{"doi":"10.1089/jpm.2022.0376","title":"End-of-Life Care, Symptom Burden, and Quality of Life in Couples Facing Stage IV Lung Cancer: The Role of Patient and Spousal Psychospirituality and Discussions Around Fear of Death and Disease Progression","abstract":"Background:As patients live longer with stage IV nonsmall cell lung cancer, correlates of end-of-life (EOL) care and experience are increasingly relevant. Methods:We, therefore, prospectively examined associations among psychospirituality (Center for Epidemiologic Studies Depression Scale, Functional Assessment of Chronic Illness Therapy–Spiritual Well-Being), discussions around fear of death and disease progression, and hospital-based EOL care in patients and caregivers. Patients additionally reported symptom burden (MD Anderson Symptom Inventory–Lung Cancer total) and quality of life (QOL) (quality-of-life at EOL). Results:Of the baseline patients (n = 75), 32% were alive at time of the analyses (mean = 4.6 years postbaseline). Deceased patients (n = 51) were middle aged (mean = 65.3 years) and non-Hispanic White (81%). Caregiver spiritual well-being (r = 0.34, p = 0.02) and depression (r = −0.31, p = 0.03) were associated with EOL care metrics. Patients who “held back” more of their fear of death or disease progression experienced greater symptom burden (r = 0.41, p < 0.001) and poorer QOL (r = −0.44, p < 0.001). Conclusion:For couples facing prolonged metastatic disease, psychospirituality is highly relevant to EOL care with potential sequelae of withholding one's fear regarding death or disease progression.","journal":"Journal of Palliative Medicine","year":2023,"id":361797,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":8,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9544,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":424381,"name":"Morgan H. Jones","orcid":"0000-0002-5466-0624","position":1,"is_corresponding":false},{"id":380275,"name":"Aileen B. Chen","orcid":"0000-0002-5385-3360","position":2,"is_corresponding":false},{"id":1114989,"name":"Chunyi Yang","orcid":null,"position":3,"is_corresponding":false},{"id":1032156,"name":"Cindy L. Carmack","orcid":"0000-0002-8505-7297","position":4,"is_corresponding":false},{"id":307383,"name":"Lorenzo Cohen","orcid":"0000-0003-4372-9208","position":5,"is_corresponding":false},{"id":307384,"name":"Éduardo Bruera","orcid":"0000-0002-8745-0412","position":6,"is_corresponding":false},{"id":307376,"name":"Kathrin Milbury","orcid":"0000-0003-2605-3592","position":7,"is_corresponding":false},{"id":1114568,"name":"Juliet L. Kroll","orcid":"0000-0002-8873-7239","position":0,"is_corresponding":true}],"reference_count":33,"raw_metadata":null,"created_at":"2026-07-19T01:14:15.063476Z","pmid":"36856536","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}