Multidimensional Study of the Attitude towards Euthanasia of Older Adults with Mixed Anxiety-Depressive Disorder
Abstract
:1. Introduction
2. Material and Methods
2.1. Inclusion and Exclusion Criteria
2.2. Instruments
3. Statistical Analysis
4. Results
4.1. Descriptive Analysis
4.2. Multiple Regression Analysis of the Patient’s Sample
5. Discussion
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Patients (n = 114) | Controls (n = 25) | p-Value | |
---|---|---|---|
Gender, n (%) | 0.001X | ||
Female | 87 (76.3) | 11 (44) | |
Male | 27 (23.7) | 14 (56) | |
Age (years), med [1stQ; 3rdQ], min-max | 72 [68.8; 76.3], 65–91 | 71 [69.5; 75], 66–78 | 0.520M |
Years of school, med [1stQ; 3rdQ], min-max | 4 [4; 4], 0–17 | 6 [4; 13.5], 3–17 | <0.001M |
Civil status, n (%) | 0.214F | ||
Married | 69 (60.5) | 21 (84) | |
Divorced | 12 (10.5) | 1 (4) | |
Single | 7 (6.1) | 0 (0) | |
Widow | 26 (22.8) | 3 (12) | |
Religion, n (%) | 0.112F | ||
Catholic | 111 (97.4) | 23 (92) | |
Jehovah witness | 2 (1.8) | 0 (0) | |
Agnostic | 1 (0.9) | 2 (8) | |
Profession, n (%) | 1F | ||
Self-employed | 1 (0.9) | 0 (0) | |
Manager | 1 (0.9) | 0 (0) | |
Retired | 112 (98.2) | 25 (100) | |
Household, med [1stQ; 3rdQ], min-max | 2 [2; 3], 1–11 | 2 [2; 2], 1–5 | 0.912M |
Baseline | Six Months Later | |||||
---|---|---|---|---|---|---|
Scales | Patients (n = 114) | Controls (n = 25) | Mann–Whitney’s p-Value with Bonferroni Correction for Multiple Testing (33 Tests) * | Patients (n = 90) | Controls (n = 17) | Mann–Whitney’s p-Value with Bonferroni Correction for Multiple Testing (33 Tests) * |
Med (IIQ), Min–Max | Med (IIQ), Min–Max | Med (IIQ), Min–Max | Med (IIQ), Min–Max | |||
HADS Depression (8–10: mild symptoms) | 9 (6; 10), 0–15 | 1 (0; 2), 0–5 | <0.001 | 8 (3; 9), 0–14 | 1 (0.5; 2), 0–3 | <0.001 |
HADS Anxiety (8–10: mild symptoms) | 8 (5; 10), 1–19 | 1 (0.5; 2), 0–4 | <0.001 | 7 (3; 9), 2–14 | 1 (0; 2), 0–2 | <0.001 |
MMS | 28 (26; 29), 11–30 | 30 (29; 30), 25–30 | <0.001 | 28.5 (27; 30), 15–30 | 30 (30; 30, 28–30 | 0.001 |
CDT | 9 (7; 9.5), 1–10 | 10 (9.5; 10), 5–10 | <0.001 | 9.25 (7.9; 9.5), 1–10 | 10 (9.5; 10), 9–10 | 0.002 |
UCLALs | 36.5 (20; 46), 16–64 | 22 (17; 27.5), 16–31 | 0.001 | 33 (20; 41,3), 16–60 | 19 (16.5; 22.5), 16–25 | 0.007 |
MAT | 5.86 (5.25; 6), 3.71–6 | 6 (5.4; 6), 5–6 | 1 | 5.86 (5.43; 6), 3.71–6 | 5.86 (5.57; 6), 5.29–6 | 1 |
BI | 100 (100; 100), 70–100 | 100 (100; 100), 100–100 | 1 | 100 (100; 100), 75–100 | 100 (100; 100), 100–100 | 1 |
YATEs | 83.5 (51.5; 95.25), 3–104 | 52 (30; 80.5), 2–103 | 0.288 | 86 (41; 97.5), 3–104 | 55 (23.5; 80.5), 0–103 | 0.590 |
WATEs (patient’s decision) | 4 (2.75; 4.75), 1–5 | 3.25 (2.25; 4), 1–5 | 1 | 4 (2.4; 4.5), 1–5 | 4 (2; 4), 1–5 | 1 |
WATEs (doctor’s decision) | 2.75 (1.5; 3.875), 1–5 | 2 (1.5; 2.5), 1–4 | 0.612 | 2.33 (1.7; 3.6), 1–5 | 2 (2; 2), 1–3 | 1 |
MDMQ | ||||||
Self-esteem (max = 12) | 8 (5; 10), 1–12 | 10 (8; 11), 6–12 | <0.001 | 8 (5.8; 10), 1–12 | 11 (8; 11.5), 6–12 | 0.315 |
Vigilance (max = 12) | 10 (6; 12), 0–12 | 12 (10; 12), 2–12 | 1 | 11 (8; 12), 0–12 | 12 (10; 12), 3–12 | 1 |
Buck Passing (max = 12) | 6 (2; 11), 0–12 | 3 (1.5; 6), 0–12 | 0.514 | 5 (2; 10), 0–12 | 4 (1; 7), 0–9 | 1 |
Procrastination (max = 10) | 3 (1; 6.25), 0–10 | 3 (1; 4), 0–9 | 1 | 3 (1; 6), 0–10 | 3 (1; 4.5), 0–9 | 1 |
Hypervigilance (max = 10) | 6 (3.75; 8), 0–10 | 4 (2; 5), 0–10 | 0.144 | 5.5 (3; 8), 0–10 | 4 (3; 5.5), 0–7 | 1 |
NEO-FFI | ||||||
Neuroticism | 31 (20; 36.25); 2–47 | 16 (12; 19.5), 4–28 | <0.001 | 28.5 (18; 34), 4–41 | 14 (13; 20), 11–25 | <0.001 |
Extraversion | 19.5 (16; 25.25), 8–44 | 31 (26; 33), 17–36 | <0.001 | 20.5 (17; 26), 9–39 | 29 (26.5; 33), 20–36 | <0.001 |
Openness | 12 (7; 19), 3–39 | 23 (18.5; 27.5), 6–33 | <0.001 | 14 (10; 19), 3–35 | 23 (18.5; 26.5), 14–35 | <0.001 |
Agreeableness | 33 (30; 35), 18–41 | 33 (29.5; 36.5), 20–41 | 1 | 32.5 (30; 34), 19–38 | 33 (30; 34.5), 24–36 | 1 |
Conscientiousness | 33.5 (31; 36), 4–46 | 36 (34; 39.5), 31–45 | 0.016 | 34 (31; 36), 12–39 | 36 (35; 37.5), 28–41 | 0.064 |
IRI | ||||||
Perspective Taking | 3.17 (2; 3.67), 0.5–4 | 2.5 (1.5; 3.3), 1–4 | 1 | 3.17 (1.7; 3.8), 0–4 | 1.67 (1.17; 3.34), 1–3.83 | 1 |
Empathic Concern | 3.33 (2.63; 3.83), 1.3–4 | 3.2 (2.4; 3.6), 1.5–4 | 1 | 3.42 (2.8; 3.8), 1.7–4 | 2.83 (2.50; 3.25), 1.67–3.83 | 1 |
Personal Distress | 2.83 (1.83; 3.33), 0–4.2 | 1.7 (0.8; 2.3), 0–3 | <0.001 | 2.75 (2; 3.3), 0.5–4 | 1.5 (1; 2.09), 0.33–2.67 | <0.001 |
Fantasy | 1.5 (0.67; 2.33), 0–3.7 | 1.7 (1.2; 2.3), 0.3–3.3 | 1 | 1.5 (0.5; 2.2), 0–3.7 | 1.5 (1.09; 1.67), 0.50–3.33 | 1 |
SF36v2 | ||||||
physical functioning | 90 (65; 95), 10–100 | 95 (92.5; 100), 60–100 | <0.001 | 90 (70; 90), 10–95 | 95 (90; 95), 50–100 | 0.005 |
physical role | 93.75 (62.5; 100), 12.5–100 | 100 (100; 100), 75–100 | 0.012 | 100 (75; 100), 6.3–100 | 100 (100; 100), 100–100 | 0.026 |
pain | 74 (62; 84), 0–100 | 84 (62; 100), 51–100 | 1 | 84 (62; 100), 12–100 | 84 (74; 100), 62–100 | 1 |
general health | 38.5 (30; 50), 15–95 | 67 (51; 73.5), 35–100 | <0.001 | 37.5 (28.8; 52), 10–87 | 67 (56; 74,5), 30–95 | <0.001 |
vitality | 37.5 (25; 62.5), 6.25–93.75 | 75 (71.9; 81.3), 56.25–93.75 | <0.001 | 43.75 (31.3; 56.3), 0–87.5 | 75 (69; 81), 69–100 | <0.001 |
social function | 50 (25; 87.5), 0–100 | 100 (81.3; 100), 62.5–100 | <0.001 | 62.5 (25; 90,6), 0–100 | 100 (100; 100), 75–100 | <0.001 |
emotional role | 75 (50; 100), 0–100 | 100 (100; 100), 83.33–100 | <0.001 | 91.67 (58.3; 100), 25–100 | 100 (100; 100), 100–100 | 0.003 |
mental health | 50 (35; 70), 5–100 | 90 (80; 90), 65–100 | <0.001 | 67.5 (50; 85), 15–95 | 90 (85; 90), 55–100 | 0.003 |
TASR | 7 (4; 10), 2–18 | 3 (2; 3), 2–8 | <0.001 | 5.5 (3; 7), 3–16 | 3 (2; 3), 2–3 | <0.001 |
Scales | Baseline, Med (IIQ), Min–Max | Six Months Later, Med (IIQ), Min–Max | Wilcoxon’s p-Value with Bonferroni Correction for Multiple Testing (14 Tests) |
---|---|---|---|
HADS Depression | 9 (6; 10), 0–15 | 8 (3; 9), 0–14 | <0.001 |
HADS Anxiety | 8 (5.8; 10), 1–19 | 7 (3; 9), 2–14 | <0.001 |
MMS | 28 (26; 29), 11–30 | 28.5 (27; 30), 15–30 | <0.001 |
CDT | 9 (6.9; 9,5), 1–10 | 9.25 (7.9; 9.5), 1–10 | 1 |
UCLALs | 36 (20; 45), 16–62 | 33 (20; 41.3), 16–60 | <0.001 |
MAT | 5.86 (5.25; 6), 3.71–6 | 5.86 (5.43; 6), 3.71–6 | 1 |
SF36v2 Physical functioning | 90 (65; 95), 10–100 | 90 (70; 90), 10–95 | 1 |
SF36v2 Physical role | 100 (67.2; 100), 12.5–100 | 100 (75; 100), 6.3–100 | 0.010 |
SF36v2 Pain | 74 (62; 91), 0–100 | 84 (62; 100), 12–100 | 0.238 |
SF36v2 General health | 38.5 (25; 50.5), 15–87 | 37.5 (28,8; 52), 10–87 | 1 |
SF36v2 Vitality | 37.5 (25; 62.5), 6.25–93.75 | 43.75 (31.3; 56.3), 0–87.5 | 1 |
SF36v2 Social function | 56.2 (25; 87.5), 0–100 | 62.5 (25; 90.6), 0–100 | 0.007 |
SF36v2 Emotional role | 75 (50; 100), 0–100 | 91.67 (58.3; 100), 25–100 | 0.001 |
SF36v2 Mental health | 50 (35; 70), 5–100 | 67.5 (50; 85), 15–95 | <0.001 |
Correlation with YATEs | ||
---|---|---|
Scales and Subscales | Patients | Controls |
UCLALs | −0.181 | 0.159 |
HADS Depression | −0.100 | 0.280 |
HADS Anxiety | −0.084 | 0.297 |
IRI Perspective taking | 0.758 ** | 0.803 ** |
IRI Empathic concern | 0.325 ** | 0.668 ** |
IRI Personal distress | −0.200 * | −0.128 |
IRI Fantasy | 0.378 ** | 0.368 |
NEO-FFI Neuroticism | −0.167 | 0.021 |
NEO-FFI Extroversion | 0.101 | 0.011 |
NEO-FFI Openness | 0.232 * | 0.012 |
NEO-FFI Agreeableness | 0.223 * | 0.188 |
NEO-FFI Conscientiousness | 0.293 ** | −0.114 |
MDMQ Self-esteem | 0.302 ** | 0.260 |
MDMQ Vigilance | 0.276 ** | 0.179 |
MDMQ Buck passing | −0.280 ** | −0.384 |
MDMQ Procrastination | −0.371 ** | −0.415 * |
MDMQ Hypervigilance | −0.344 ** | −0.375 |
SF36v2 Physical functioning | 0.163 | −0.227 |
SF36v2 Physical role | 0.086 | 0.180 |
SF36v2 Pain | 0.007 | −0.329 |
SF36v2 General health | −0.060 | −0.177 |
SF36v2 Vitality | 0.116 | −0.132 |
SF36v2 Social function | 0.128 | −0.050 |
SF36v2 Emotional role | 0.089 | 0.172 |
SF36v2 Mental health | 0.087 | −0.149 |
TASR | −0.124 | −0.146 |
Independent Variables | Simple Linear Regression Model | Initial Multiple Model R2 = 0.362 F(16,97) = 3.44, p < 0.001 | Final Multiple Model R2 = 0.325 F(4109) = 13.1, p < 0.001 | |||
---|---|---|---|---|---|---|
B [I.C. a 95%] | p-Value | B [I.C. a 95%] | p-Value | B [I.C. a 95%] | p-Value | |
Age | −1.21 [−2.34; −0.08] | 0.035 | −0.33 [−1.56; 0.90] | 0.598 | ||
Gender | ||||||
Female | Reference | |||||
Male | 7.32 [−6.93; 21.6] | 0.311 | ||||
Schooling (in years) | 1.62 [−0.17; 3.42] | 0.076 | 0.13 [−2.03; 2.29] | 0.904 | ||
HADS Depression | −0.54 [−3.45; 0.38] | 0.114 | −1.19 [−3.93; 1.55] | 0.390 | ||
HADS Anxiety | −0.83 [−2.47; 0.81] | 0.318 | ||||
MDMQ Self-esteem | 3.98 [1.97; 6.00] | <0.001 | ||||
MDMQ Vigilance | 2.47 [0.80; 4.13] | 0.004 | 0.57 [−1.59; 2.73] | 0.601 | ||
MDMQ Buck passing | −2.14 [−3.48; −0.80] | 0.002 | −0.18 [−2.13; 1.77] | 0.857 | ||
MDMQ Procrastination | −3.90 [−5.69; −2.10] | <0.001 | ||||
MDMQ Hypervigilance | −4.22 [−6.32; −2.13] | <0.001 | ||||
NEO-FFI Neuroticism | −0.54 [−1.14; 0.06] | 0.079 | 0.29 [−0.87; 1.46] | 0.618 | ||
NEO-FFI Extraversion | 0.48 [−0.39; 1.35] | 0.276 | ||||
NEO-FFI Openness | 0.90 [0.14; 1.66] | 0.020 | 0.15 [−0.82; 1.12] | 0.762 | ||
NEO-FFI Agreeableness | 1.60 [0.20; 2.99] | 0.025 | −0.35 [−1.87; 1.17] | 0.652 | ||
NEO-FFI Conscientiousness | 2.15 [1.22; 3.09] | <0.001 | 1.65 [0.50; 2.81] | 0.005 | 1.65 [0.77; 2.54] | <0.001 |
IRI Perspective taking | 25.92 [22.3; 29.51] | <0.001 | ||||
IRI Empathic concern | 15.7 [7.26; 24.2] | <0.001 | 15.79 [6.46; 25.13] | 0.001 | 14.32 [6.19; 22.46] | <0.001 |
IRI Personal distress | −6.89 [−13.1; −0.67] | 0.030 | −3.21 [−11.16; 4.74] | 0.425 | −6.01 [−11.78; −0.25] | 0.041 |
IRI Fantasy | 11.3 [5.62; 16.9] | <0.001 | 5.54 [−1.41; 12.48] | 0.117 | 6.51 [1.15; 11.86] | 0.018 |
UCLALs | −0.37 [−0.80; 0.06] | 0.089 | −0.47 [−1.09; 0.16] | 0.145 | ||
SF36v2 Physical functioning | 0.25 [−0.02; 0.52] | 0.069 | 0.11 [−0.41; 0.57] | 0.748 | ||
SF36v2 Physical role | 0.10 [−0.13; 0.33] | 0.406 | ||||
SF36v2 Pain | 0.09 [−0.19; 0.38] | 0.515 | ||||
SF36v2 General health | −0.08 [−0.44; 0.28] | 0.645 | ||||
SF36v2 Vitality | 0.20 [−0.08; 0.47] | 0.159 | 0.08 [−0.41; 0.57] | 0.748 | ||
SF36v2 Social function | 0.15 [−0.04; 0.34] | 0.122 | −0.25 [−0.57; 0.08] | 0.133 | ||
SF36v2 Emotional role | 0.13 [−0.09; 0.36] | 0.234 | ||||
SF36v2 Mental health | 0.11 [−0.12; 0.38] | 0.296 |
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Fonseca, L.; Castro, L.; Rêgo, G.; Nunes, R. Multidimensional Study of the Attitude towards Euthanasia of Older Adults with Mixed Anxiety-Depressive Disorder. Healthcare 2024, 12, 1078. https://doi.org/10.3390/healthcare12111078
Fonseca L, Castro L, Rêgo G, Nunes R. Multidimensional Study of the Attitude towards Euthanasia of Older Adults with Mixed Anxiety-Depressive Disorder. Healthcare. 2024; 12(11):1078. https://doi.org/10.3390/healthcare12111078
Chicago/Turabian StyleFonseca, Luís, Luísa Castro, Guilhermina Rêgo, and Rui Nunes. 2024. "Multidimensional Study of the Attitude towards Euthanasia of Older Adults with Mixed Anxiety-Depressive Disorder" Healthcare 12, no. 11: 1078. https://doi.org/10.3390/healthcare12111078
APA StyleFonseca, L., Castro, L., Rêgo, G., & Nunes, R. (2024). Multidimensional Study of the Attitude towards Euthanasia of Older Adults with Mixed Anxiety-Depressive Disorder. Healthcare, 12(11), 1078. https://doi.org/10.3390/healthcare12111078