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Predictors of palliative care attitudes among US patients with cancer and survivors: ideology, personality, world beliefs
  1. Nicholas Kerry1,
  2. Laura M Perry2 and
  3. Jeremy D W Clifton1
  1. 1Positive Psychology Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  2. 2Tulane University School of Medicine, New Orleans, Louisiana, USA
  1. Correspondence to Dr Nicholas Kerry, University of Pennsylvania, Philadelphia, USA; nickerry{at}

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Palliative care is recommended for patients with cancer to support symptom management and psychosocial needs throughout their illness. However, preferences for using palliative care vary considerably, resulting in patients missing out on care that could improve quality of life. Recent research underscores the importance of individual difference measures in predicting these attitudes. For example, emotional distress (eg, anger, anxiety and depression) is a risk factor for less favourable attitudes about palliative care.1 Personality traits may also play a role: US states whose residents are higher in Openness (to experience) tend to have more acceptance of palliative care programmes.2 More research into the psychological processes contributing to palliative care attitudes might inform novel strategies for increasing palliative care uptake.

Basic beliefs about the world—for example, beliefs that the world is a safe, enticing or just place—are relatively stable, trait-like variables termed ‘primal world beliefs’.3 World beliefs could shape how people interact with their environment, including healthcare attitudes and decisions, and are strong correlates of psychological well-being.3 Beliefs that the world is improvable and enticing (ie, full of interesting, beautiful, things) may be particularly important if they motivate engagement with surroundings due to elevated expectations of pleasure, psychological richness and malleability. Enticing world beliefs are particularly strong correlates of well-being,3 while initial work suggests that improvable belief could mitigate emotional distress from negative events including serious illness.4

We tested whether …

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  • Contributors NK and LMP planned the study. NK collected data. NK and LMP wrote a draft. JDWC provided crucial edits.

  • Funding The present research was funded by the Templeton Religion Trust, Grant #0298. LMP was supported by the NIH/NCI training grant T32CA193193.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.