Beyond the bucket list: Unfinished and business among advanced cancer patients

• Main Authors: Breitbart, W. (Author), Holland, J. (Author), Jankauskaite, G. (Author), Lichtenthal, W.G (Author), Masterson, M.P (Author), Pessin, H. (Author), Schofield, E. (Author), Slivjak, E. (Author)
• Format: Article
• Language: English
• Published: John Wiley and Sons Ltd 2018
• Subjects: Adaptation, Psychological; adult; Adult; advanced cancer; affect; Affect; aged; Aged; anxiety; Anxiety; Article; attitude to death; Attitude to Death; attitude to life; cancer; cancer patient; Caucasian; cognition; content analysis; controlled study; coping behavior; cross-sectional study; death; Death; depression; Depression; disease association; distress syndrome; educational status; end of life; etiology; existential distress; existential transcendence; female; Female; hopelessness; Hospital Anxiety and Depression Scale; human; Humans; Individual Meaning Centered Psychotherapy; longitudinal study; major clinical study; male; Male; mental stress; middle aged; Middle Aged; mixed methods; mortality; neoplasm; Neoplasms; oncology; pathology; psychology; qualitative analysis; quality of life; Quality of Life; questionnaire; randomized controlled trial; randomized controlled trial (topic); religion; self concept; Self Concept; self report; Self Report; self transcendence; sex difference; spiritual well being; Spirituality; Stress, Psychological; Surveys and Questionnaires; Terminally Ill; terminally ill patient; thematic analysis; unfinished business; Unfinished Business Questionnaire; wellbeing
• Online Access: View Fulltext in Publisher
• ISBN: 10579249 (ISSN)
• DOI: 10.1002/pon.4821

Objective: The study aims to examine the prevalence and common themes of unfinished business (UB) and its associations with distress among advanced cancer patients. Methods: A total of 223 patients from a larger randomized controlled trial of Individual Meaning-Centered Psychotherapy (IMCP) 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. Results: A total of 161 (72%) patients reported the presence of UB. The mean UB-related distress score was 7.01 (SD = 2.1) out of 10. Results of independent t tests showed that patients with UB reported significantly higher levels of anxiety and lower levels of existential transcendence than patients without UB. Linear regression equations indicated that UB-related distress significantly predicted hopelessness (F1,154 = 9.54, P < 0.05, R2 = 0.058), anxiety (F1,154 = 4.31, P < 0.05, R2 = 0.027), personal meaning (F1,136 = 6.18, P < 0.05, R2 = 0.043), and existential transcendence (F1,119 = 6.7, P < 0.05, R2 = 0.053). Ten UB themes emerged from open-ended responses; UB themes were not associated with UB-related distress or psychological adjustment. Conclusions: Unfinished business was both prevalent and distressing in our sample. Findings underscore the need to develop and implement interventions designed to help patients resolve or find solace with UB. © 2018 John Wiley & Sons, Ltd.