Measurement of Denial in the Terminally Ill: A Critical Review

ABSTRACT

Denial related coping behaviors in those facing terminal illness seem to defy measurement. This review examines the concept of denial and some of the measurement issues confronting clinicians and researchers. The strengths, weaknesses, and appropriateness of ten instruments in the published literature are reviewed. Few instruments are available with demonstrated reliability and validity. The most effective measurement strategies utilized repeated administration of more than one denial measure. Self report and observational measures were found to be more effective than physiological response modes. Suggestions for further research are given.

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Notes on contributors

Stephen R. Connor

Stephen R. Connor is Director of the hospice program at Kaiser-Permanente Medical Center in Walnut Creek, California. He has been active in clinical and administrative hospice work for the past 10 years as founding director of Hospice of the Monterey Peninsula and Hospice of San Francisco. He is a PhD candidate at the San Francisco Professional School of Psychology researching denial in terminal illness. Direct correspondence to the author at Kaiser Hospice, 1425 South Main Street, Walnut Creek, CA 94596. The author wishes to thank Drs. Andrew Kneier and Dale Larson for their valuable comments.