Thesis (Ph. D.)--University of Rochester. Margaret Warner Graduate School of Education and Human Development, 2020.
When people are diagnosed with terminal illness their sense of inner peace is
disturbed leading to heightened existential crisis and psychological distress – triggered by
decreased quality of life and realization that death is near. Particularly, terminally ill
cancer patients are vulnerable to numerous challenges and deal with multiple physical
symptoms, a range of emotions, spiritual issues, and challenging social circumstances and
yet try to remain connected and preserve their identity and sense of wholeness as they
face death. However, there is limited information on psychosocial elements of the illness.
Using the VOICE data, a Structural Equation Model was tested to explore: 1) The
association between relational well-being and peaceful acceptance of the illness among
281 terminal cancer patients, 2) The change in patients’ peace scores over time, and 3)
The contribution of Self-Determination Theory’s basic psychological needs (i.e.,
competence, autonomy, and relatedness) for patients to peacefully come to terms with
their illness. The model yielded substantially significant results. Patients that reported
optimal relations with their family/friends and physician were more likely to peacefully
accept their diagnosis. This relationship was consistent over time and had bi-directional
effect. In addition, patients’ peace scores showed fluctuation over time but it was not
statistically significant. Similarly, while the perceived basic psychological needs such as
competence and relatedness in patient-physician relationship significantly predicted peaceful acceptance, the results did not hold for the perceived need for autonomy
warranting further research. Overall, the results highlight the importance of having good
relations for patients to achieve best quality of life and peaceful acceptance of their
illness.
