Introduction:

Existential distress is defined as a state of psychospiritual pain in terms of meaninglessness, loss of autonomy, loss of dignity, hopelessness and death anxiety. Currently, existential distress is not routinely assessed and consequently may lead to unnecessary suffering for patients at the end of life. High rates of anxiety, depression and pain are often observed in patients that suffer from existential distress. This study aims to (i) discover the incidence and possible predictors of existential distress in patients receiving palliative care in a rural area, and (ii) identify if medication usage is higher in patients with significant distress (Death and Dying Distress Scale (DADDS) score ≥ 45) for these symptoms.

Methods:

This study uses a cross sectional and longitudinal prospective cohort study design. The cross-sectional study includes collecting the patients’ baseline DADDS score to identify existential distress, demographic data and their initial prescribed medications. The longitudinal prospective cohort study involves following medication changes over time for anxiety, depression and pain, as well as repeating the DADDS monthly for a period of 18 months/until death/loss to follow up. The sample size for this study is 80 patients from a coastal regional area.

Results:

Findings of this research will include prevalence and incidence of existential distress and associations with predictor variables including medication prescribing and patient demographics. Comparing patients distress levels with medications prescribed may show if there is a relationship between higher distress levels and increased medication prescribing. The outcomes from this study may be of interest to palliative care teams, physicians and pharmacists.

Conclusion:

Identifying existential distress more accurately and the possible predictors of existential distress in patients receiving palliative care, may allow for interventions to be developed and implemented. Future research could examine the impact of these interventions to better manage distress and decrease symptoms of anxiety/depression/pain in patients receiving palliative care.