Personal Death Anxiety and Communication About Advance Directives Among Oncology Social Workers

Abstract

This study examined the extent to which the death anxiety of oncology social workers impacts the completion of personal advance directives, and their communication about advance directives with patients. One hundred fourteen members of the Association of Oncology Social Work completed death anxiety and advance directive communication practices survey instruments. Two research questions served as the foundation for the study: (a) To what extent does death anxiety correlate with the completion of personal advance directives, and (b) To what extent does death anxiety correlate with the communication with patients about advance directives? Sixty-eight percent of the respondents reported having completed a personal advance directive. Results indicated that as death anxiety scores increased, the communication scores decreased related to disclosure of information about advance directives and values in living. The study findings contribute to furthering the understanding of practice challenges that oncology social workers may face as they pursue end-of-life planning with patients.

KEYWORDS:

• advance directives
• communication
• death anxiety
• oncology social work
• Terror Management Theory

The author wishes to thank Dr. Kathy Black for consultations, and permission to use the Advance Directive Communication Practices Instrument (ADCPI); and the Association of Oncology Social Work members who participated in this study. The author also thanks Dr. Debra Parker Oliver for her assistance throughout the study.

Notes

Note. Death anxiety includes measures 1–3. YOD = Your Own Death, YD = Your Own Dying. TOTAL DEATH ANXIETY = the grand mean of Your Own Death and Your Own Dying. Communication includes measures 4–12. Disclosure = Disclosure of information, Surrogate = Surrogate appointment, Treatment = Treatment options, Values = Values in living, Family = interactions with family members and others, Factors = Factors motivating interactions with family members and others, Collaboration = Collaboration with other health care providers. TOTAL Communication = the grand mean of initiation, disclosure, surrogate, treatment, values, family, factors and collaboration.

∗∗p < 0.01 (2-tailed).

∗p < 0.05 (2-tailed).