Spiritual Considerations

The Mediating Role of Resilience in the Relationship Between Hope and Spiritual Well-being in Cancer Patients: A Study From Turkey

BACKGROUND

Cancer is a significant public health concern in the healthcare landscape. Amidst this challenging journey, the levels of hope, spiritual well-being, and resilience in patients with cancer have emerged as pivotal factors influencing the healing process.

OBJECTIVE

This study aimed to evaluate the relationship between hope and spiritual well-being in cancer patients and the mediating role of resilience in the relationship between hope and spiritual well-being levels.

METHODS

This study is a descriptive, cross-sectional, correlational study. The study included 152 cancer patients undergoing treatment. A patient information form, the 12-item Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-SP-12) Scale, the Dispositional Hope Scale, and the Brief Resilience Scale were used to collect study data.

RESULTS

Positive and meaningful correlations were observed between the Dispositional Hope Scale and FACIT-SP-12, Brief Resilience Scale, and FACIT-SP-12 (r = 0.390, P < .05; r = 0.246, P < .05). Mediation analysis indicated that Brief Resilience Scale scores partially mediated the relationship between the Dispositional Hope Scale and FACIT-SP-12 Scale scores; the indirect effect of hope on spiritual well-being through resilience was 0.351 (P < .05).

CONCLUSION

The study has indicated a direct relationship between hope and spiritual well-being, and resilience partially mediated the relationship between hope and spiritual well-being.

IMPLICATIONS FOR PRACTICE

It is significant to provide psychosocial care to cancer patients to increase their resilience levels and to support their hope and spiritual well-being.

Improving Spiritual Well-Being of Polish Pain Outpatients: A Feasibility Mixed Methods Study

Introduction: A physician in a chronic pain treatment clinic must recognize that the relationship between pain and spirituality is bidirectional. Chronic pain can decrease the level of spiritual well-being, and low spiritual well-being can also significantly intensify the perception of pain and worsen coping with it. Currently, for many scientific and medical communities, it is evident that spiritual care is an indispensable element of holistic medicine. Objective: The authors developed a non-religious spiritual care model provided by a physician at a chronic pain treatment clinic from May 2022 to February 2024. Method: The study utilized a mixed-method approach to conduct the research. The analysis consisted of twelve patients. A FACIT-Sp-12 questionnaire evaluated the individual's spiritual well-being before the intervention. The intervention involved asking patients open-ended questions about their life history, experiences, and spiritual beliefs and the physician's use of active listening and empathetic responses to what patients shared (relationship-building activities). The intervention aimed to assist patients in accepting the limitations of an incurable chronic disease, affirming the value of their lives, enhancing inner harmony, and increasing their sense of belonging to something greater. After the intervention, a re-assessment of the patient's spiritual well-being was conducted using the FACIT-Sp-12 questionnaire. Researchers collected qualitative data through a confidential survey that included the following instructions: "Please express an anonymous opinion on how you perceive the spiritual care provided by the physician". Results: There was an increase in spiritual well-being, assessed using the FACIT-Sp-12 scale, in 9 out of 12 patients. The median, as well as the average, level of spiritual well-being increased in a statistically significant way after the intervention (p < 0.05). This was primarily due to the higher value of the peace subscale of the questionnaire. Qualitative analysis revealed benefits reported by patients (personal development, gratitude, satisfaction, support, hope) resulting from physician's actions. Conclusions: Both qualitative and quantitative data showed that establishing a relationship with the doctor improves the spiritual well-being of patients. Therefore, this model can be recommended for physicians in chronic pain treatment clinics.

Responding to Soul Injury: Tools for Hope and Healing

Soul Injury is defined as a wound that separates a person from their real self, caused by unmourned loss and hurt, unforgiven guilt and shame, and fear of helplessness or loss of control. Tools and interventions have been developed to guide people impacted by Soul Injury. This study assessed the effectiveness of 12 tools and interventions provided during a 4-day Soul Injury Leadership Institute. This 2-part investigation included an online survey of participants who had attended a 4-day Institute training and a post-Institute narrative inquiry conducted as virtual structured interviews. Ninety-one professionals completed the online survey, which inquired about the impact of specific Soul Injury tools and interventions on the respondents' personal and professional life. The Anchor Your Heart tool was the most frequently used tool and had the most enduring utilization across time and settings. Qualitative data collected in virtual interviews with 15 volunteers demonstrated the power of the Write/Tell Your Story technique in which storied narratives permit an individual to integrate powerful experiences such as traumatic events, serious illness, and even death, providing further validation that Soul Injury is an important human phenomenon.

Spiritual Care[Givers] Competence in Palliative Care: A Scoping Review

To deliver spiritual care, professionals must be skilled in physical, mental, social, and spiritual care. Spiritual care competence includes knowledge, behaviors, attitudes, and skills that enable successful or efficient care. This review aims to identify the scope of competence and the specific skills, knowledge, and attitudes used in providing spiritual care to people needing palliative care, and the main challenges and facilitators. A scoping review was developed using the Joanna Briggs Institute methodology. Six databases (Web of Science; MEDLINE/Pubmed; Scopus; CINAHL; MedicLatina and SciELO) were searched in September 2023, with an update in January 2024. The resulting 30 articles were analyzed using a content analysis approach. Information was categorized into three domains: cognitive, affective, and functional (based on three personal resources: intrapersonal, interpersonal, and transpersonal). Palliative care professionals face a lack of training and insufficient preparation to deliver spiritual care. Spiritual care competence depends on professional spiritual development and experience, spiritual intelligence (cognitive), spiritual humility (affective), and having a critical and reflexive mind (functional). In the future, palliative care should seek to improve competent spiritual care. This review could help clarify the real configuration of competent spiritual care and lead to improvements in a professional's empowerment when delivering effective spiritual care to patients and families.

Spiritual issues, beliefs, needs, and resources in palliative healthcare providers: An Italian qualitative study

The significance of spirituality in navigating the meaning of illness and death has been well-established. However, healthcare professionals working with palliation also grapple with their own spiritual dimensions when confronted with these circumstances. This study aimed to explore spirituality from a subjective standpoint among a sample of palliative care professionals, investigating its role and associated needs. For the first time, the FICA Spiritual History Tool was applied in a focus group setting. The meetings were transcribed, and thematic analysis was performed. The findings underscore how spirituality is perceived as more relational than transcendent, potentially fostering connections between the self, patients, and colleagues, thereby enhancing resilience. Simultaneously, spirituality needs to be considered as a potential source of suffering that could impact both the quality of life and work of healthcare workers involved. This issue should be addressed through dedicated moments of shared reprocessing, with beneficial implications for public health.

Cross-cultural adaptation, reliability and validity of the Spanish version of the long-term quality of life questionnaire

Purpose

The aim of this study was to translate, culturally adapt, and evaluate the psychometric properties of the Spanish Long-Term Quality of Life (LTQL) questionnaire.

Methods

The LTQL was initially translated into Spanish and cross-culturally adapted based on established guidelines. The Spanish LTQL was administered to patients with breast cancer who had completed their initial treatment 5 years earlier, along with other self-report measures: Quality of Life in Adult Cancer Survivors (QLACS), Hospital Anxiety and Depression Scale (HADS) and EORT-QLQ-BR23. Reliability was evaluated using internal consistency and test-retest. Convergent and known-groups validity were examined. Structural validity as determined by confirmatory factor analysis (CFA) and Rasch analyses was used to assess the unidimensionality and item-functioning of the LTQL domains.

Results

Cronbach's alpha were above 0.7 in all domains. Test-retest coefficients were between 0.72 to 0.96 for LTQL domains. LTQL total score was correlated with others total scores of other measures: QLACS (r=-0.39), HADS depression (r=-0.57), HADS anxiety (-0.45) and EORTC-QLQ-BR23 (r=-0.50). CFA provided satisfactory fit indices, with RMSEA value of 0.077 and TLI and CFI values of 0.901 and 0.909, respectively. All factor loadings were higher than 0.40 and statistically significant (P<0.001). Rasch analysis showed that Somatic Concerns domain had 4 misfitting items, and Philosophical/Spiritual View of Life and social Support domains only 1 misfit item. However, unidimensionality was supported for the four domains.

Conclusion

The findings support the validity and reliability of the Spanish version of LTQL questionnaire to be used in long-term cancer female survivors.

The expression of ultimate life goals in co-creative art processes with palliative cancer patients

BACKGROUND

Co-creation, characterized by artists and patients creating a joint work of art, may support patients with the integration of disruptive life events into their life story, such as living with cancer. Focusing on experiences of contingency and life goals could support this process. The research questions are: (1) 'how are patient's ultimate life goals and experiences of contingency expressed in the work of art as created in a process of co-creation?'; (2) 'how do the four phases of integration of experiences of contingency unfold during co-creation?'

METHODS

Ten patients who were in a palliative stage of cancer treatment completed co-creation processes. Audio recordings of these co-creation processes were imported in Atlas-Ti and analysed by applying directed content analysis. We searched for life goals and experiences of contingency in the four phases of co-creation; Art communications, Element compilation, Consolidation, Reflection.

RESULTS

Patients used 4-8 sessions (median 5 sessions) with a duration of 90-240 min each (median duration 120 min). All patients expressed their experience of contingency and their ultimate life goals within the four phases of co-creation and in their work of art. A case description is presented illustrating the co-creation process.

CONCLUSIONS

During co-creation, patients move through four phases in which experiences of contingency and ultimate life goals can be made explicit through art making and can be expressed in the work of art, supporting integration of experiences of contingency into one's life narrative.

Spiritual well-being among patients newly diagnosed with cancer in Jordan: thematic analysis

PURPOSE

Patients newly diagnosed with cancer experience a grief process that disturbs their spiritual well-being. The purpose of this study was to explore the spiritual well-being among patients with cancer within the first 3 months of diagnosis.

METHODS

The study used a qualitative approach using thematic analysis. In-depth interviews were conducted with sixteen participants diagnosed with cancer within the first 3 months prior to data collection using a purposive sampling method. The interviews took place in oncology outpatient clinics at three selected hospitals in Jordan.

RESULTS

Four main themes emerged from the texts of the participants' stories. These themes were "Hopeful yet uncertain expectation of achieving future goals," "A wake-up call for self-transcendence," "Religious struggle," and "Facing Reality provoke questions about meaning of life."

CONCLUSION

To conclude, analysis of texts from the Jordanian patients who are newly diagnosed with cancer has revealed rich and meaningful evidence of the effect of this diagnosis on disturbing patients' beliefs and meaning of life. Those patients may experience uncertainty; however, they become more connected with others and God. Health care providers need to understand patients' sources of hope and adjustment that may influence management goals before and during starting treatment.

The concept of spirituality in the context of Chinese patients with cancer: A scoping review

AIM

To elucidate how the concept of spirituality has been addressed in studies with Chinese people with cancer.

DESIGN

A scoping review.

METHODS

Patterns in conceptual definitions of spirituality and indicators for measuring spirituality were analysed.

DATA SOURCES (INCLUDE SEARCH DATES)

Literature published from inception to August 2022 was searched in five electronic databases (CINAHL, PubMed, Web of Science, PsycINFO and a Chinese database).

RESULTS

Using data from 10 qualitative studies, a new taxonomy of concepts of spirituality among Chinese people with cancer was derived, consisting of four categories: Creation of meaning, Connection, Transcendence and Existence. A total of 12 instruments developed outside of Chinese contexts and used to measure dimensions of spirituality across 27 quantitative studies were compared to the taxonomy developed in this review, and patterns were identified according to the dimensions of spirituality. Several instruments required modifications or additional explanations in questions regarding God/Higher Power and religion.

CONCLUSION

The four categories of spirituality classified in the current review are considered universal across all cultural contexts. Spirituality is multidimensional and functional concept, and the components of the instruments differed depending on which dimension of spirituality was being measured.

IMPACT

The findings of this study suggest that for measuring spirituality in research and clinical settings with Chinese people with cancer, it is important to use culturally appropriate scales that are consistent with the dimensions of spirituality being measured.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

Even instruments developed outside of the Chinese context could be used for Chinese people with cancer if appropriately selected for their intended use.

REPORTING METHOD

This paper adheres to the EQUATOR guidelines and has no direct patient or public contribution.

Spirituality in Critical Care: An Observational Study of the Perceptions of Professionals, Patients and Families, in Spain and Latin America

This research aims to describe the perspectives of health care professionals, patients, and family members regarding spiritual care options in intensive care units (ICUs). Participants were recruited consecutively from January to August 2019, during which time data collection was conducted. A total of 1211 Spanish-language questionnaires were collected from 41 ICUs in Spain and Latin America. Approximately 655 participants worked as ICU professionals (74.5% of these participants were women, and 47.5% were nurses). Additionally, 340 questionnaires were sent to patients' families, and patients completed 216 questionnaires; 59.7% of these participants were men, and their mean age was 59.4 years. Most (69.7%) of the critical care professionals considered this type of care to be a part of their profession, 50.1% did not feel competent to provide this type of care, and 83.4% felt that training in this area was necessary. Most families (71.7%) and patients (60.2%) felt that spiritual suffering occurred during their stay in the ICU. The results of this study suggest a perceived deficit in spiritual care in ICUs.

Co-creative art processes with patients: A theoretical framework and qualitative study among artists

A cancer diagnosis may be experienced as a contingent life event. Co-creation—in which artists together with patients create a work of art reflecting on aspects of the patients’ life story—may be used to support patients to integrate such a contingent life event into their life story. We conducted a qualitative study in which we interviewed 10 professional artists to explore if co-creative art processes could facilitate integration of experiences of contingency in patients. Template analyses were performed in AtlasTi. We identified co-creation as a specific form of support to the process of integration of experiences of contingency. In the formation of a new life narrative, patients transcend the boundaries of their previous life narrative by changing their perspective. Self-transcendence forms a pivotal point in co-creation, which may be helpful for patients to integrate experiences of contingency into their life narratives.

A Qualitative Study on Coping Strategies of Chinese Women With Metastatic Breast Cancer Undergoing Chemotherapy

Objectives

Women who underwent chemotherapy (CT) for metastatic breast cancer (MBC) used both adaptive and maladaptive coping strategies but had low implementation levels. The present study explores the qualitative experience of coping strategies for women with MBC undergoing CT in Beijing.

Methods

A hermeneutic phenomenological approach was employed on twenty Chinese MBC women undergoing CT. These interviews were transcribed verbatim, coded using thematic analysis, and analyzed using NVivo 11.

Results

Three themes are highlighted: Maintaining hope; Spiritual growth, and Self-perceived support resources.

Conclusion

The present study results have led to a greater understanding of the tremendous impact of CT on MBC women’s lives. This research provides insight into the scope of maintaining hope. Spiritual growth and self-perceived support resources were crucial factors to coping strategies among MBC women to improve their quality of life.

Clinical Relevance

By attaining the adaptive coping strategies and further understanding about Chinese MBC women, health care professionals are encouraged to appraise MBC women’s specific problems and adopt effective interventions to improve MBC women’s psychosocial wellbeing.

Perceptions of Spiritual Dryness in Iran During the COVID-19 Pandemic

This study addresses perceptions of spiritual dryness (a specific form of spiritual struggle) during the COVID-19 pandemic among Iranian Muslims (n = 362), and how these perceptions can be predicted. Spiritual dryness was perceived often to regularly by 27% and occasionally by 35%. Regression models revealed that the best predictors of spiritual dryness (SDS-7) were usage of mood-enhancing medications, loneliness/social isolation and praying as positive predictors, and being restricted in daily life concerns as negative predictor. The pandemic challenges mental stability of people worldwide and may also challenge trust in God. Reliable and humble support of people experiencing these phases is required.

The Role of Beliefs and Psychological Factors in Caring of Patients With Cancer: The Lived Experiences of Informal Caregivers

Cancer affects not only the patient but also family members as informal caregivers. In order for family caregivers to achieve balance and improve their caregiving roles, it is essential to identify the beliefs and psychological aspects affecting them. The present study was carried out qualitatively with a descriptive phenomenological design in 2020. The main participants in this study were selected from one of the major referral centers for cancer patients in West Azerbaijan Province, located in northwestern, Iran. Twenty-two family caregivers were selected through a purposive sampling method. Data analysis showed that the 3 main themes of "emotional and religious preconceptions," "feeling committed to caring for beloveds," and "resilience" played a prominent role in family caregivers. These factors led to caregivers' commitment to and responsibility for care. Holistic care necessitates consideration of all aspects of human life. The results of this study led to an understanding of the complex tendencies and feelings of family caregivers. Based on the results, it was found that care is influenced by beliefs, religious preconceptions, sociocultural, and psychological factors. Identifying these variables helps medical staff share planning, interventions, and counseling with family caregivers and address issues that affect them.

Exploring the Use of Psilocybin Therapy for Existential Distress: A Qualitative Study of Palliative Care Provider Perceptions

There is a growing body of research suggesting that palliative care patients coping with existential distress may benefit from psilocybin. However, there is a large gap regarding the perceptions of palliative care providers who may provide education, counseling services, recommendations, and/or prescriptions for psilocybin if it is decriminalized, commercialized, and/or federally rescheduled and legalized. The aim of this study was to explore the experiences and perceptions of interdisciplinary palliative care providers regarding existential distress and the use of psilocybin therapy. Five (n = 5) health care providers from a hospital-based palliative care team completed a semi-structured interview related to their experiences supporting patients with existential distress and their beliefs and attitudes related to psilocybin as a possible treatment modality. A qualitative descriptive approach was used to identify key themes which included: 1) multiple barriers to addressing existential distress at the cultural, institutional/organizational, relational, and individual levels, 2) the duality and power of presence, 3) suffering as an intrinsically subjective phenomenon, and 4) uncertainty about the risks and benefits of psilocybin. To inform an inclusive, safe, and holistic approach, more research is needed regarding the possible integration of psilocybin therapy within palliative care for the treatment of existential distress.

Expanding Application of the Long-Term Quality of Life Instrument to the Population of Women Undergoing Treatment of Advanced Breast Cancer

BACKGROUND

The Long-Term Quality of Life (LTQL) instrument was designed for female cancer survivors who have completed treatment and includes an existential spirituality subscale that is omitted in many other quality of life scales. Women with advanced breast cancer are now living longer, while also expressing greater spiritual concerns.

OBJECTIVE

The objective of this analysis was to test the psychometric properties of the LTQL among women undergoing treatment of advanced breast cancer.

METHODS

This secondary analysis was based on a sample of 385 women. Validity was evaluated using a confirmatory factor analysis and associations with Functional Assessment of Cancer Therapy-Breast Cancer. Internal consistency reliability was assessed using Cronbach's α for each subscale of the LTQL.

RESULTS

The mean age was 56 years, 84% of participants were white, and 69% had metastasis. Model fit indices for the confirmatory factor analysis were acceptable, with the root mean square error of approximation of 0.076 (90% confidence interval, 0.071-0.081) and a comparative fit index of 0.91. The LTQL subscale scores were significantly correlated with the subscales of the Functional Assessment of Cancer Therapy-Breast Cancer of similar conceptual content. Internal consistency reliability for the subscales ranged from 0.80 to 0.86.

CONCLUSIONS

The factor structure of the LTQL was consistent with previous findings in long-term female cancer survivors. The instrument has adequate psychometric properties for use among women with advanced breast cancer.

IMPLICATIONS FOR PRACTICE

The LTQL can be used to assess the physical, psychosocial, and existential spiritual domains of quality of life among women with advanced breast cancer as well as in long-term female cancer survivors.

'The experience of spirituality in family caregivers of adult and elderly cancer patients receiving palliative care: A meta-synthesis'

INTRODUCTION

Spirituality is a multidimensional aspect of human experience. In the context of palliative care, it is an individual resource that can be used to cope with illness and to assign new meanings to suffering. Qualitative studies that aim to investigate the experience of spirituality and the needs of family caregivers in this context are rare.

OBJECTIVE

This meta-synthesis aimed to synthesise qualitative studies on the experience of spirituality in family caregivers of adult and elderly cancer patients receiving palliative care.

METHODS

A systematic review was performed in six databases, and 14 studies were included in this meta-synthesis.

RESULTS

The results are presented as a thematic synthesis divided into two analytical themes: (1) The interweaving of spirituality with end-of-life care and (2) The dimensions of suffering and spirituality in the dying process of the loved one. Each analytical theme is explained by two descriptive themes. The results showed that family caregivers express their spirituality in a multidimensional way, giving meaning to the care provided and reassessing the meanings of their lives and their suffering.

CONCLUSION

Investigating the suffering and spiritual needs of family members in this context may be of value to inform comprehensive and multi-professional psychosocial care.

[Spirituality and health care. The perspective of patients with chronic pain]

Hintergrund

Chronischer Schmerz betrifft alle menschlichen Lebensdimensionen und wirft auch spirituelle Fragen auf, die im Rahmen eines multimodalen Behandlungsmodells berücksichtigt werden sollten.

Ziel der Arbeit

Wir untersuchten die Perspektive von Patienten mit chronischen Schmerzen zu spirituellen Themen und deren möglicher Integration in den Behandlungsprozess.

Material und Methoden

Es wurden fünf Fokusgruppen- und zwei Kleingruppeninterviews an fünf Studienzentren durchgeführt. Daran nahmen 42 Patienten mit chronischen Schmerzen teil, die aktuell in ambulanter oder stationärer Schmerzbehandlung waren. Die Interviews wurden transkribiert und einer thematischen Analyse unterzogen.

Ergebnisse

Drei Themen traten hervor: 1. Chronischer Schmerz durchdringt die gesamte menschliche Existenz. 2. Spirituelle Ressourcen stellen eine Möglichkeit im Umgang mit chronischen Schmerzen dar. 3. Patienten ist es ein Anliegen, mit Fachpersonen in einen Dialog treten zu können, der auch für spirituelle Themen offen ist. Diese haben aus Sicht der Teilnehmenden große Relevanz. Sie verknüpften sie vielfach, aber nicht ausschließlich mit religiösen Überzeugungen. Häufig wurde geschildert, in der Schmerzerfahrung nicht ernst genommen zu werden.

Diskussion

Strategien für einen effektiven Umgang mit chronischem Schmerz zu finden, stellt einen Wendepunkt im Leben dar. In diesem Prozess unterstützt ein offener Dialog mit Fachpersonen, der auch spirituellen Themen Rechnung trägt.

Sentidos de vida e morte: reflexões de pacientes em cuidados paliativos

Resumo Cuidados paliativos visam amenizar o sofrimento de pacientes com doenças crônicas e ameaçadoras da vida nas dimensões: física, social, psicológica e espiritual. Na dimensão espiritual, procura-se imbuir de sentido aspectos transcendentais, como vida e morte. Conhecer esses sentidos é o objetivo deste estudo, que se trata de pesquisa qualitativa de caráter exploratório e faz uso de entrevistas semiestruturadas para a coleta de dados e análise do discurso. Foram entrevistados quatro pacientes e identificadas três categorias de significado: recursos de enfrentamento relativos à finitude; sofrimentos relativos à finitude; sentidos atribuídos à vida e à morte. Percebeu-se como maior sofrimento não a finitude em si, mas o que decorre dela, como perda funcional, preocupação com a família e ameaça de valores. A dificuldade em se falar sobre a morte não necessariamente se encontra em si mesma, mas em identificar o sentido que ela tem para a pessoa e os sofrimentos subjacentes.

Patient-Reported Quality-of-Life Outcome Measures in the Thyroid Cancer Population

Background: There is an escalating worldwide population of thyroid cancer (TC) survivors. In addition to conventional metrics of quality of care, quality-of-life (QoL) assessment in TC patients is imperative. TC survivors face unique impediments to health-related quality of life (HRQoL), including thyroid-specific symptoms and exposure to disease-related stressors-including fear of recurrence and financial toxicity-over a prolonged survival period. Survey instruments currently used to assess HRQoL in TC survivors may be insufficient to accurately capture the burden of disease in this population. We aimed to identify the HRQoL instruments in the literature, which have been applied in the TC survivor population, and to present the psychometric properties of the scales and indexes that have been used. We hypothesized that few instruments have shown evidence of validity in this population. Summary: Of the 927 articles identified by search criteria, only 28 studies using 15 HRQoL instruments met inclusion criteria. Of the 15 HRQoL instruments identified, 9 were psychometric health status instruments and 6 were preference-based indexes, but none had been validated in the TC survivor population. While the majority of reviewed studies demonstrated impaired psychological and emotional well-being in TC survivors, these findings were not uniformly demonstrated across studies, and the longevity of the impact of TC on HRQoL was variably reported. Conclusions: Discrepancies in the literature regarding the impact of TC survivorship on HRQoL emphasize the challenges of accurately assessing patient perspectives, reinforcing the importance of using well-constructed instruments to measure patient-reported outcomes in the target population. Care providers involved in the treatment of TC survivors should be aware of longitudinal effects on HRQoL, especially pertaining to chronic psychological debilitation. Further development and rigorous validation of TC-specific instruments will allow for better data gathering and understanding of the barriers to achieving high long-term HRQoL in TC survivors throughout their long postsurvival course.

The effect of applying Spiritual Care Model on well-being and quality of care in cancer patients

PURPOSE

The study was an attempt to explore the effect of applying spiritual model of nursing care on spiritual well-being and quality of spiritual care in cancer patients.

METHOD

A quasi-experimental study, the present inquiry was carried out with control and intervention groups with participation of 72 patients and 63 nurses in an advanced center in Iran. The Spiritual Care Model (SCM) was designed by the researchers in this study and was performed on the intervention group by nurses after they received proper training. The data were collected using Demographic Information Questionnaire, Spiritual Well-Being Scale (SWBS), and Spiritual Care Delivery Rating Scale (SCDRS) in pre-intervention and post-intervention stages and were analyzed with SPSS v.16.

RESULTS

Before the intervention, the means for spiritual well-being and the quality of spiritual care were not significantly different for the intervention and control groups (p < 0.05). After the intervention, i.e., upon discharge from the hospital, the mean of spiritual well-being in the intervention group was significantly higher than that of the control group (p < 0.001). Based on the opinions of both nurses and patients, the mean of the spiritual care quality was significantly higher in the intervention group in comparison to that in the control group once the intervention was over (p < 0.001).

CONCLUSION

Given the positive effect of the SCM on enhancing the spiritual care quality and improving the patients' spiritual well-being, it is recommended that the SCM be used as a proper guideline and as a model for boosting nurses' professional performance in spiritual care.

Spiritual care interventions in nursing: an integrative literature review

As an important part of the holistic care, spiritual care is considered an indicator of care quality. This study aims to identify and characterize nursing spiritual care interventions. In order to identify and select resources, an integrative review was done. The search was conducted in national and international databases such as Google Scholar, Scopus, INML, Iran Medex, Iran Doc, Web of Science, Wiley, SID, ProQuest, Ovid, Science Direct, PubMed, ebrary, Sage, CINAHL, and Magiran from 1994 to 2018. As a result, 1625 articles were detected, 59 of which were included in synthesis. Data extraction and analysis presented eight categories of spiritual care interventions in the field of nursing including (1) the exploration of spiritual perspective, (2) healing presence, (3) the therapeutic use of self, (4) intuitive sense, (5) patient-centeredness, (6) meaning-centered therapeutic interventions, (7) the creation of a spiritually nurturing environment, and (8) the documentation and evaluation of spiritual care.

Spirituality and Emotional Distress Among Lung Cancer Survivors

BACKGROUND

Emerging research is highlighting the importance of spirituality in cancer survivorship as well as the importance of early distress screening. The purpose of this study was to prospectively examine the relationships among spirituality, emotional distress, and sociodemographic variables during the early period of lung cancer survivorship.

PATIENTS AND METHODS

Eight hundred sixty-four lung cancer survivors completed the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being, and the Short-Form-8 for emotional distress within the first year after lung cancer diagnosis, and 474 of these survivors completed the survey again 1 year later.

RESULTS

At baseline, spirituality was associated with lower prevalence of emotional distress, being married, fewer years of cigarette smoking, and better Eastern Cooperative Oncology Group performance status. Additionally, high baseline spirituality was associated with lower rates of high emotional distress at 1-year follow-up.

CONCLUSION

These findings suggest that spirituality might serve as a protective factor for emotional distress among lung cancer survivors. Further research is warranted to explore the role of spirituality in promoting distress management among lung cancer survivors.

Assessing spirituality: is there a beneficial role in the management of COPD?

Here,we report on the role of spirituality assessment in the management of chronic obstructive pulmonary disease (COPD). Although a positive effect of addressing spirituality in health care has been proved in a number of chronic diseases, its potential in COPD has received less attention. Although limited, available evidence suggests that spirituality may play an important role in improving quality of life of patients with COPD. The fruitful results in other long-term conditions may lay the foundation for further research on addressing spirituality in COPD. This should focus where the burden of COPD is greatest, including low-resource settings globally. Implementation research should include exploration of an acceptable consultation process to identify patients who would welcome spiritual discussions; how to integrate spiritual approaches into health care professional curricula so that they are aware of its importance and have the confidence to raise it with patients and how to integrate spiritual approaches into holistic COPD care.

Pain and Suffering

OBJECTIVE

To review literature on the relationship of pain, spirituality, and suffering as it relates to the patient with cancer who is experiencing pain.

DATA SOURCES

Peer-reviewed articles, textbooks, internet.

CONCLUSION

Pain and suffering are distinct and yet closely related in patients with cancer. Oncology nurses are important in assessing a patient's pain, including dimensions of spirituality and suffering.

IMPLICATIONS FOR NURSING PRACTICE

Oncology nurses are the front line of pain management for patients. This includes recognizing existential distress and suffering and responding to suffering.

Palliative care: needs of advanced breast cancer patients

Advanced breast cancer is characterized by many physical manifestations with the potential to undermine the quality of life (most related to the cancer and some to treatments), as well as substantial impact on psychosocial well-being. Patients with advanced breast cancer and their families have complex needs that have to be addressed in order to minimize severe distress and deterioration in the quality of life of patients and their family members. This task requires the full engagement of an interdisciplinary approach to palliative care with strong emphasis on the assessment of needs and anticipated needs, patient expectations, skilled therapeutics, and commitment to continuity of care. In this review, we address four issues: 1) organizational and conceptual issues in palliative care of patients with breast cancer, 2) common physical symptoms among patients with breast cancer and their management, 3) common psychological issues among patients with breast cancer, and 4) common challenging palliative care problems in breast cancer.