{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T09:27:10Z","timestamp":1786958830270,"version":"build-2736575974"},"reference-count":20,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Palliat Med"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Death anxiety is common in advanced cancer, but little is known about risk factors for its occurrence, frequency or severity in those receiving specialized palliative care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>This study aimed to determine the prevalence and correlates of death anxiety in outpatients with advanced cancer receiving specialized palliative care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Cross-sectional observational study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting\/Participants:<\/jats:title>\n                    <jats:p>We identified the prevalence of death anxiety in 203 patients with advanced cancer attending an outpatient palliative care clinic in a large tertiary care hospital, and examined its association with sociodemographic factors, time since advanced cancer diagnosis, time since initial palliative care consultation, and proximity to death. Death anxiety was measured using the Death and Dying Distress Scale (DADDS). Variables that demonstrated significant univariable associations were subsequently included in a multivariable regression analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Moderate to severe death anxiety (DADDS score\u2009\u2a7e\u200925) was reported by 46.3% of participants. Multivariable analysis demonstrated that greater death anxiety was associated with lower household income (\u2a7e$100,000+ vs &lt;$30,000:\n                      <jats:italic toggle=\"yes\">\u00df<\/jats:italic>\n                      \u2009=\u2009\u22120.30,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.002; $60,000\u2013$99,999 vs &lt;$30,000:\n                      <jats:italic toggle=\"yes\">\u00df<\/jats:italic>\n                      \u2009=\u2009\u22120.27,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.004; $30,000\u2013$59,999 vs &lt;$30,000:\n                      <jats:italic toggle=\"yes\">\u00df<\/jats:italic>\n                      \u2009=\u2009\u22120.31,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and living alone (\n                      <jats:italic toggle=\"yes\">\u00df<\/jats:italic>\n                      \u2009=\u20090.16,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.03), but not with time since advanced cancer diagnosis or initial palliative care consultation, or with proximity to death.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Moderate to severe death anxiety is reported by almost half of patients with advanced cancer receiving outpatient palliative care and is associated with economic disadvantage and solitary living arrangements. Further research is needed to determine to what extent targeted psychosocial and palliative interventions can alleviate such distress in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02692163261450754","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T05:45:29Z","timestamp":1780551929000},"page":"1216-1222","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Social determinants of death anxiety in patients with advanced cancer receiving outpatient palliative care"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6476-0813","authenticated-orcid":false,"given":"Emily","family":"Lau","sequence":"first","affiliation":[{"name":"Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Miljanovski","sequence":"additional","affiliation":[{"name":"Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada"},{"name":"Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, ON, Canada"},{"name":"Department of Psychology, University of Windsor, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Mah","sequence":"additional","affiliation":[{"name":"Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2214-8263","authenticated-orcid":false,"given":"Gilla K.","family":"Shapiro","sequence":"additional","affiliation":[{"name":"Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, ON, Canada"},{"name":"Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, ON, Canada"},{"name":"Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, ON, Canada"},{"name":"Global Institute of Psychosocial, Palliative and End-of-Life Care (GIPPEC), University of Toronto and Princess Margaret Cancer Centre, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashlee R.","family":"Loughan","sequence":"additional","affiliation":[{"name":"Division of Neuro-Oncology, Department of Neurosurgery, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athena","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada"},{"name":"Department of Medical Communication, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4692-9101","authenticated-orcid":false,"given":"Anne","family":"Rydall","sequence":"additional","affiliation":[{"name":"Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4889-0244","authenticated-orcid":false,"given":"Camilla","family":"Zimmermann","sequence":"additional","affiliation":[{"name":"Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada"},{"name":"Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, ON, Canada"},{"name":"Department of Psychology, University of Windsor, ON, Canada"},{"name":"Division of Palliative Care, Department of Medicine, University Health Network, Toronto, ON, Canada"},{"name":"Division of Palliative Medicine, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0881-555X","authenticated-orcid":false,"given":"Breffni","family":"Hannon","sequence":"additional","affiliation":[{"name":"Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada"},{"name":"Division of Palliative Medicine, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6626-6974","authenticated-orcid":false,"given":"Gary","family":"Rodin","sequence":"additional","affiliation":[{"name":"Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, ON, 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