Subscription is FREE for qualified healthcare professionals in the US.
10 Articles in Volume 17, Issue #8
A Fresh Look at Opioid Antagonists in Chronic Pain Management
Addressing Chronic Pain in the United States Armed Forces
Are biosimilars as effective as their biologic counterparts?
Integrative Pain Care: When and How to Prescribe?
Lady Gaga, Fame, and Fibromyalgia
Letters to the Editor: An opportunity to learn what is on the minds of your colleagues and patients.
Must-Have Devices for Your Pain Practice
Obsessive-Compulsive Disorder & Chronic Pain
Theory of Motivated Information Management and Coping With Death
United Nations Says Untreated Pain Is “Inhumane and Cruel”

Theory of Motivated Information Management and Coping With Death

In part two of this three-part series, the authors expand on their exploration of how pain practitioners might frame the uncertainty of dying with their patients, family, and caregivers.
Page 1 of 2

What happens in the moments just before and right after death? Will it be painful? Is there an after-life? Religious beliefs and intellectual convictions influence our expectations, but none of us has direct experience to rely on. Dying patients can feel uncertain about what they’ll encounter as they approach and experience death. Caregivers and practitioners may feel uncertain about how to address this subject with their patients. An individual’s coping efficacy can influence how they manage information and uncertainty.1

Those who work with the dying can gain new perspectives by exploring theories and research related to handling uncertainty.2-5 One such theory, the Theory of Motivated Information Management (TMIM), addresses why and how people intentionally manage and cope with uncertainties, and how effective they may be at this process.1-6

Faith and religion enhance coping when patients face death and dying

Theory of Motivated Information Management

According to TMIM, the management of uncertainty involves three phases: the interpretation phase, the evaluation phase, and the decision phase. During the interpretation phase, individuals feel uncertainty about a challenging situation. They examine the extent and amount of uncertainty they feel and compare it to the amount of uncertainty they want to feel about the issue.

The gap between an individual’s actual level of uncertainty and their desired level of uncertainty can lead to feelings of anxiety or other emotions, such as fear, nervousness, or happiness.6 The larger the discrepancy, the more the emotion they are likely to feel. When individuals feel uncertainty beyond what is comfortable for them, they can become motivated to look deeper and find ways to deal with the challenge.

In the evaluation phase, individuals consider the potential outcome of an uncertain situation and predict what is likely to happen if they took a particular action.1 They may expect a negative or positive outcome. Individuals also consider how important or critical an outcome is and how likely it is, based on their own perception.1 Their assessment of the potential outcome can influence how they manage information and how they assess efficacy.

During their evaluation, individuals consider diverse factors, including the ability to gather, manage, receive, share, and transmit information.1 For example, communication efficacy addresses how well an individual thinks they can carry out the tasks included in managing the information, whether they are working alone or interacting with another person.

An example of intrapersonal communication efficacy can be how capable a person is to look up information online. Interpersonal communication efficacy is how able a person is in effectively communicating a need to others. In addition, target efficacy describes both whether a person thinks the target will be able to understand the situation and how trusted the target’s information is as a source or how willing the target is to share information.1

In the decision phase, individuals choose an information management strategy (eg, seek information or avoid it) based on the assessments made and/or the level of emotion caused by the uncertainty discrepancy.1

Coping Efficacy

The benefits and circumstances of effective coping have been studied in a wide range of health contexts.7,8 For example, coping efficacy has been shown to decrease risks for depressive symptoms in African American children and to mediate the negative association between activity limitation due to a disability and perceptions of independence.7,8 Family support correlates positively with coping efficacy and can be measured by levels of encouragement and conversation, which are relevant for critically ill patients.9-21

Humor is a noted coping strategy that is linked to life satisfaction.11 In addition, multiple researchers have shown religion and spirituality to offer successful coping mechanisms.12-16 However, despite all the research done on coping, there has been no research on perceived ability to cope with a cancer patient’s death under the theoretical framework of TMIM. In the context of a gravely ill cancer patient, for example, coping efficacy can be defined as the patient’s perceived ability to handle their own death or dying status by means of social networking, financial resources, emotional or other resources.1 For a caregiver, coping efficacy is the perceived ability to handle the patient’s death and dying.

The Influence of Religion and Spirituality

In general, religion and spirituality have been shown to have a positive influence on individuals lives. Researchers looked at coping and church support, spiritual meaning, meditation, prayer, and church attendance as it relates to health.17 Adolescents who were religious also reported less negative health outcomes, such as lower rates of early sexual initiation and risky health behaviors, as well as more positive health outcomes, such as coping during times of physical illness.17

Spirituality was found to be a crucial variable for patients responsiveness to a cancer diagnosis, especially for women with breast cancer.18,19 In these cases, a belief in religion was shown to lead to better health conditions, lifestyle choices, and improved morale.20,21

Religion influences a patient’s coping ability by helping to relieve stress and to maintain a sense of his/her life’s purpose.13,22-25 Little research has been done directly on how religion and spirituality help patients cope with dying or with the idea of death. However, when researchers looked at a population of older, terminally ill cancer patients, they found that higher spiritual wellbeing correlated with lower anxiety.26

Continue Reading:
Integrative Pain Care: When and How to Prescribe?

Join The Conversation

Register or Log-in to Join the Conversation