Abstract
Background Patients with a life-limiting illness, such as cancer, and their carers experience elevated psychological distress. However, the psychological mechanisms underpinning psychological distress in palliative care have been little studied. Recent theories predict that individuals who experience increased uncertainty in the contexdt of ongoing difficulties, such as palliative-care patients and their carers, will (a) think more abstractly; (b) ruminate more; and (c) be more distressed.
Methods Patients (n=36, 90% with cancer), their carers (n=29), and age-matched controls (n = 30) completed standardized questionnaires to assess anxiety, depression, and rumination, and open-ended interviews to identify their concerns and idiosyncratic levels of rumination. Concerns were analyzed linguistically for level of abstraction.
Results As predicted, (i) palliative patients and carers reported significantly more uncertainty, rumination, and abstract thinking than controls; (ii) uncertainty, abstractedness, and rumination were associated with psychological distress.
Conclusions Abstraction and rumination are psychological mechanisms potentially involved in increased psychological distress in palliative care.
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