaining meaning following
- hypothesized that people high in investigating existential threat than are people lower in emotional clarity.
trait whether individuals with high trait Meaning resides in the self in the form of its emotions, but some
emotional clarity will view their lives levels of emotional clarity have greater clarity may be necessary to detect it.
as more meaningful and that this will meaning in life and are better able to Considering the importance of meaning to psychological and
 be true.
Abshire et al. To consider how fear and
(2015) symptom experience are perceived in
USA patients with heart failure at the end
of life.
Bovero et al. To show the different components of
(2015) spirituality in the last few weeks of
Italy life for advanced cancer patients
admitted to hospice and to evaluate
quality of life (QoL), pain, anxiety,
depression and psychological
adjustment to cancer.
maintain meaning in life in the context physical health, emotional clarity may prove to be a vital resource
of existential threat. for adaptive functioning.
Falta todo
A convergent mixed - A convenience sample was used to Patients denied fear when asked directly, but frequently referred
methods design was collect both the quantitative (n = 55) to moments of being afraid when they were experiencing
used. and qualitative (n = 5) data. symptoms. In addition, patients reported few troublesome
-Data from the symptoms on the survey, but mentioned many more symptoms
McGill Quality of Life during interviews.
Questionnar. (n = 55) ¿EXCLUIDO?: ES UN ARTÍCULO QUE - Conclusion: These data not only identify the relationship
were compared to APORTA POCO A NUESTROS INTERESES, between psychological issues and symptom experience but also
data from in-depth AUNQUE INCLUYO REVISIÓN. elucidate the benefit of a mixed method approach in describing
interviews (n = 5). such experiences from the perspective of the patient.
Falta todo menos n total
Se utilizaron 115 patients were interviewed with a - En la muestra italiana, se observó que cuando los pacientes
estadísticas series of rating scales: están cerca de muerte, la fe es un componente más importante
descriptivas para el The average participant age was 67.06 de la espiritualidad que el sentido/paz. Este estudio confirma que
análisis de la years old [standard La CdV puede estar relacionada con síntomas físicos y
información deviation (SD) 12.3; range 21–82]. The psicológicos, y esto reitera la importancia de la fe en atención en
sociodemográfica. majority of the el final de la vida.
y características sample was men (67.8%, n = 78).
clínicas de los dos Participants had a poor
grupos de pac. education and almost half of the
Asociaciones entre participants were married.
QoL (LQoL vs. HQoL) The majority of the sample considered
y las características themselves
de los pacientes Catholics (86%, n = 75).
fueron evaluadas At the time of data analysis, awareness
usando v2 y oneway of prognosis was
ANOVA cuando fue available for 36 (n = 31.3) patients.
apropiado. Se utilizó Consistent with the
una regresión advanced cancer population assessed,
logística binaria un study participants
para verificar las died a median of 25 days (range: 1–120
asociaciones entre days) after the
CV y la espiritualidad study interview.
considerando todos
los posibles factores
 de confusión. Falta EC, edad media
Scales: The
Functional
Assessment of
Chronic Illness
Therapy – Spiritual
Well-Being Scale, the
Hospital Anxiety and
Depression Scale, the
Visual Analogue
Scale for pain, the
Brief Coping
Orientation to
Problem Experienced
and the Functional
Assessment of
Cancer Therapy Scale
– General Measure.
Breitbart et al. To test the efficacy of meaning- - Patients with advanced cancer (N 253) were randomly assigned - Hierarchical linear models that included a priori covariates and
(2015) centered group psychotherapy to manualized eight-session interventions of either MCGP or only participants who attended three sessions indicated a
USA (MCGP) to reduce psychological supportive group psychotherapy (SGP). significant group time interaction for most outcome variables.
distress and improve spiritual well- - Specifically, patients receiving MCGP showed significantly
being in patients with advanced or -Patients were assessed before and after completing the greater improvement in spiritual well-being and quality of life and
terminal cancer. treatment and 2 months after treatment. The primary outcome significantly greater reductions in depression, hopelessness, desire
measures were spiritual well-being and overall quality of life, for hastened death, and physical symptom distress compared with
with secondary outcome measures assessing depression, those receiving SGP.
hopelessness, desire for hastened death, anxiety, and physical - No group differences were observed for changes in anxiety.
symptom distress. Analyses that included all patients, regardless of whether they
MCGP SGP attended any treatment sessions (ie, intent-to-treat analyses), and
Características No. % No. % no covariates still showed significant treatment effects (ie, greater
Sex benefit for patients receiving MCGP v SGP) for quality of life,
Male 38 28.8 39 32.2 depression, and hopelessness but not for other outcome
Female 94 71.2 82 67.8 variables.
Age, years 57.0 11.5 59.6 10.3 - This large randomized controlled study provides strong support
Years of education 15.9 2.4 15.9 2.7 for the efficacy of MCGP as a treatment for psychological and
Race/ethnicity existential or spiritual distress in patients with advanced cancer.
White/non-Hispanic 94 71.2 80 66.7
African American 17 12.9 18 15.0
 Hispanic 13 9.8 13 10.8
Other 8 6.1 9 7.5
Religion
Catholic 50 38.2 38 31.7
Other Christian 19 14.5 13 10.9
Jewish 29 22.1 33 26.7
Other 19 14.5 27 22.5
None 14 10.7 10 8.3
Primary cancer diagnosis
Breast 42 31.9 33 27.3
Pancreatic 18 13.6 27 22.3
Lung 24 18.2 16 13.2
Colon or rectal 21 15.9 18 14.9
Other 27 21.4 27 22.3
Karnofsky performance 82.9 9.3 82.3 9.6
score
Brown et al. To evaluate if an individual’s level of Multi-site analysis of 104 patients. - After adjusting for potential confounders, it was found
(2015) meaning/peace women with newly that higher M/P predicted better QOL (FACT-O) (p<0.0001).
Germany (M/P) predicts various quality of life diagnosed stages II– N=104 Higher M/P also predicted decreased death anxiety, depression,
(QOL) and mental wellbeing IV ovarian, primary Age and anxiety (p≤0.005).
measures. peritoneal, or Mean (SD) 55.28 (10.57) Finally, higher M/P predicted increased hope and coping scores
fallopian tube Median 55 (p≤0.0005).
cancer. Min–Max 33–83 - Conclusions Level of M/P is associated with several important
- Linear regression Religious preference mental and physical health states. This information may
models were created Catholic/Episcopal 34 (35.1 %) allow providers to identify patients at increased risk for
to examine the effect Baptist 23 (23.7 %) mental/physical distress and may facilitate early referral to
of M/P (FACITSp) Other protestant 25 (25.8 %) targeted psychotherapy interventions focused on improving
upon QOL, Christian/non- 11 (11.3 %) patient QOL and decreasing anxiety and depression.
symptoms, and other denominational - Data suggests that assessing a patient’s level of M/P, as
measures of mental Other 2 (2.1 %) estimated from the FACIT-Sp, may enable providers to identify
well-being. None 2 (2.1 %) patients at increased risk for mental and physical distress
Not specified 7 during the management of their cancer.
Race
White 65 (63.1 %)
Black 14 (13.6 %)
Hispanic 20 (19.4 %)
Other 4 (3.9 %)
Unknown/missing 1
 Marital status
Married 66 (64.1 %)
Live-in partner 1 (1.0 %)
Separated 4 (3.9 %)
Divorced 5 (4.9 %)
Single 14 (13.6 %)
Widowed 13 (12.6 %)
Partnered/not
partnered
No partner 36 (35.0 %)
Partner 67 (65.0 %)
Unknown/missing 1
Stage
Stage II 12 (11.5 %)
Stage III 79 (76.0 %)
Stage IV 13 (12.5 %)
Cook et al. To bring peace to the final days of a Mixed-methods 21-bed medical–surgical intensive care - Los 159 deseos fueron implementadas y clasificadas en 5
(2015) patient's life and to ease the grieving study. unit. categorías: humanización el medio ambiente, los homenajes, las
USA process. Intervention: To Participants: Dying patients and their reconexiones familiares, las celebraciones, y "pagando por
honor each patient, a families and clinicians. adelantado".
set of wishes was - Entre los participantes se encontraban - For patients, eliciting and customizing the wishes honored them
generated by 40 personas fallecidas, al menos una by celebrating their lives and dignifying their deaths. For families,
patients, family familia miembro por paciente, y 3 it created positive memories and individualized end-of-life care for
members, or médicos por paciente. their loved ones. For clinicians, it promoted interprofessional care
clinicians. The wishes and humanism in practice.
were implemented - The 3 Wishes Project facilitated personalization of
before or after death Baseline characteristics N=40 the dying process through explicit integration of palliative and
by patients, families, Mean age (SD), y spiritual care into critical care practice.
68.1 (15.5)
clinicians (6 of whom Women, n (%) 20 (50.0)
were project team White race, n (%) 35 (87.5)
members), or the Mean APACHE II score (SD) 30.1 (9.6)
project Location before ICU, n (%) 20 (50.0)
team. Hospital ward 10 (25.0)
- Semistructured ED 1 (2.5)
interviews of family Dialysis unit 1 (2.5)
members and Operating room 8 (20.0)
clinicians were Other hospital ward 14 (35.0)
transcribed ICU admitting diagnosis, n (%) 12 (30.0)
 verbatim, and Cardiovascular/vascular 5 (2.5)
qualitative Respiratory 4 (10.0)
description was used GI 4 (10.0)
to analyze them. Neurologic 1 (2.5)
Sepsis 39 (97.5)
Renal 1 (2.5)
Admission type, n (%) 9 (22.5)
Medical 8 (20.0)
Surgical 10 (25.0)
No CPR order on ICU 7 (17.5)
admission, n (%)
Dialysis-dependent before 4 (10.0)
ICU, n (%)
Spiritual belief, n (%) 4 (10.0)
Roman Catholic 2 (5.0)
Agnostic 1 (2.5)
Baptist 1 (2.5)
Anglican 1 (2.5)
Muslim 6 (15.0)
Lutheran 4 (10.0)
Greek Orthodox 24 (60.0)
United 16 (40.0)
None 68.1 (15.5)
Unknown 20 (50.0)
Reason for enrollment, n (%) 35 (87.5)
Very poor prognosis 30.1 (9.6)
Decision to withdraw 20 (50.0)
advanced life support
Ellis J, et al. To explore the concept of suffering - A qualitative study 49 palliative day care patients. - Para aquellos pacientes que percibieron que estaban sufriendo,
(2015) and distress by eliciting what design of focused este estudio reveló una amplia espectro de definiciones que
individual patients with advanced narrative interviews Mean age was 65.8 years (age range podrían describirse en las siguientes áreas: lo inevitable y lo
cancer perceived as suffering and how analysed by thematic 31–89 years) and 28% were male. The inevitable. el sufrimiento evitable, el sufrimiento físico y
they utilised their own resources to analysis. common cancer diagnoses were breast emocional, el sufrimiento como pérdida y, finalmente, la
manage suffering. - All transcriptions cancer (24%), colorectal cancer (16%) transformación a través del sufrimiento.
were coded and lung cancer (22%). The ECOG - Desesperanza absoluta donde la vida no tiene significado o valor
thematically using performance status of 75% of patients intrínseco puede llevar a una estado de desesperación ante la
NVivo 7 Qualitative was one or two. Thirty-seven percent of percepción de la inutilidad de la existencia, a la que Schopenhauer
analysis software. patients had been diagnosed with se refirió a como'Nihilismo Pasivo'34 - la separación de uno mismo

Leung et al., This article reports on a quasi-
(2015) experimental study on Chinese
China patients with chronic diseases who
participated in a psycho-education
group on positive death preparation.
depression or an anxiety related de voluntad y deseo para reducir sufrimiento.
disorder before the cancer diagnosis. - La desesperanza y la pérdida de control se asocian con una
Ten patients (20.4%) died within 3 mayor interés en las medidas para acelerar la muerte.
months of recruitment: the median - Aunque se puede argumentar que hay una relación entre el
survival of patients was 58.5 days (range sufrimiento de dolor severo y el deseo de una vida acelerada.
10–262 days). Of the patients muerte en pacientes con cáncer avanzado, dolor no se ha
interviewed, 98% described themselves encontrado que sea una entidad independiente.
as White British and 58% were married. - There is a correlation between the terminally ill patients’ strong
desire to
hasten death, and depression, symptom severity and
Falta reigion, hopelessness.
Conclusión: Este estudio revela que el concepto de el sufrimiento
es mucho más complejo de lo referido por otros estudios. Algunos
los participantes parecen experimentar una transformación a
través del sufrimiento y a través de este transformación, muchas
de las habilidades de afrontamiento evolucionó, como por
ejemplo; ganando una vida más espiritual la percepción de la
vida, que a su vez le dio más sentido y aceptación de la vida, de
uno mismo y de los demás.
- Quasi-experimental Among the 160 participants, 81 were This study is the first to evaluate the effectiveness of a death
pretest-posttest recruited to the intervention group and educational group on psycho-spiritual outcomes for Chinese with
design. 79 were in the control group. chronic diseases in Hong Kong. It informs the international
- The effectiveness of community that a death education intervention group can help
the intervention is N=160 reduce death-related distress and enhance death preparedness.
established by Age (SD) 56.72 - Los participantes informaron que la reducción de su nivel de
comparing the Years since diagnosis (SD) 12.58 miedo y la evitación de la muerte en la postintervención
intervention group Sex inmediata; y los cambios positivos adquiridos se mantuvieron a un
with a control group. Female 106 mes de seguimiento.
- Measurements Male 54 - Second, behaviorally, an increased level of acceptance and
were administered at Type of disease tendency in positive death preparation at post-intervention were
three different time Stroke and brain injured 27 observed.
points: baseline (T0), Diabetes 26 - Third, spiritually, participants reported higher levels of
immediately after Heart disease 21 tranquility and spirituality when facing their own death after
intervention (T1), Rheumatic disease 17 participating in the group.
and 1-month post- Respiratory disease 4
intervention (T2). Epilepsy 3
Pair sample t-tests to Chronic pain 6
comparte groups. Parkinson’s disease 6
 Hypertension 9
More than one diagnosis 17
Othera 17
Did not specify 7
Religion
Buddhism 31
Ancestral worship 29
Christianity 21
Catholics 13
Taoism 4
No religion/Did not specify 62
Miyashita et al. The objectives of this study were to First, we calculated 310 patients, 353 subjects from the - The desire to "fight against cancer" was highly significantly
(2015) compare the importance of the mean score of general population, 109 oncologists, different between patients and oncologists (effect size [ES] = -
Japan components of a good death among components of a and 366 oncology nurses participated. 1.40; P = 0.001) and patients and oncology nurses (ES = -1.12; P = 
cancer good death among 0.001).
patients, the general population, groups (cancer SI SON NECESARIOS ESTOS DATOS, - "Physical and cognitive control" was, similarly, highly
oncologists, and oncology nurses, and patients, general MEJOR MIRAR TABLA1 EN EL ARTÍCULO significantly different between patients and oncologists (ES = -
explore which patients preferred population, ES ENORME PORQUE HAY MUCHOS 1.30; P = 0.001) and patients and oncology nurses (ES = -1.06; P = 
“fighting against cancer” oncologists, and GRUPOS. 0.001).
oncology nurses). - Patients who emphasized "maintaining hope and pleasure" (P = 
We calculated the 0.0001), "unawareness of death" (P = 0.0001), and "good
effect sizes (Cohen’s relationship with family" (P = 0.004) favored "fighting against
d) and conducted completo cancer."
Wilcoxon rank sum - The patients, however, who emphasized "physical and
tests comparing psychological comfort" did not significantly favor "fighting against
cancer patients with cancer" (P = 0.004).
other groups. - Conclusión: The importance of good death components differed
- etc between groups. Medical professionals should be aware of the
diversity of values surrounding death and assess the patient’s
values and discuss them to support his or her quality of life. In
addition, the development of care and a medical/social system to
maintain hope and pleasure after failure of anticancer treatment
is necessary.
Montross- This study will instead focus on Randomized 90 patients with cancer receiving - Dignity Therapy has shown mixed results when evaluating its
Thomas et al. whether Dignity Therapy enhances controlled trial of hospice or palliative care will complete impact on distress, although no other study to date has solely
(2015) positive outcomes in this population*. Dignity Therapy (n = a mixedmethods. focused on the potential positive aspects of this treatment. This
USA * Dignity Therapy is a brief 45) versus study is novel in its use of mixed methods assessments to focus on
psychotherapy that can enhance a Supportive Attention NO INCLUYEN CARACTERÍSTICAS DE LOS positive outcomes, and will provide valuable information about
 sense of legacy while addressing the (n = 45). PACIENTES... NO SÉ VERLO. patients’ direct experiences in this area.
emotional and existential needs of - The primary
patients receiving hospice or palliative outcomes examine
care whether the Falta todo menos n total y enfermedad
treatment will
quantitatively
increase levels of
positive affect and a
sense of life closure.
Secondary outcomes
focus on gratitude,
hope, life
satisfaction, meaning
in life, resilience, and
self-efficacy.
- this study will
additionally use
qualitative
interviews to
explore patients’
perceptions
regarding the use of
positive outcome
measures and
whether these
outcomes are
appropriately
matched to their
experiences in
therapy.
Morita et al. The aim was to explore the Methods. A cross- A total of 505, 207, and 211 responses In all 12 components of a good death, there were significant
(2015) differences in attitude toward patient sectional survey was were obtained from Japanese, differences by country. Japanese physicians regarded
Japan autonomy and a good death among performed involving Taiwanese, and Korean physicians, physical comfort and autonomy as significantly more important
East palliative care respectively. and regarded preparation, religion, not being a burden to others,
Asian palliative care physicians. physicians in Japan, receiving maximum treatment, and dying at home as less
Taiwan, and Korea. ESTE ESTUDIO APORTA POCO A LO important. Taiwanese physicians regarded life completion and
Physicians’ attitudes NUESTRO: ES MUY LOCAL Y ABORDA being free from tubes and machines as significantly more
toward patient LAS IMPRESIONES DE LOS important. Korean physicians regarded being cognitively intact as

Pestinger et al. This study evaluated the motivations
(2015) of patients expressing such a desire
Germany (desire to hasten death) in a country
with prohibitive legislation on
euthanasia and physician-assisted
suicide.
autonomy and PROFESIONALES, NO LAS DE LOS
physician-perceived PACIENTES.
good death were
assessed. Falta todo menos n total y etnia
A modified form of N: 12.
Grounded Theory - Patients from the departments of
was used. palliative medicine in three hospitals in
Germany were recruited when they had
made a statement or request to hasten
death. Participants were interviewed
face to face. Recruitment was stopped
with 12 participants because of data
saturation.
Participants included 5 women and
7 men with a mean age of 62 years
(standard deviation (SD) = 12 years,
range = 38–78 years). Two patients had
chronic obstructive gastrointestinal
syndrome with polyneuropathy
and had been admitted to the palliative
care unit for pain treatment. The other
patients suffered from advanced cancer
with a limited prognosis. Six patients
were single, and six were married and
had adult children.
significantly more important.
- Hay diferencias considerables entre países en las actitudes de los
médicos hacia la autonomía y la percepción de los médicos.
de una buena muerte.
- Thematic analysis revealed three main motivational themes: self-
determination, agony, and time. Expectations toward health
professionals, attitudes toward death, and secureness related to
the end of life were additional main themes emerging from the
analysis.
- The desire to hasten death may be used as an extreme coping
strategy to maintain control against anticipated agony. Patients
expected health professionals to listen to and respect their
experiences. Emerging hypotheses included the following: (a)
patients try to balance life time and anticipated agony, and the
perception of time is distressing in this balancing act; (b)
anticipated images of agony and suffering in the dying process
occur frequently and are experienced by patients as intrusive; (c)
patients expressing a desire to hasten death are in need of more
information about the dying process; and (d) patients wanted
their caregivers to listen to and respect their wish to hasten
death, and they did not expect the caregivers to understand this
as an order to actually hasten their death.

Tomás-Sábado To examine MiL in inpatients with
et al. (2015) advanced cancer from Barcelona,
Spain Spain, and to compare the findings
with those obtained in German and
Swiss samples.
Cross-sectional study 101 pacientes hospitalizados - Family, Partnership, Well-Being and Friends were the four areas
in which the completaron el SMiLE. listed by the largest proportion of Spanish patients. Compared
Schedule for with the German sample, Spanish patients were more likely to list
Meaning in Life Characteristic n % Well-Being (P< 0.01) and Pleasure (P< 0.05), and less likely to list
Evaluation (SMiLE) Gender Animals/Nature, Leisure Time and Finances (P< 0.01). With
was administered. Male 62 61.4 respect to their Swiss counterparts, Spanish patients were more
Female 39 38.6 likely to list Health (P< 0.01) and less likely to list Friends, Leisure
Age Time, Animals/Nature and Finances (P< 0.01).
Mean (SD) [range] 61.7 (±11) [33-84] - Se identificaron diferencias en las áreas de MiL enumeradas por
 Marital status los participantes según el país de origen. En comparación con sus
Single 11 10.9 homólogos alemanes y suizos, los pacientes españoles
Married/common-law 81 80.2 enumeraron más áreas que involucran relaciones interpersonales.
Separated/divorced 9 8.9
Family situation
Lives alone 9 8.9
Lives with partner/family 44 43.6
Lives with a non-family
Caregiver 35 34.7
Lives in an institution 7 6.9
Other 6 5.9
Education
Primary education 19 18.9
Secondary education 64 63.4
Higher education 18 17.7
Nationality
Spanish 95 94.1
completo
Wagner et al. They tested the feasibility and The single-arm pilot 12 Twelve couples in which the patient - The study showed goodfeasibility. One of the two patients
(2015) preliminary efficacy of a meaning- study tested a 4- was diagnosed with stage IIB to IV lung depressed at baseline was no longer depressed at
USA based intervention for couples. session, tailored, (10 patients) or breast cancer (2 postintervention. Patients’ threat appraisals decreased and
activities-based patients) participated in this study. In transcendence increased. In partners, depression, anxiety, and
couple’s all, 10 couples were heterosexual and 2 challenge appraisal decreased; threat and secondary appraisals
intervention. couples were same-sex female couples, and peace with illness increased.
resulting in 8 female - Intervention: The intervention was grounded in existential
patients, 4 male patients, and 6 male psychotherapy and was designed to increase meaning in life and
and 6 female caregivers. sense of transcendence, determine wishes and hopes, and help
patients and their partners communicate more openly about
Patient (n= 11) 7 Female; 4 Male death and dying.
Spouse (n=11)
Gender 6 Female; 5 Male
Employment (patient/spouse)
Employed 3 / 8
Retired 3/ 2
Disabled 5 /1
Education (patient/spouse)
HS 5/6
College 2/0
 Postcollege 4/5
Age (patient/spouse)
M=59.10 years / Range (46-66 years)
M= 59.60 years / Range (54-68 years
Wang et al. The aim of this study was to examine A cross-sectional Ochenta y cinco pacientes terminales. - El bienestar espiritual correlacionó negativamente con la
(2015) the mediating or design was used. This gravedad de los síntomas.
Taiwan moderating role of spiritual well- study was conducted Gender n % - Gravedad de los síntomas correlacionó negativamente con CV y
being in reducing the impact of in the palliative care Male 40 47.1 positivamente con desesperanza y el DAM (+).
cancer-related unit of a university- Female 45 52.9 - El bienestar espiritual fue un mediador y moderador parcial
symptoms on quality of life and the affiliated hospital in Marital status entre la gravedad de los síntomas, y calidad de vida.
desire for hastened death in the Taipei area. A Married 68 80.0 - El bienestar espiritual era un mediador parcial entre los síntomas
terminally ill cancer convenience sample Unmarried 17 20.0 la severidad y el DAM(+).
patients. comprising Inpatient - La subescala de Sentido, el bienestar era un predictor más
terminally ill cancer No 35 41.2 significativo del DAM y CV la subescala de la fe.
patients was Yes 50 58.8 - Conclusión: El bienestar espiritual puede reducir los impactos
recruited for this Religious affiliations negativos del cáncer en la CV y el DAM.
study. None 10 11.8
Buddhist or Taoist 54 63.5
Christian 18 21.2
Others 3 3.5
Cancer diagnosis
Gastrointestinal 24 28.2
Head and neck 12 14.1
Breast 12 14.1
Liver 12 14.1
Gynecologic and urinary 10 11.8
Lung 7 8.3
Others 8 9.4

Delgado-Guay We conducted a randomized Los datos se N: 100 Los diez deseos más comunes identificados como muy
(2016) controlled trial to assess the EOL resumieron importante para los pacientes en la primera y segunda prueba
USA wishes of 100 patients with advanced utilizando Median age 56 (27–83) fueron 1) estar en paz con Dios (74 vs. 71 %); 2) orar (62 vs. 61 %);
cancer estadísticas Sex 3) tener familia presente (57 vs. 61 %); 4) estar libre de dolor (54
treated at The University of Texas MD descriptivas estándar Female 60 vs. 61 %); 5) 60 % no ser una carga para mi familia (48 vs. 49 %); 6)
Anderson Cancer Center. The purpose y tablas de Male 40 confiar mi médico (44 vs. 45 %); 7) mantener mi sentido del
of this study was to determine the contingencia. Ethnicity humor (41 vs. 45 %); 8) 45 %); despedirme de personas
EOL Correlación de White 68 importantes en mi vida (41 vs. 41 %); 9) 37 % tener a mi familia
wishes of patients with advanced variables continuas Hispanic 17 preparada para mi muerte (40 vs. 49 %); 10) y poder ayudar a los
 cancer and to compare patients’ se evaluó utilizando African American 9 demás (36 frente a 31%).
preference between the GWG and el coeficiente de Asian 3
List of wishes/ correlación de Other 3 - Conclusión Pacientes con cáncer avanzado a los que se les asigna
statements (LOS) containing the same Spearman. Marital status una gran importancia a la espiritualidad y a la
number of items. Se determinó la Married 62 presencia/relaciones de la familia. Los resultados fueron
asociación entre Single 17 consistentes en las dos pruebas. El GWG no empeoró la ansiedad.
variables categóricas Divorced/separated 11
usando la prueba de Widowed 10
chi-cuadrado o la Religion
prueba exacta de Christian 74
Fisher. Catholic 19
Buddhist 1
Other 6
Education
College or more 71
High school 20
Less than high school 9
Primary cancer diagnosis
Gastrointestinal 30
Lung 13
Breast 11
Urinary 10
Gynecological 7
Skin 7
Head or neck 6
Prostate 6
Leukemia/lymphoma 5
Central nervous system 1
Park et al. Estudian la relación de la We used hierarchical 191 pac. con ICC. - Although both religion and spirituality were associated with
(2016) espiritualidad con la mortalidad en Cox proportional better health behaviors at baseline in bivariate analyses, a
USA pacientes con insuficiencia cardíaca hazards models to - The sample consisted of 191 CHF proportional hazard model showed that only spirituality was
congestiva (ICC) predict patients. The sample was 64% male and significantly associated with reduced mortality risk (by 20%),
Hipótesis: la espiritualidad se risk of death. the mean age was 68.6 years (SD _ 10.1, controlling for demographics, health status, and health behaviors.
asociaría con un menor riesgo de Because we had a range _ 46 –92). Fifty-nine percent of - Experiencing spiritual peace, along with adherence to a healthy
mortalidad relatively small participants were married, 18% were lifestyle, were better predictors of mortality risk in this sample of
sample and a large widowed, and 11% were divorced. CHF* patients than were physical health indicators such as
number of variables, Racial functional status and comorbidity
we used a composition of the sample was 83.2% - congestive heart failure (CHF)

3) Tang ST et Whether prognostic awareness
al. (2016) benefits terminally ill cancer patients’
Taiwan psychological–
existential well-being and quality of
life (QOL) is unclear because of lack of
well-controlled longitudinal studies.
This study longitudinally evaluated
the associations of accurate
prognostic awareness and prognostic
acceptance with psychological
distress, existential suffering, and
QOL while comprehensively
controlling for confounders in
Taiwanese terminally ill cancer
patients’ last year of life.
correlation matrix to Caucasian, 10.8% African American,
identify variables 5.4% Native American, and 0.5% other.
that were not related
to survival or
mortality and completo
omitted
them from the
multivariate
analyses.
Patients and - Accurate prognostic awareness was - Representativeness of the target population
Methods: A not associated with the likelihood of may have been compromised by convenience sampling from a
convenience sample severe anxiety or depressive symptoms single medical center, limiting the generalizability of their findings.
of 325 cancer but significantly increased the likelihood - A remarkable proportion (10.6%) of patients withdrew from the
patients was of high self-perceived sense of burden study, and their baseline prevalence of severe depressive
followed until death. to others and was associated with symptoms, accurate prognostic awareness, and high prognostic
Psychological poorer QOL in participants’ last year of acceptance were significantly lower than for those who died
distress and life. Participants who knew and highly during the study. Whether the associations of their prognostic
existential suffering accepted their prognosis were awareness and acceptance with the identified outcome variables
were assessed by significantly less likely to experience are similar to the findings reported here remains unknown.
severe anxiety and severe anxiety symptoms than those - Our findings are also limited by assessing depressive and anxiety
depressive who were unaware of or knew their symptoms with the HADS rather than sychiatrists’ diagnostic
symptoms and high prognosis but had difficulty accepting interviews; using a questionnaire may overestimate the
self-perceived sense it. prevalence of severe anxiety/depressive symptoms but avoids
of burden to others, - In conclusion, knowing one’s poor misrecognizing patients’ need for psychological support.
respectively. prognosis and confronting one’s - The discovery of associations of accurate prognostic awareness
Dichotomized and impending death without acceptance and high prognostic acceptance with psychological distress,
continuous (QOL) and adequate professional psycho- existential suffering, and QOL does not indicate a cause–effect
outcome variables spiritual support may relationship. We cannot rule out the possibility that our
were evaluated by harm more than benefit terminally ill observations may be associated with unmeasured confounders,
multivariate logistic cancer patients’psychological state, for example, coping capacities or strategies.
and linear regression existential well-being, and QOL.
modeling with the - Prognostic disclosure should not be
generalized universally advocated for all terminally
estimating equation, ill cancer patients without
respectively. appropriately assessing their
preferences for and individual
- Participants were psychological–existential vulnerabilities
predominantly male to prognostic discussions.
(n =187; 57.5%), - Minimizing the negative effects of
younger than 66 prognostic awareness on terminally ill
years old (n =225; cancer patients’ psychological distress,
69.2%), married (n = lifting their selfperceived sense of
250, 76.9%), burden to others, and enhancing their
Buddhists or Taoists QOL may promote optimal quality of
(n =206, 63.4%), with care at EOL.
less than a senior
high school Falta todo menos n total, esa
education (n =181, informacion no es de la muestra, los
55.7%), and without campos estan en donde no
financial strain (n corresponden
=244, 75.1%).

The most common

cancer sites were
stomach (n =61,
18.8%), liver (n= 54,
16.6%), pancreas (n
=49, 15.1%), head
and neck (n =33,
10.2%), and lung (n
=32, 9.9%).

At enrollment,
participants had
been diagnosed with
cancer on average
for 18.97 months
(SD=34.16; range=1–
359; median=9).
After enrollment,
they survived 153.12
days (SD=162.40;
range=5–667;
median=94.0), with
14.8% (n=48), 33.5%
(n=109), 24.0%
 (n=78), and 27.7%
(n=90) surviving 1–
30, 31–90, 91–180,
and 181–365 days,
respectively.

2) Tang ST et; This study was undertaken to - Severe anxiety - A convenience sample of 325 patients - The prevalence of severe anxiety symptoms increased as death
al. (2016) describe changes in the prevalence of symptoms were with cancer was followed until death. approached (18.6%, 21.9%, 26.7%, and 33.4% at 181-365, 91-180,
Taiwan severe anxiety symptoms and to identified as anxiety 31-90, and 1-30 days before death, respectively). However, after
identify its correlates in the last year subscale scores of 11 - Of 433 eligible patients, 380 were controlling for covariates, this temporal increase was not
of life for patients with cancer. or greater on the enrolled (87.8% participation). significant. The prevalence of severe anxiety symptoms was not
Hospital Anxiety and Characteristics of patients who did and associated with fixed demographics and disease-related
Depression Scale. did not participate cannot be compared characteristics, except for diagnosis and metastatic status, but
Longitudinal changes because of restricted access to was significantly higher in patients with cancer with high physical
in and correlates of information about those who refused to symptom distress, severe depressive symptoms, high perceived
severe anxiety participate. Patients who died during burden to others, and strong perceived social support.
symptoms were the study (N=325) comprised the final - Severe anxiety symptoms were not associated with time
examined from sample. proximity to death per se but were related to factors modifiable
demographics, by high-quality EOL care. Clinicians may decrease the likelihood
disease-related - Participants were primarily male, older of severe anxiety symptoms at EOL by adequately managing
characteristics, than 56 years, married, and physical and depressive symptoms and lightening perceived
disease burden, Buddhists/Taoists. Half the patients burden to others for patients strongly connected with their
perceived burden to (50.1%) had stomach, liver, and pan- social network to improve their psychological well-being.
others, and social creatic cancer.
support using
multivariate logistic Falta EC,
regression modeling
with generalized
estimating
equations.
1) Tang ST et al. To explore longitudinal changes in LST preferences Elegible pat. N=433 Participants predominantly rejected cardiopulmonary
(2016) LST* preferences and their (cardiopulmonary Final Sample: 249. resuscitation, ICU care, intubation, and mechanical ventilation at
Taiwan associations with accurate prognostic resuscitation, EOL without significant changes as death approached.
awareness, intensive care unit Repeated Assessments - Patients with inaccurate prognostic awareness were significantly
physician-patient EOL care [ICU] care, No n =53; Yes n =249 more likely than those with accurate understanding to prefer ICU
discussions, and depressive symptoms intubation, and care, intubation, and
in terminally ill cancer patients’ last mechanical mechanical ventilation than to reject these LSTs.
year. ventilation) were Total, n=302: - Patients with more severe depressive symptoms were less likely
*life-sustaining treatment measured Gender, % to prefer ICU care and to be undecided about wanting ICU care
approximately every Male 57.0 and mechanical ventilation than to reject such LSTs.
two weeks. Changes Female 43.1 - LST preferences were not associated with physician-patient EOL
in LST preferences Age, %,-yrs care discussions, which were rare in our sample.
and their <=45 15.2 - In conclusion, the majority of terminally ill Taiwanese cancer
associations with 46-55 24.8 patients did not prefer LSTs at EOL, and such preferences
independent 56-65 27.8 remained stable even when
variables were >65 32.1 death approached. Accurate prognostic awareness and more
examined by Educational level, % severe depressive symptoms were associated with a higher
hierarchical <Senior high school 59.5 likelihood of rejecting LSTs. However, only approximately one-half
generalized linear >=Senior high school 40.5 of our participants were
modeling with With chronic disease, % accurately aware of their prognosis at enrollment.
logistic regression. Yes 61.9
No 38.1
Cancer site, %
Liver-pancreas 32.5
Stomach 17.9
Lung 10.3
Head and neck 9.6
Other 29.8
Metastasis, %
Yes 75.8
No 24.2
Postdiagnosis survival at enrollment,
months, %
1e6 42.4
7e12 18.9
13e24 19.9
$25 18.9
Prognostic awareness, %
Yes 70.9
No 20.1
Accurate prognostic awareness, %
Yes 54.3
No 45.7
EOL care discussion, %
Yes 11.3
No 88.7
 Preference for CPR, %
Yes 10.4
No 62.5
Undecided 27.1
Preference for ICU care, %
Yes 14.8
No 54.9
Undecided 30.3
Preference for intubation, %
Yes 9.0
No 66.2
Undecided 24.8
Preference for mechanical ventilation
support, %
Yes 11.4
No 60.5
Undecided 28.1

completo
Tipseankhum n, The aims of this study were to explore - A qualitative There were seven participants engaged - Three main themes emerged: 1). ‘State of being’, experience
et al. (2016) the experiences approach was through multiple in-depth interviews. facing the end of life. 2). ‘Quality of life’, experience of life
Thailand of people with advanced cancer in employed using a - Their family caregivers, and five public satisfaction and satisfaction with care; and 3) ‘Compassionate
home-based palliative care and to phenomenological health nurses provided perspectives on care in the Buddhist view’, a holistic approach through
study and inform investigation of caregiving through focus group caregiver assistance, resources and supplies. Palliative care
caregiving for them. people with discussions. experiences served to enhance the quality of life for people with
advanced cancer - The particip. with advanced cancer had advanced cancer through a culturally-appropriate,
with data gathered a mean age of 59 with a range of 37-84 holistic approach of family and nursing care.
from 2011 to 2012. years. - This study shows how persons with cancer and their relatives
- faced end of life crises while fighting to maintain peace and
PAC Age Marital Priordignity. Sufferers' life experiences and how caregivers helped
Gender status occupation
people with advanced cancer deal with their cancer, suffering, and
M1 68 M* married small trade
enabled them to have a better quality of life.
M2 58 M married wage workers
W3 58 W* married housewife
W4 53 W widow housewife
W5 84 W widow none
W6 55 W widow housewife
M7 37 M married employee
Bernard M et al 1) the relationship between cross-sectional study - 206 Swiss palliative patients. Los resultados indicaron una relación negativa significativa entre
(2017) spirituality, meaning in life, wishes for involving face-to- FACIT-Sp / SMILE y las puntuaciones totales de HADS (P = 0,000).
Switzerland hastened death and psychological face interviews Age El mejor modelo para QOL explicó el 32.8% de la varianza (P =
distress in palliative patients and 2) - Cuestionarios: 30-49 years 13 6.3 0.000) e incluyó los puntajes totales de FACIT-Sp, SMILE y SAHD, el
the extent to which these nonphysical including the 50-59 years 38 18.4 puntaje de "religiosidad privada" del IIR, así como el puntaje de
determinants influence QOL. Schedule for 60-69 years 65 31.6 "depresión" de HADS.
Meaning in Life 70-79 years 58 28.2 - Tanto el bienestar espiritual como el significado en la vida
Evaluation (SMILE), 80-99 years parecen ser factores protectores potenciales contra la angustia
the Functional Missing psicológica al final de la vida.
Assessment of 32 15.5
Chronic Illness Gender
Therapy-Spiritual Male 100 48.5
Well-Being Scale Female 106 51.5
(FACIT-Sp), the Idler Marital status
Index of Religiosity Single 31 15.0
(IIR), the Hospital Married /
Anxiety and Legal Partnership
Depression Scale 91 44.2
(HADS), and the Divorced/
Schedule of Attitudes Seperated
toward Hastened 45 21.8
Death (SAHD). QOL Widowed 34 16.5
was measured with a Missing 5 2.4
single-item visual Education
analogue scale (0- Less than or primary school / secondary
10). school 44 21.4
Professional school/ Apprenticeship /
High school 105 50.9
Vocational school / University
Other
54
1
26.2
0.5
Missing 2 1.0
 Mother tongue
French 66 32.0
German 97 47.1
Italian 34 16.5
Other
Missing
9 4.4
Religion
Catholic 106 51.5
Protestant 67 32.5
Atheist 16 7.8
Other 12 5.9
Missing 5 2.4
Primary Diagnosis
Cancer 197 95.6
End stage heart disease 1 0.5
End stage pulmonary disease 1 0.5
ALS 5 2.4
Missing 2 1.0

Brown AJ et al. The purpose of this study is to
(2017) evaluate if locus of
USA control (LOC) predicts various quality
of life (QOL) and mental
well-being measures among
terminally ill cancer patients at
the time of palliative care consult.
Methods Multi-site N=100.
analysis of patients Gender Male 48 (48.00%); Female 52
with advanced (52.00%)
cancer being seen as Race/Ethnicity Asian/ 2 (2.02%)
new patients in a Black/African American 14 (14.14%)
Palliative and Latino/Hispanic 2 (2.02%)
Supportive Care White/Caucasian 81 (81.82%)
outpatient clinic. Unknown 1
Education High school graduate 28
(28.28%)
Some College 39 (39.39%)
College and/or graduate school 32
(32.32%)
Unknown 1
Marital status Married 67 (67.00%)
Divorced/separated 16 (16.00%)
Single 7 (7.00%)
Widowed 10 (10.00%)
- After adjusting for site, race, and partnership status, higher levels
of LOC chance predicted decreased QOL (FACT-G) (p <
0.01).Higher levels of LOC chance also correlated with increased
depression and anxiety (p ≤ 0.01) and decreased meaning/peace
and faith (p ≤ 0.01). Additionally, higher levels of LOC chance
predicted decreased hope (HHI) (p ≤ 0.001).
- Terminally ill cancer patients with a high LOC chance may be at
risk for decreased physical and mental wellbeing at the end of
life. Efforts should be made to identify
these patients and design interventions to increase their feelingof
control over the situation in order to improve physical and mental
well-being at the end of life.
 Religion
Catholic 21 (21.21%)
Protestant 15 (15.15%)
Baptist 19 (19.19%)
Jewish 3 (3.03%)
None 3 (3.03%)
Other 38 (38.38%)
Unknown 1
Primary disease
Gynecologic Oncology 10 (10.00%)
Breast 11 (11.00%)
Lung 24 (24.00%)
Head and Neck 8 (8.00%)
Gastrointestinal 19 (19.00%)
Genitourinary 12 (12.00%)
Leukemia 3 (3.00%)
Lymphoma 3 (3.00%)
N Mean (SD) Median Min-max
Age
100 60.02 (10.85) Median 60 Min-Max
35.0–91.0
Months since diagnosis 9
9 1.38 (1.47) 0.83 0.0–5.6
Months until death/last-FU
100 12.09 (22.28) 2.88 0.1–84.5
Chimluang, J et To evaluate the effect of an Quasi-experimental 48 patients participated in this study: 23 - El bienestar espiritual de los participantes en el grupo
al. (2017) intervention based on basic Buddhist research study had in the experimental group and 25 in the experimental fue significativamente mayor que el de los
Thailand principles on the spiritual well-being pre- and post-test control group. Their mean age was 53 participantes en el grupo de control en el segundo test posterior
of patients with terminal cancer. control groups. (standard deviation 10) years. (P <0.05).
- The experimental - There are considerable benefits to encouraging
group received Personal data Control group patients to increase their spiritual well-being through practicing
conventional care Total (N=48) the Buddhist principles of precept, concentration and wisdom.
and an intervention Sex: Male 21 (43.75); Female 27 (56.25) - Este resultado respalda los efectos beneficiosos de implementar
based on basic Age (years) este tipo de intervención para pacientes con cáncer terminal.
Buddhist principles <40 4 (8.33)
for three consecutive 40-50 14 (29.17)
days, including seven 51-6020 (41.67)
activities based on >60 10 (20.83)
 precept activities, Marital status
concentration Single 6 (12.50)
activities and Married 35 (72.92)
wisdom activities. Divorced 3 (6.25)
The control group Widowed4 (8.33)
received Education level
conventional care Uneducated 1 (2.08)
alone. Primary school 24 (50.00)
High school or equivalent 10 (20.83)
Bachelor's degree or higher
13 (27.08)

Egan R et al. International studies have shown that
(2017) patients want their spiritual needs
New Zealand attended to
at the end of life. The present authors
developed a project to investigate
people’s understanding
of spirituality and spiritual care
practices in New Zealand (NZ)
hospices.
Falta religion,
- A mixed-methods 52 entrevistas semiestructuradas y una
approach. encuesta de 642 pacientes, familiares y
- employed a generic personal de 25 (78%) de los hospicios de
qualitative design Nueva Zelanda.
and analysis to
capture the - Study One involved 52 participants at
experiences and 7 hospice sites and 1 hospital oncology
understandings of site (patients n 24, fam=ily members n ¼
participants’ 9, staff n=8, chaplains n=8, Ma¯ori
spirituality and experts n= 3). There were 24 men and
spiritual care, while a 28 women
cross-sectional participants. Some 88% of participants
survey yielded were European/pa¯keha¯ ; the majority
population level (73%) were married; and59% we re
information. affiliated with a Christian religion, while
28% had no affiliation. Almost half
(47%) the participantshad some
university qualifications, 26% had
graduated from a trade school, and 28%
had secondary school qualifications.
- Findings suggest that spirituality is broadly understood and
considered important for all three of the populations studied.
- The patient and family populations had high spiritual needs that
included a search for (1) meaning, (2) peace of mind, and (3) a
degree of certainty in an uncertain world.
- The healthcare professionals in the hospices surveyed seldom
explicitly met the needs of patients and families. Staff had spiritual
needs, but organizational support was sometimes lacking in
attending to these needs.
- Given that spirituality was found to be important to the majority
of our participants, it is hoped that the adoption of such an
approach will impact on spiritual care for patients and families in
NZ hospices. (primer estudio sobre NE a nivel nacional en NZ).

completo

XGB et al. Describir los resultados cuantitativos Se emplearon 29 equipos EAPS (133 profesionales). Creamos 29 equipos de apoyo psicosocial con 133 profesionales,
(2017). y cualitativos generales de un métodos cualitativos 8954pacientes y 11810 familiares. principalmente psicólogos y trabajadores sociales. Durante el
Spain programa de la Fundación La Caixa y
del Centro Colaborador de la OMS
titulado “Atención integral para
pacientes con enfermedades
avanzadas y sus familias” después de
cuatro años de experiencia.
y cuantitativos para - During the inclusion period, a total of
evaluar el 8,964 patients (54.8% male) attended.
programa. Se The mean age was 70.4 years (range =
utilizaron métodos 1–103 years). Most patients (77.9%) had
cuasiexperimentales, a cancer diagnosis (primarily lung,
prospectivos, colorectal, or breast cancer), while the
multicéntricos, de remaining 22.1% had otherchronic
grupo único y pretest diseases or conditions (mainly geriatric
/ posttest para frailty,multimorbidity, dementia, or
evaluar los datos cardiac/respiratory failure).
cuantitativos. - Main patient pathologies
Oncological 77.9% Non-oncological
22.1%
Lung 16.1% Geriatric comorbidities
16.1%
Colorectal 10.6% Dementia 3.7%
Breast 6.2% Heart failure 2.7%
período de estudio, asistieron 8964 pacientes y 11810
familiares. Se observaron mejoras significativas en las
dimensiones psicosociales y espirituales evaluadas. Los pacientes,
los familiares y las partes interesadas mostraron altos niveles de
satisfacción.
- las intervenciones psicosociales específicas administradas por
expertos bien capacitados pueden ayudar a aliviar el sufrimiento
y la incomodidad en pacientes con cuidados paliativos al final de
su vida, particularmente aquellos con altos niveles de dolor o
angustia emocional.
- In 1,175 patients whowere interviewed on three or more visits,
the visit effect was significant for peace of mind/forgiveness (LR ¼
190.94, p , 0.0001), decreasing by 3% between the first and
second visits and by 6% between the first and third (interesa a
nuestra revisión)

- A total of 11,810 family members

attended during the inclusion period.
The average age of family caregivers
was 55.3 years (SD ¼ 15.8). Most
caregivers were female (70.2%).

Guerrero- El objetivo de este estudio fue
Torrelles analizar la relación entre WTHD
(2017). (DAM) y MiL (Sentido de la Vida) y
Spain proponer un modelo teórico de
relaciones funcionales entre WTHD,
Performance Status (PS), depresión y
MiL.
Cross-sectional - 101 pacientes - El WTHD se correlacionó significativamente (P  <0.01) con MiL
Estudio transversal ( r  = 0.60), performance status (r  = 0.548) y depresión (r  =
de 101 pacientes en 62 men and 39 women completed the 0.397). El análisis de modelación de ecuaciones estructurales
una unidad de study; mean age = 61.7 years (SD = 11), mostró que aunque no hubo un efecto directo significativo entre
cuidados paliativos, range 33-84. el PS y el WTHD, hubo un efecto total significativo debido a la
que fueron mediación de la depresión y la MiL. Este último jugó el papel más
evaluados en el Falta EC, etnia, religion, importante, representando el 76.5% de la mediación.
contexto de una - Estos resultados respaldan el modelo propuesto y proporcionan
entrevista clínica. Las evidencia de un efecto mediador de MiL y depresión en la relación
medidas de entre el deterioro físico y la WTHD en pacientes avanzados. Los
resultado incluyeron hallazgos sugieren que las intervenciones para mejorar MiL
estado de podrían ayudar a abordar y / o prevenir la aparición de una
rendimiento, WTHD en esta población.
 depresión, MiL y
WTHD. Se utilizó el
modelado de
ecuaciones
estructurales para
analizar las
relaciones
funcionales entre
estos factores.

Lisa Kastbom et The aimof this study was to explore Qualitative content n = 66 (in 1997– 1998 n = 54 and in
al. (2017) the perception of a good death in analysis (interviews) 2007 n = 12).
Sweden dying cancer patients in Sweden. Age mean (range) 64.7 years (30–90)
Gender men/women (n) 44% (29)/56%
(37)
Cohabitant/living alone (n) 52%
(34)/48% (32)
Having children yes/no (n) 83%
(55)/17% (11)
Having religious faith (n) 21% (14)
Diagnosis: malignancy (n)
Digestive organs 30% (20)
Female genital organs 17% (11)
Lymphoid or haematopoietic system
14% (9)
Respiratory tract 12% (8)
Breast 12% (8)
Urinary tract 5% (3)
Various (skin, central nervous system,
male genital organs, unspecified) 10%
(7)
Time from cancer diagnosis to
interview <3 months 9% (6)
4–12 months 33% (22)
>1 year 58% (38)
Los pacientes contemplan la muerte como un proceso.
- A good death was associated with living with the prospect of
imminent death, preparing for death and dying comfortably, e.g.,
dying
quickly, with independence, with minimised suffering and with
social relations intact. Some were comforted by theirbelief that
death is predetermined. Others felt uneasy as they considered
death an end to existence. Past experiences of the death of others
influenced participants’ views of a good death.
- Conclusiones: El personal sanitario que atiende a pacientes
paliativos debería considerar pedirles que describan lo que
consideran una buena muerte para identificar objetivos para la
atención. Explorar la experiencia personal de los pacientes sobre
la muerte y el morir puede ayudarles a abordar sus temores a
medida que se acerca la muerte.

Martoni AA et Este estudio evalúa el bienestar
al. (2017) Italy espiritual (SpWB) en pacientes con
cáncer muy avanzado asistidos por el
programa de cuidados paliativos en el
hogar de ANT Foundation, una
organización italiana sin fines de
lucro.
Time from interview to death <1 month
12% (8)
1–3 months 30% (20)
4–12 months 27% (18)
>1 year 30% (20)
Type of care when interviewed
Oncological outpatient clinic 35% (23)
Palliative care ward (hospice) 35% (23)
Palliative home care 30% (20)
Ongoing palliative oncological
treatment 12% (8)
Falta religion, etnia,
Quantiative. - Pacientes con cáncer muy avanzado - El estudio sugiere que los pacientes italianos con cáncer
Transversal. domiciliarios. avanzado asistidos por equipos expertos multiprofesionales en el
- Los cuestionarios fueron distribuidos a entorno de cuidados paliativos en el hogar tienen un bajo nivel de
1.055 pacientes y 683 fueron SpWB, lo que pone de relieve la necesidad de integrar el apoyo
compilados y evaluables para su espiritual como parte de la atención integral del cáncer.
análisis: - Dado que el SpWB confirmó ser un componente importante en
la QoL, la implementación de apoyo espiritual en este tipo de
Gender n/% pacientes debe considerarse. El objetivo principal de esta
Female 327 54.2 intervención debe ser
Male 276 45.8 destinado a ayudar a los pacientes a encontrar un significado y un
Age propósito de sus experiencias pasadas y presentes, y lograr una
18–45 22 3.3 sensación de paz interior independ. de las creencias religiosas.
46–65 155 22.7 - los médicos del equipo, las enfermeras y los psicólogos deberían
66–75 205 30.0 ser más sensibles a las Necesidades espirituales y religiosas.
>75 282 42.5
Citizenship
Italian 563 98.6
European non-EU 4 0.7
Non-European 4 0.7
Region of residence in Italy
North 287 42
Center 139 20.4
South 257 37.6
Marital status
 Married 417 61.3
Widow 163 24
Single/divorced/separated 100 14.7
Years of education
<5 41 6
5–8 443 65.2
12–13 145 21.4
>13 50 7.4
Karnofsky Performance Status
≤40 172 27.2
50–60 279 44.1
70–100 181 28.6
Years elapsed from diagnosis
<1 197 29.2
1–3 237 35.1
>3 241 35.7
Religion
Catholic 626 92.3
Other religion 17 2.5
None 35 5.2
Participation in religious rituals
Full 157 23.2
Partial 352 51.9
None 169 24.9

Mosher CE, et …examined whether adding a peer
al. (2017). helping component to a coping skills
USA intervention leads to improved
meaning in life and peace for
advanced gastrointestinal cancer
patients and their caregivers.
randomized trial - Randomized (n=50 patients; n=50
caregivers).
- Eligible patients had been diagnosed
with stage IV GI cancer.
- Eligible caregivers lived with the
patient or had visited the patient at
least twice a week for the past month.
- One or both dyad members had to
report moderate to severe distress,
defined as a score of 3 or higher on the
Distress Thermometer.
- Small effects in favor of the coping skills group
were found regarding meaning in life/peace at 1 and 5 weeks
post-intervention.
- With both groups showing small decreases in patient and
caregiver fatigue and caregiver distress and burden.
- Although a telephone-based intervention is
feasible and acceptable for this population, peer helping in the
context of a coping skills intervention does not enhance
spiritual well-being relative to coping skills alone.
Rohde et al. Explorar el SWB (bienestar espirit.) en
(2017) pacientes con cáncer colorrectal que
Norway reciben quimioterapia en la fase
paliativa.
Steinhauser, et Determine whether an intervention
al. 2017. to address seriously ill patients’
USA existential concerns improves
preparation, completion (elements of
quality of life [QOL] at end of life),
and reduces anxiety and depression.
qualitative method Se incluyeron 20 pacientes con cáncer El conocimiento sobre el uso de diferentes estrategias por parte
of in-depth colo-rectal en fase paliativa; rango: 34 a de los pacientes para aumentar su SWB puede ayudar a los
interviews and a 75 años: profesionales de la salud a guiarles. Necesitan coraje y disposición
hermeneutic 12 pacientes con QMT 1ªlínea y 8 con para compartir los pensamientos, creencias y “grief” de sus
editing approach for QMT 2ªl. pacientes para guiarles hacia la mejora del SWB.
the analyses and 12 hombres y 8 mujeres
interpretations.
Falta todo menos n total, enfermedad, y
sexo
A randomized Patients (n= 221) were randomly - Outlook had an impact on social well-being and preparation
controlled trial assigned 1:1:1 to outlook, RM, and UC. compared with UC. The lack of impact on anxiety and depression
comparing outlook Patients were 96% males, 46% with differs from previous results among hospice patients. Results
intervention, cancer, 58.4% married, and 43.9% of suggest that outlook is not demonstratively effective in
relaxation African American origin. populations not experiencing existential or emotional distress.
meditation (RM), and - Thus, the trial did not produce the hypothesized effects.
usual care (UC). Diagnosis (Overall) n(%)
Cancer 102 (46.2)
Chronic obstructive pulmonary disease
73 (33.0)
Congestive heart failure 30 (13.6)
End-stage renal disease 15 (6.8)
End-stage liver disease 1 (0.5)
Marital status
Married/living with a partner 129 (58.4)
Divorced/separated 60 (27.1)
Widowed 16 (7.2)
Single, never married 16 (7.2)
Race
White 117 (52.9)
Black/African American 97 (43.9)
Other 7 (3.2)
Hispanic/Latino ethnicity
Yes 3 (1.4)
No 218 (98.6)
Education
Less than high-school degree 21 (9.5)

Walshe et al. To understand successful strategies
(2017). used by people to cope well when
UK. living with advanced cancer; to
explore how professionals can
support effective coping strategies; to
understand how to support
development of effective coping
strategies for patients and family
carers.
High-school degree or GED 79 (35.7)
Some college, associate’s degree, and
trade school 84 (38.0)
Bachelor’s degree 21 (9.5)
Some graduate/profession school or
degree completion 16 (7.2)
Religion
Christianity 203 (93.1)
Other 5 (2.3)
Not member of a religion 10 (4.6)
Do you consider yourself?
Not at all religious 9 (4.3)
Only slightly religious 17 (8.2)
Fairly religious 87 (41.8)
Deeply religious 95 (45.7)
How important is faith or spirituality in
your life?
Very important 150 (68.8)
Somewhat important 61 (28.0)
Not at all important 7 (3.2)
comleto
Qualitative serial (4- 26 people with advanced (stage 3-4) - 45 patient and 41 carer interviews were conducted plus 4 focus
12 week intervals) breast, prostate, lung or colorectal groups (16 participants).
interview study with cancer, or in receipt of palliative care, - People with advanced cancer and their informal/family carers
people with and 24 paired nominated develop coping strategies which enable effective management of
advanced cancer and informal/family carers. psychological wellbeing. People draw from pre-diagnosis coping
their informal carers - Participants recruited through strategies, but these develop through responding to the
followed by focus outpatient clinics at two tertiary cancer experience of living with advanced cancer. Strategies include
groups. The iterative centres in Merseyside and Manchester, being realistic, indulgence, support, and learning from others,
design had a novel UK, between June 2012 and July 2013. which enabled participants to regain a sense of wellbeing after
focus on positive emotional challenge. Learning from peers emerged as particularly
coping strategies. Gender Patient: M = 17; F = 9 important in promoting psychological wellbeing through the
Interview analysis Age Age range 32-82 (Mean 56.9) development of effective 'everyday', non-clinical coping
focused on patients Ca. strategies.
and carers as 1. Breast = 4 - Peer support may have potential, and could be a patient-
individuals and pairs, 2. Prostate = 3 centred, cost effective way of managing the needs of a growing
 exploring multiple 3. Lung = 8 population of those living with advanced cancer.
dimensions of their 4. Colorectal = 9
coping experiences. 5. Other (via palliative care clinic) = 2
Focus group analysis Occupation
explored strategies 1. Retired = 12
for intervention 2. Working = 13
development. 3. Home maker = 1

Gender Participant: M = 6; F = 18
Age range 28-74 (Mean 52.5)
Relationship to patient participant
1. Spouse = 17
2. Child = 4
3. Parent = 2
4. Sibling = 1
Occupation
1. Retired = 6
2. Working = 12
3. Home maker = 6

Falta etnia, religion,

Warmenhoven explorar las opiniones de los A pilot qualitative 15 pacientes ambulatorios con ca. - Patients reported on attitudes and specific coping strategies that
et al (2017) pacientes de cuidados paliativos study (flojito) was avanzado. they found helpful, as well as aspects of their life narrative and
Belgium sobre los recursos y las formas de performed through - Eight women and seven men spirituality. Resources were found in meaningful contacts with
afrontamiento que los ayudan a face-to-face semi- participated in this study. Patients had a family and friends and in personal attention of professional
prevenir o controlar los síntomas del structured mean age of 65 years with a range of medical caregivers for their wellbeing.
estado de ánimo. interviews. 51-89 years. - In helping patients to identify the personal resources that are
- Las entrevistas accessible and available in their specific context, patient
fueron transcritas - Total 15 autonomy in enhancing resilience could be increased.
textualm. y el análisis Age: 65 (range 51-89)
cualitativo fue 15.9 (range 5-35)
realizado de forma Self-reported history of depression
independiente por N=7
dos investigadores, Months since receiving diagnosis of
de acuerdo con el incurable illness (median and range)
principio del análisis 22 (range 1-115)
comparativo
constante. Falta todo menos n total, enfermedad,

Bovero et al. The study aimed to investigate
(2018). dignity among end-of-life cancer
Italy. patients, by examining the Italian
version of the PDI factor
structure and assessing the
relationship between dignity and
other patients’ psychosocial and
spiritual variables to improve a
patient-centered clinical practice.
Breitbart et al. They examined the effectiveness of
(2018). USA. Individual Meaning Centered
Psychotherapy (IMCP) compared to
supportive psychotherapy (SP) and
enhanced usual care (EUC) in
improving spiritual well-being and
quality-of-life and reducing
psychological distress in patients with
advanced cancer
sexo, ni grupos
Cross-sectional - The sample included 127 hospice
study. patients with a life expectancy of a few
weeks and a Karnofsky Performance
Status ≤40. Factor structure and
concurrent validity of PDI and
correlations between dignity and
anxious and depressive
symptomatology, quality of life,
demoralization, personal coping styles,
spiritual well-being, and spiritual daily
experience were analyzed.
- Sex, n (%) Male 65 (51.2) Female 62
(48.8) Age (years) 75.2 ± 11.4.
- Marital status, n (%) Married 72 (56.8)
Never married 20 (15.7)
Separated/divorced 6 (4.7) Widowed 29
(22.8).
- Religious practice, n (%) Prayer 74
(58.3) Not prayer 53 (41.7)
‘
completo
Quantitative; A total of 4618 patients were assessed
intervention. for eligibility, and 346 were deemed
3-arm randomized, eligible and provided informed consent:
controlled design
The final sample, described in Table 1,
included 230 women (71.7%), ranging in
age from 25 to 85 (M=58.0, SD=11.0).
The sample was predominantly
white/non-Hispanic (n=242, 75.7%), and
the most common cancer diagnoses
were lung (n=55, 17.4%), pancreatic
(n=54, 16.8%), and ovarian (n=48,
15.0%). There were no significant
differences between the three
treatment arms on any demographic or
- Factor analysis highlighted a five-factor solution, accounting for
60% of the overall
variance. The factors were labeled Psychological Distress, Social
Support, Physical Symptoms and Dependency, Existential Distress,
and Loss of Purpose/Meaning. Dignity assessment evidenced that
self-blame coping style, emotional and physical well-being, and
depression were the loss of dignity significant predictors (R2 =
0.605; p < 0.01).
- Personality traits seem to have an active role in the loss of
dignity, whereas spirituality is confirmed to be positively involved
in dignity enhancement.
Significant treatment effects (small to medium in magnitude) were
observed for IMCP, compared to EUC, for five of seven outcome
variables (quality-of-life, sense of meaning, spiritual well-being,
anxiety and desire for hastened death), with Cohen’s d ranging
from .1 to .34; no significant improvement was observed for
patients receiving supportive therapy (SP) (d < .15, p > . 05 for all
variables). The effect of IMCP was significantly greater than SP for
quality-of-life and sense of meaning (d=.19), but not for the
remaining study variables. MCP is an effective
intervention for improving quality-of-life and spiritual well-being
and reducing
psychological distress. This intervention targets the challenging
domains of existential and
spiritual despair, which many clinicians feel ill prepared to
address.
 medical variables.

Falta etnia, EC, religion,

Chaar et al. To assess the impact of spirituality on Observational N=115 Lebanese cancer patients.
2018 the quality of life, depression, and transversal Average age 56.90 ± 15.48 years (67% of
Lebanon anxiety of Lebanese cancer patients. monocentric study women). 80.4% were married; 90,7%
(Líbano) lived within a family; 61,5% completed
university education; and 32% worked
full time (32%). The two most common
cancers were breast cancer (37.1%) and
cancer of the trachea, bronchus, and
lungs (15.5%). 74.2% of patients had
stage IV cancer.
Better emotional and cognitive functioning was seen in patients
with higher meaning, peace, faith, and total FACIT scores.
Meaning, peace, and total FACIT scores were also higher among
patients with better global health status and quality of life.
Anxiety as well as depression was significantly associated to all
spiritual well-being factors. Conclusion: Spirituality can improve
quality of life and decrease the incidence of anxiety and
depression in cancer patients.

Falta, EC, religion

Guerrero- Procesos de fin de vida en residencias A descriptive and - 34 familiares respondieron al
García et al. de ancianos desde la perspectiva de retrospective study. cuestionario. El 67,6% fueron mujeres
(2018) los familiares (media de 57,03 a. (DT = 12,35). En
cuanto a los pacientes fallecidos, la
mayoría fueron mujeres (61,8%), con
una edad media de 86 años (DT = 7,23).
El 48,3% tenía deterioro cognitivo y el
síntoma más intenso en los últimos días
de vida de fue la depresión (media [m] =
7,75; DT = 2,44). El 79,3% de la muestra
presentaba una enfermedad no
oncológica.
- La dimensión que los familiares puntuaron mejor fue «Ser
respetado como individuo» (m = 6,01; DT = 1,56) y la peor
«Independencia» (m = 1,72; DT= 1,28). Los familiares de pacientes
con demencia reportaron en menor porcentaje de una buena
muerte (23,1% vs. 61,1%, p = 0,00) que el resto.
- Las dimensiones «Bienestar físico y psicológico» (p = 0,00),
«Mostrar esperanza y placer» (p = 0,03) y «Sentir que su vida vale
la pena vivirla» (p = 0,01) obtuvieron mayores puntuaciones en los
casos que se informó de una buena muerte.
- Casi la mitad de los familiares de los pacientes fallecidos en
hogares de ancianos informó de una buena calidad de muerte.
Aspectos tales como el respeto humano y la intimidad fueron
valorados positivamente.

Falta etnia, EC, religion

Masterson et To examine the prevalence and
al. (2018) common themes of unfinished
business (UB)* and its associations
with distress among advanced cancer
patients.
Randomized N=223 advanced cancer patients; 72%
controlled trial were female; 81% Caucasian; and
college educated (Mean years of
education = 16.6; SD = 2.6). The age of
patients ranged from 25 to 84 with a
Over 70% reported the presence of UB, with nearly half (45%)
providing a distress rating of “8” or above on the 10- point rating
scale. Their results identified significant associations between UB,
UB-related distress, and psychological adjustment. Patients
demonstrated significantly higher levels of anxiety and

Shirkavand et To study the correlation between
al. (2018). spiritual well-being with life
Iran satisfaction and death anxiety among
patients enduring cancer at major
hospitals in Tehran.
Shukla – Rishi To find out the role of attributional
(2018) style and explore the relation
India between different types of well-being
and death anxiety across gender in
order to strengthen their adaptability
mean of 57.8 years (SD = 10.8).
Completed self-report questionnaires
that assessed UB and UB-related
distress, hopelessness, desire for
hastened death, anxiety and
depression, quality of life, spiritual well-
being, and purpose/meaning.
Unfinished business themes were
identified by qualitative analysis of
open-ended data.
*UB is defined as a cognitive process
that involves appraising one's
relationship
with a deceased loved one as
incomplete, unexpressed, or
unresolved, lacking closure.).
falta etnia, Ec, religion,
descriptive- N= 185 Iranian elderlies enduring cancer
correlation study. at major hospitals in Tehran in 2016.
The age of patients ranged from 60 to
85 with mean age of 65.8 ± 6.9. 58.4%
(108 individuals) were females and
41.6% (77 individuals) were males.
73,5% were married; 62.7% with
elementary education level; housewife
(63.7%), and an income level of less
than 130$ per month (67.5%); and
48.6% of research participants lived
with their spouse and children.
Falta etnia, Ec, religion
Purposive sampling. N=80 advanced-stage cancer patients.
Eighty advanced-stage cancer patients
were selected through purposive
sampling technique where 45 were
male and 35 were female patient with
significantly lower existential transcendence scores than patients
who did not report UB. UB-related distress was a significant
predictor of several psychosocial outcomes, including increased
hopelessness and anxiety, as well as diminished personal meaning
and existential transcendence. The results showed the significant
relationship between UB and distress, namely, existential distress,
at the end of life.
The research showed that there is a positive significant
relationship between spiritual well-being and life satisfaction (at
0.05). Spiritual well-being can predict satisfaction with life in
understudied elderlies. There was seen a significant inverse
relationship between death anxiety and spiritual well-being. As a
result, the individuals with higher spiritual well-being would
experience less death anxiety. Conclusion: Spiritual well-being is
of effective factors of death anxiety and satisfaction with life
among elderlies suffering from cancer.
In relation to death anxiety and health locus of control, a positive
relationship was found showing that externally oriented patients
had higher levels of death anxiety. Finally, it was found that
internal locus of control is associated with better quality of life
and those who are internally oriented are better able to cope with
with disease. age ranging between 18 and 72 years their illness in comparison with those who are externally oriented
(M = 45 years)

Falta religion, etnia, EC, edad media,