Physician death anxiety and defensive style as affect perception of emotional state in terminal cancer patients

The present study examined how two salient physician variables affected physician perceptions of emotional distress in terminal patients. It replicates a previous study by Dr. L. Derogatis et al. (1976) which found that physicians differently weighted some patient emotional states more distressing than others, and tended to correlate certain patient symptom distress with shorter life span. Specific hypotheses tested were: (a) Physician death anxiety and repressive-sensitization are positively correlated and both positively correlate with perceptions of overall emotional distress. (b) Physician death anxiety and defensive style affect perceptions of patient emotional symptom distress. (c) With increasing global distress, physicians see increasing levels of anxiety, hostility, and psychoticism in terminal patients. Physician death anxiety affects these relationships. (d) With increasing levels of patient global distress, physicians see more interpersonal sensitivity and less anxiety and depression than terminal patients see themselves. Physician death anxiety affects these relationships. (e) Physician prognosis is related to patient reported depression and overall distress. Physician death anxiety affects these relationships.;Terminal cancer patients and their treating physicians (fifty physician-patient pairs) from six area hospitals participated. Both patients and physicians completed a demographic questionnaire, the Death Anxiety Scale, and the Revised Repression-Sensitization Scale. Two weeks into treatment, patient participants completed the SCL-90, and physician participants completed the SCL-90 Analogue Scale and the Global Assessment Scale. Multivariate analyses were conducted.;Results from the present study did not confirm the Derogatis et al. (1976) findings. Physician death anxiety and repression-sensitization defenses did not correlate with global distress though physicians high in death anxiety utilized repressive defenses and those low in death anxiety utilized sensitizing defenses. Physician death anxiety positively correlated with ratings of patient distress on anxiety and interpersonal sensitivity. As physician perception of overall distress increased, they saw distress on somatization, depression, and phobic anxiety. Only physician death anxiety affected perceived distress on anxiety. As perceived overall distress increased, physicians perceived more phobic anxiety in patients than patients saw in themselves, but physician death anxiety did not affect this relationship. No relationship was found between distress on depression and prognosis.