| dc.description.abstract | INTRODUCTION: Palliative care is becoming more widely available and its benefits, including improved quality of life for patients, have been demonstrated. However, misperceptions, lack of knowledge, stigma, and other psychological barriers to palliative care remain among patients, caregivers, and health professionals. This study aims to explore whether more approach-focused, active coping styles may be associated with more positive attitudes towards palliative care and whether more disengaged, avoidant coping styles are associated with more negative attitudes towards palliative care. The current study also seeks to understand how death anxiety may be related to coping styles and attitudes towards palliative care. METHODS: Adults ages 65 and older completed interviews over the phone. Measures of coping styles, death anxiety, attitudes towards palliative care, and knowledge of palliative care were administered. Information about age, sex, education, race, ethnicity, marital status, and family and personal experience with palliative care was also collected. Linear regression analyses were conducted to determine predictors of attitudes towards palliative care, controlling for potential confounds. Two separate linear regression models were executed: an approach model (active coping) and an avoidance model (disengaged coping). RESULTS: Of eighty-seven completed interviews, 56.32% were female and 86.21% were White. Most of the sample (77.01%) held either optimistic or favoring views of palliative care. In both approach (active coping) and avoidance (disengaged coping) models, more knowledge of palliative care was associated with more positive attitudes towards palliative care (β = .71, p<.01). Coping by engaging more social support was significantly associated with more positive attitudes towards palliative care (β = .54, p<.05). For the avoidance model, results indicated a significant interaction (β = -1.24, p<.01) such that women who endorsed high levels of disengaged coping reported more favorable attitudes towards palliative care than did men who who endorsed high levels of disengaged coping. Men who endorsed lower levels of disengaged coping endorsed more positive attitudes towards palliative care than women who reported lower levels of disengaged coping. CONCLUSION: Though the present study examined attitudes towards palliative care among relatively healthy, community-dwelling older adults the results indicate the need for a tailored approach to palliative care education for patients and families. For older adults who tend not to engage social support when coping with a stressor, aspects of palliative care such as symptom management may be more attractive than discussing emotional concerns with a provider. Men who often cope via distraction, venting, self-blame, denial, or giving up when confronted with a stressor may be less receptive to acceptance of palliative care. Future research on educational interventions tailored for individuals with distinct coping styles may be beneficial, particularly for men who frequently rely on disengaged coping styles. | |
