The trajectory of death anxiety in patients with advanced cancer and their family caregivers

Death anxiety can affect the quality of life of patients with advanced cancer and their family caregivers. This study examines the trajectory of death anxiety over one year and in relation to patients' death. We conducted a longitudinal cohort study with five assessment points over one year. We recruited patients with incurable cancer and their family caregivers. Death anxiety was measured using the Death and Dying Distress Scale and analyzed via multilevel models. Among 671 patients and 168 family caregivers, death anxiety decreased over one year (<i>B</i> = -1.6, <i>p</i> < .001), and was higher in family caregivers (<i>B</i> = 17.4, p < .001). Among 435 deceased patients, death anxiety intensified near death and followed a non-linear trajectory (<i>B</i> = 1.9, <i>p</i> = .02), with family caregivers experiencing a greater increase (<i>B</i> = 23.8, <i>p</i> < .001). Early psychological support can help patients and their family caregivers to manage end-of-life distress.