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Psychosomatics 46:7-10, February 2005
© 2005 The Academy of Psychosomatic Medicine

Understanding the Will to Live in Patients Nearing Death

Harvey Max Chochinov, M.D., Ph.D., Thomas Hack, Ph.D., C.Psych., Thomas Hassard, Ph.D., Linda J. Kristjanson, Ph.D., Susan McClement, Ph.D., and Mike Harlos, M.D.

From the Department of Psychiatry, Medicine, University of Manitoba, Winnipeg, Canada; Manitoba Palliative Care Research Unit, CancerCare Manitoba, Winnipeg; Patient and Family Support Services, CancerCare Manitoba, Winnipeg; Community Health Sciences, University of Manitoba, Winnipeg; the Faculty of Nursing, University of Manitoba, Winnipeg; Edith Cowan University, Perth, N.S.W., Australia; and St. Boniface General Hospital, Winnipeg, Canada. Address reprint requests to Dr. Chochinov, Department of Psychiatry, University of Manitoba, 3021-675 McDermot Ave., Winnipeg, Manitoba R3E 0V9; harvey.chochinov{at}cancercare.mb.ca (e-mail).

This study examined concurrent influences on the will to live in 189 patients with end-stage cancer. The authors found significant correlations between the will to live and existential, psychological, social, and, to a lesser degree, physical sources of distress. Existential variables proved to have the most influence, with hopelessness, burden to others, and dignity entering into the final model. Health care providers must learn to appreciate the importance of existential issues and their ability to influence the will to live among patients nearing death.




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