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. 2018 Nov;27(11):2573-2580.
doi: 10.1002/pon.4821. Epub 2018 Jul 27.

Beyond the bucket list: Unfinished and business among advanced cancer patients

Melissa P Masterson  1   2 , Elizabeth Slivjak  1 , Greta Jankauskaite  3 , William Breitbart  1 , Hayley Pessin  1 , Elizabeth Schofield  1 , Jason Holland  4 , Wendy G Lichtenthal  1
Affiliations

Beyond the bucket list: Unfinished and business among advanced cancer patients

Melissa P Masterson et al. Psychooncology. 2018 Nov.

Abstract

Objective: The study aims to examine the prevalence and common themes of unfinished business (UB) and its associations with distress among advanced cancer patients.

Methods: A total of 223 patients from a larger randomized controlled trial of Individual Meaning-Centered Psychotherapy (IMCP) completed self-report questionnaires that assessed UB and UB-related distress, hopelessness, desire for hastened death, anxiety and depression, quality of life, spiritual well-being, and purpose/meaning. Unfinished business themes were identified by qualitative analysis of open-ended data.

Results: A total of 161 (72%) patients reported the presence of UB. The mean UB-related distress score was 7.01 (SD = 2.1) out of 10. Results of independent t tests showed that patients with UB reported significantly higher levels of anxiety and lower levels of existential transcendence than patients without UB. Linear regression equations indicated that UB-related distress significantly predicted hopelessness (F1,154 = 9.54, P < 0.05, R2 = 0.058), anxiety (F1,154 = 4.31, P < 0.05, R2 = 0.027), personal meaning (F1,136 = 6.18, P < 0.05, R2 = 0.043), and existential transcendence (F1,119 = 6.7, P < 0.05, R2 = 0.053). Ten UB themes emerged from open-ended responses; UB themes were not associated with UB-related distress or psychological adjustment.

Conclusions: Unfinished business was both prevalent and distressing in our sample. Findings underscore the need to develop and implement interventions designed to help patients resolve or find solace with UB.

Keywords: cancer; end of life; existential distress; mixed methods; oncology; thematic analysis; unfinished business.

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Conflict of interest statement

CONFLICT OF INTEREST

The authors contributing to this manuscript have no conflict of interest to declare.

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