Longitudinal Changes in Spiritual Well-being and Associations with Emotional Distress, Pain, and Optimism-pessimism: a Prospective Observational Study of Terminal Cancer Patients Admitted to a Palliative Care Unit

Overview

Journal Support Care Cancer

Specialties Critical Care
Oncology

Date 2021 Jun 19

PMID 34146165

Citations 7

Authors

Yilong Yang

Xinxin Zhao

Meng Cui

Simeng Wang

Yumei Wang

Affiliations

Soon will be listed here.

Abstract

Purpose: Although spiritual well-being (SWB) is gaining increasing attention within the international palliative care (PC) guidelines, a lack of insight exists into the correlates and course of SWB among cancer patients. We therefore conducted a prospective observational study to capture trend of SWB and to identify their predictors in Chinese inpatients with terminal cancer receiving short-term PC.

Methods: A prospective observational study was conducted of terminal cancer inpatients in the hospice ward, Shengjing Hospital of China Medical University. A total of 108 patients completed self-report questionnaires on Functional Assessment of Chronic Illness Therapy-Spiritual Well-being, Hospital Anxiety and Depression Scale, Numerical Rating Scales, and Life Orientation Scale-Revised anonymously at baseline; SWB, depression, anxiety, and pain were subsequently assessed at 1-week interval. Multilevel regression was used to analyze the temporal course and predictors of SWB.

Results: Patients' existential well-being (B = - 0.99, p = 0.008; 95%CI = - 1.72 to - 0.26) and meaning dimension (B = - 0.87, p < 0.001; 95% CI = - 1.29 to - 0.43) significantly decreased after admission to the PC unit, but peace and faith did not change over time. Increases in depression and pain were related to lower existential well-being, particularly in the meaning dimension. Optimism-pessimism moderated the linear trend of existential well-being and meaning domain, such that those with higher optimism and lower pessimism paired with a decrease in outcomes.

Conclusions: Terminal cancer patients experienced worsening existential well-being, particularly in the meaning facet while hospitalized, indicating that PC should include content that targets the existential concerns of spirituality in China. These findings also supported the need for an integrated PC to address personality traits and emotional and physical distress in this population.

Citing Articles

Trajectories of Cancer Survivors' Spiritual Well-Being Through the Transition From Treatment to Early Survivorship.

Park C, Magin Z, Bellizzi K, Sanft T Psychooncology. 2024; 33(12):e70040.

PMID: 39632284 PMC: 11793928. DOI: 10.1002/pon.70040.

Meaning-centered pain coping skills training for patients with metastatic cancer: Protocol for a randomized controlled efficacy trial.

Fisher H, Check D, Somers T, Kelleher S, Majestic C, Yu J Contemp Clin Trials. 2023; 135:107363.

PMID: 37884120 PMC: 10842087. DOI: 10.1016/j.cct.2023.107363.

Dimensions of spiritual well-being in relation to physical and psychological symptoms: a cross-sectional study of advanced cancer patients admitted to a palliative care unit.

Yang Y, Zhao X, Cui M, Wang Y BMC Palliat Care. 2023; 22(1):137.

PMID: 37710223 PMC: 10500771. DOI: 10.1186/s12904-023-01261-x.

Longitudinal evolution of meaning in life and its relationship with coping strategies in Spanish patients with a breast cancer diagnosis.

Marco J, Castejon J, Isern C, Grau L, Perez Rodriguez S Support Care Cancer. 2023; 31(7):424.

PMID: 37358665 PMC: 10293404. DOI: 10.1007/s00520-023-07885-2.

Meaning-centered pain coping skills training for patients with metastatic cancer: Results of a randomized controlled pilot trial.

Winger J, Kelleher S, Ramos K, Check D, Yu J, Powell V Psychooncology. 2023; 32(7):1096-1105.

PMID: 37173865 PMC: 10330450. DOI: 10.1002/pon.6151.

References

Yang Y, Liu L, Wang Y, Wu H, Yang X, Wang J . The prevalence of depression and anxiety among Chinese adults with cancer: a systematic review and meta-analysis. BMC Cancer. 2013; 13:393. PMC: 3765872. DOI: 10.1186/1471-2407-13-393. View

Sun G, Yang Y, Yang X, Wang Y, Cui X, Liu Y . Preoperative insomnia and its association with psychological factors, pain and anxiety in Chinese colorectal cancer patients. Support Care Cancer. 2019; 28(6):2911-2919. DOI: 10.1007/s00520-019-05151-y. View

Clyne B, ONeill S, Nuzum D, ONeill M, Larkin J, Ryan M . Patients' spirituality perspectives at the end of life: a qualitative evidence synthesis. BMJ Support Palliat Care. 2019; 12(e4):e550-e561. DOI: 10.1136/bmjspcare-2019-002016. View

Bandeali S, Roze des Ordons A, Sinnarajah A . Comparing the physical, psychological, social, and spiritual needs of patients with non-cancer and cancer diagnoses in a tertiary palliative care setting. Palliat Support Care. 2019; 18(5):513-518. DOI: 10.1017/S1478951519001020. View

Peterman A, Fitchett G, Brady M, Hernandez L, Cella D . Measuring spiritual well-being in people with cancer: the functional assessment of chronic illness therapy--Spiritual Well-being Scale (FACIT-Sp). Ann Behav Med. 2002; 24(1):49-58. DOI: 10.1207/S15324796ABM2401_06. View

Cheng Q, Liu X, Li X, Wang Y, Mao T, Chen Y . Improving spiritual well-being among cancer patients: implications for clinical care. Support Care Cancer. 2019; 27(9):3403-3409. DOI: 10.1007/s00520-019-4636-4. View

Jimenez-Fonseca P, Lorenzo-Seva U, Ferrando P, Carmona-Bayonas A, Beato C, Garcia T . The mediating role of spirituality (meaning, peace, faith) between psychological distress and mental adjustment in cancer patients. Support Care Cancer. 2017; 26(5):1411-1418. DOI: 10.1007/s00520-017-3969-0. View

Visser A, de Jager Meezenbroek E, Garssen B . Does spirituality reduce the impact of somatic symptoms on distress in cancer patients? Cross-sectional and longitudinal findings. Soc Sci Med. 2018; 214:57-66. DOI: 10.1016/j.socscimed.2018.08.012. View

Wang Y, Lin C . Spiritual Well-being May Reduce the Negative Impacts of Cancer Symptoms on the Quality of Life and the Desire for Hastened Death in Terminally Ill Cancer Patients. Cancer Nurs. 2015; 39(4):E43-50. DOI: 10.1097/NCC.0000000000000298. View

10.

Puchalski C, Ferrell B, Virani R, Otis-Green S, Baird P, Bull J . Improving the quality of spiritual care as a dimension of palliative care: the report of the Consensus Conference. J Palliat Med. 2009; 12(10):885-904. DOI: 10.1089/jpm.2009.0142. View

11.

Best M, Leget C, Goodhead A, Paal P . An EAPC white paper on multi-disciplinary education for spiritual care in palliative care. BMC Palliat Care. 2020; 19(1):9. PMC: 6964109. DOI: 10.1186/s12904-019-0508-4. View

12.

Nguyen H, Ruel N, Macias M, Borneman T, Alian M, Becher M . Translation and Evaluation of a Lung Cancer, Palliative Care Intervention for Community Practice. J Pain Symptom Manage. 2018; 56(5):709-718. PMC: 6248339. DOI: 10.1016/j.jpainsymman.2018.07.018. View

13.

Ning X . Hospice and palliative care research in mainland China: Current status and future direction. Palliat Med. 2019; 33(9):1127-1128. DOI: 10.1177/0269216319857495. View

14.

Zhao X, Cui M, Geng Y, Yang Y . A systematic review and meta-analysis of randomized controlled trials of palliative care for pain among Chinese adults with cancer. BMC Palliat Care. 2019; 18(1):69. PMC: 6688327. DOI: 10.1186/s12904-019-0456-z. View

15.

Bovero A, Tosi C, Botto R, Opezzo M, Giono-Calvetto F, Torta R . The Spirituality in End-of-Life Cancer Patients, in Relation to Anxiety, Depression, Coping Strategies and the Daily Spiritual Experiences: A Cross-Sectional Study. J Relig Health. 2019; 58(6):2144-2160. DOI: 10.1007/s10943-019-00849-z. View

16.

Rabow M, Knish S . Spiritual well-being among outpatients with cancer receiving concurrent oncologic and palliative care. Support Care Cancer. 2014; 23(4):919-23. DOI: 10.1007/s00520-014-2428-4. View

17.

Kandasamy A, Chaturvedi S, Desai G . Spirituality, distress, depression, anxiety, and quality of life in patients with advanced cancer. Indian J Cancer. 2011; 48(1):55-9. DOI: 10.4103/0019-509X.75828. View

18.

Bai J, Brubaker A, Meghani S, Bruner D, Yeager K . Spirituality and Quality of Life in Black Patients With Cancer Pain. J Pain Symptom Manage. 2018; 56(3):390-398. DOI: 10.1016/j.jpainsymman.2018.05.020. View

19.

Faye-Schjoll H, Schou-Bredal I . Pessimism predicts anxiety and depression in breast cancer survivors: A 5-year follow-up study. Psychooncology. 2019; 28(6):1314-1320. DOI: 10.1002/pon.5084. View

20.

Ren Y, Li S, Zhou S, Wang Y, Li L, Zhang J . Optimism outweighs neuroticism and anxiety sensitivity to predict insomnia symptoms in women after surgery for breast cancer. Support Care Cancer. 2018; 27(8):2903-2909. DOI: 10.1007/s00520-018-4610-6. View