Purpose: To evaluate personal value models, individual quality of life (QoL), and psychosocial symptoms in palliative care patients. To investigate the effect of ‘‘macro’’-(self-transcendent) and ‘‘micro’’-(self-enhancement)-worries on QoL and psychosocial symptoms.
Patients and Methods: 74 patients of the Interdisciplinary Palliative Care unit, and the Motor Neuron Outpatient Clinic of the Ludwig-Maximilians- University Munich were asked to complete a self-report questionnaire consisting of the Brief Symptom Inventory (Derogatis 2000), a personal value instrument (Boehnke 1998), and the Schedule for the Evaluation of Individual Quality of Life (O’Boyle 1994).
Results: 64 patients returned a completed questionnaire (response rate, 86.5%). The median age at survey was 60.5 years. 45% patients suffered from an incurable, progressive motor neuron disease (amyotrophic lateral sclerosis, ALS), 55% from advanced malignancies. Patients with ALS showed lower anxiety (M =.38 vs M =.90; P =.004), obsessive-compulsive behaviour (M =.26 vs M =.80; P =.002), psychoticism (M =.05 vs M = .37; P = .001), and a lower global symptom severity index (M =.38 vs M =.78; P <.001) than cancer patients. The total SEIQoL-DW score (73% vs 57%; P = .005) and the QoL-VAS (55% vs 36%; P =.002) were better in ALS-patients. No significant differences were found for depression, interpersonal sensitivity, hostility and paranoid ideation. There were some interesting correlations between patients’ value models and psychosocial symptoms. The micro-value ‘‘achievement’’ correlates positively with depression (r =.27; P =.03). The macro value ‘‘tradition’’ (respect, commitment, acceptance of customs/ideas that traditional culture or religion provide) correlates negatively with depression (r = -.32; P =.01).
Conclusion: There are significant differences in psychosocial symptoms between ALS and cancer patients. Patients with macro worries appear to have lower emotional stress in the palliative care situation.