Functional evaluation of treatment of chronic disease: Validity and reliability of the Turkish version of the Spiritual Well-Being Scale

The mediating role of COVID-19 anxiety on the relationship between quality of life and spiritual well-being, and hopelessness: A study on cancer patients

OBJECTIVES

The coronavirus pandemic has caused concern in the community, especially in patients. Spirituality, hopelessness, and quality of life have an impact on the management of the process in cancer patients during these crisis periods. To investigate COVID-19 anxiety's mediating role in hopelessness' relationships with the quality of life and spiritual well-being among cancer patients.

METHODS

This study used a cross-sectional design to collect data from cancer patients using self-administered questionnaires. The study recruited 176 cancer patients receiving treatment at a university hospital. The participants completed measures of spiritual well-being, COVID-19 anxiety, hopelessness, and quality of life. Following preliminary analyses, a mediation model was analyzed using the PROCESS macro for SPSS, with the bootstrap method applied (model 4).

RESULTS

The results showed that spiritual well-being was negatively associated with COVID-19 anxiety and hopelessness, and positively associated with the quality of life. COVID-19 anxiety was associated positively with hopelessness, and negatively with the quality of life. Moreover, COVID-19 anxiety mediated the relationship between hopelessness, spiritual well-being, and quality of life.

SIGNIFICANCE OF RESULTS

This study provides evidence for COVID-19 anxiety's mediating role in the relationship between spiritual well-being and quality of life and hopelessness among cancer patients. The findings suggest that interventions aimed at reducing COVID-19 anxiety may be effective in reducing hopelessness among cancer patients, by promoting higher levels of spiritual well-being and improving quality of life.

The relationship between perceived stress, spiritual well-being and alexithymia in people with epilepsy: A path analysis

AIM

The present study was performed to investigate the associations among perceived stress, spiritual well-being, and alexithymia in people with epilepsy.

METHOD

The study was performed with 140 patients diagnosed with epilepsy in the neurology clinic of a training and research hospital between May and December 2022. Personal Information Form, Perceived Stress Scale (PSS-14), Spiritual Well-Being Scale (FACIT Sp-12), and Toronto Alexithymia Scale (TAS-20) were used to collect the data. Descriptive statistical methods, simple and multiple regression analyses, and path analysis were used to analyze the data.

RESULTS

The mean scores of the patients were 25.51±9.42 for PSS-14, 29.77±8.33 for FACIT Sp-12, and 56.55±16.87 for TAS-20. Concerning direct effects, a negative association was found between perceived stress and spiritual well-being, a positive association between perceived stress and alexithymia, and a negative association between spiritual well-being and alexithymia. The confirmed mediating effect was the role of spiritual well-being in the association between perceived stress and alexithymia. Perceived stress explained 28 % of spiritual well-being. In addition, the model explained 34 % of alexithymia in total.

CONCLUSION

Perceived stress levels of people with epilepsy were low, while alexithymia and spiritual well-being levels were found to be moderate. It was found that as the stress levels perceived by people with epilepsy increased, alexithymia levels also increased. It was also found that the negative impact of perceived stress on alexithymia was reduced through spiritual well-being. The study shows how important spiritual well-being is in decreasing the negative impacts of perceived stress on alexithymia in people with epilepsy.

Spiritual Well-Being Levels and Self-Care Agency of Patients Receiving Chemotherapy With Port Catheter: A Correlational, Descriptive Study

This study was conducted to determine the levels of Patients' spiritual well-being (SWB) and self-care agency (SCA) of patients receiving chemotherapy with a port catheter. It was a correlational and observational study. Data were collected between December 2021 and March 2022. The sample was 88 people. Of the participants; 59.1% were women, 88.6% were married, 38.6% were primary school graduates, 47.7% were unemployed, and 51.1% had income equal to their expenses. Furthermore, 38.6% patients had breast cancer diagnosis and 52.3% did not have any chronic diseases. Both scale scores were affected by different variables and there was a positive correlation between SCA and SWB. Better SWB positively affected SCA. Patient age and duration after cancer diagnosis affected SCA and SWB. Notably, SCA and SWB levels of the patients may change with age and disease progression, and patients should also be monitored in this respect.

Do Spiritual Well-Being and Pain Intensity Predict Physical or Mental Components of Health-Related Quality-of-Life Scale in Patients With Multiple Myeloma?

BACKGROUND

Multiple myeloma is a complex disease and supportive care is important for improving quality of life. Management of disease treatment symptoms, bone disease, renal dysfunction, infection, anemia, pain, and coagulation disorder are specific issues. Spirituality, or spiritual well-being, is one of the most fundamental and essential concepts for coping with the difficulties and stress caused by cancer.

AIMS

This study explores whether spiritual well-being, pain, and other demographic factors predict the physical and mental components of quality of life in MM subjects.

METHODS

This cross-sectional descriptive study was conducted with 92 multiple myeloma patients registered with the Cancer Warriors Association in Turkey. The data were collected using the Personal Information Form, The Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale-12, the Numeric Rating Scale for Pain, and the Short Form-12 Health-Related Quality of Life Scale.

RESULTS

The mean age of the patients was 54.4 ± 10.7 years. It was found that the mean total pain score in the previous week was 3.9 ± 2.6, while the mean total The Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale-12 score was 28.1 ± 9.8. Their mean Short Form-12 total physical component score was 39.1 ± 25.4; whereas the Short Form-12 total mental component score was 45.5 ± 24.8. According to this model, 56.7% of the physical component score was explained by vertebroplasty, The Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale-12 total score and subscale of peace and the pain intensity experienced in the previous week. According to multiple linear regression analysis, bone-sparing therapy and FACIT-Sp-12-Total and subscale peace significantly predicted the Mental component score (p < .05).

CONCLUSIONS

Cancer pain remains undertreated, and patients with myeloma are no exception. Pain and spiritual well-being scores were significant predictors of physical and mental component scores of quality of life in this group of patients. According to this result, pain-reducing practices should be implemented to improve the quality of life in MM patients and the spiritual needs of the patients should be met.

The effects of spiritual wellbeing on life satisfaction in hematologic cancer patients aged 65 and older in Turkey: mediating role of hope

BACKGROUND

The mediating role of hope in the effects of spiritual wellbeing on life satisfaction in elderly haematologic cancer patients in Turkey was investigated in the present study.

METHODS

The study was conducted in a descriptive, cross-sectional and correlational design. The study was conducted with 150 patients aged 65 and older who were diagnosed with haematologic cancer and who were referred to a university hospital haematology clinic and outpatient clinic. Research data were collected with Descriptive Information Form, Dispositional Hope Scale (DHS), Spiritual Well-being Scale (FACIT-Sp-12) and Satisfaction with Life Scale (SWLS).

RESULTS

FACIT-Sp-12 score was 37.25 ± 7.29; DHS score was 40.42 ± 8.29, SWLS score was 16.24 ± 8.79. FACIT-Sp-12 (β = 0.668) and DHS (β = 0.226) were found to affect SWLS positively. In terms of the effect of FACIT-Sp-12 on SWLS, DHS has a mediating role and makes the positive effect of FACIT-Sp-12 on SWLS stronger (β = 0.771).

CONCLUSIONS

Spiritual wellbeing levels of the participants in our study were found to be high, while their levels of satisfaction with life and hope were found to be moderate. It was also concluded that spiritual wellbeing had a direct effect on satisfaction with life and an indirect effect through the mediating role of hope.

The Effect of Spiritual Well-Being on Self-care Agency in Chronic Obstructive Pulmonary Patients in Turkey: The Mediating Role of Psychological Resilience

The aim of the present study was to determine the mediator role of psychological resilience in examining the effect of spiritual well-being on self-care agency in Chronic Obstructive Pulmonary Patients (COPD). The present cross-sectional and correlational study has a descriptive design, and it was conducted with 200 COPD patients admitted to the chest diseases outpatient clinic of a university hospital. "Spiritual Well-Being Scale (FACIT Sp-12)," "Brief Resilience Scale (BRS)" and "Self-Care Agency Scale (SCAS)" were used in the study for collecting the research data. STROBE recommendations were followed while reporting this study. FACIT Sp-12 total score average, the BRS total average score and the ASAS total average score of the patients were found to be 29.88 ± 1.44, 21.47 ± 66.31, and 84.81 ± 14.69, respectively. In addition, it was determined that both spiritual well-being (β = 0.170) and psychological resilience (β = 0.777) positively affected self-care agency. SCAS mediates the effect of FACIT-Sp-12 on self-care agency and strengthens the positive effect of FACIT-Sp-12 on self-care agency (β = 0.843). It was seen that the predictive effect of these two variables in explaining self-care power was 60%. Spiritual well-being and self-care agency of the COPD patients were found to be moderate, and the psychological resilience was found to be high. In addition, spiritual well-being was found to affect self-care agency directly and the mediating role of psychological resilience indirectly.

Correlation between symptom status, health perception, and spiritual well-being in heart failure patients: A structural equation modeling approach

AIM

To explore predictors of spiritual well-being behaviors among heart failure patients based on Wilson and Cleary's conceptual model of health-related quality of life and to clarify the interrelationships among these variables.

DESIGN

A descriptive and correlational study design was used.

METHODS

This study included 202 heart failure patients treated between October 2020 and July 2021. Data were collected using the Symptom Status Questionnaire-Heart Failure, Perception of Health Scale, and Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale. Descriptive analysis, correlation, and structural equation modeling were performed.

RESULTS

Characteristic factors positively affected spiritual well-being both directly (β = 0.19, p = 0.007) and indirectly (β = 0.19; CI (0.106; 0.311)). The direct relationship between health perception and spiritual well-being was significant (β = 0.83, p < 0.05). Symptom status acted as an essential mediator between model variables and spiritual well-being (β = -0.28; CI (-0.449; -0.133)). Comorbidity and symptom status also influence spiritual well-being through health perceptions. These variables explain 77% of the variance in spiritual well-being.

CONCLUSION

The modified structural equation modeling based on Wilson and Cleary's conceptual model fits well in predicting spiritual well-being in patients with heart failure. Spiritual well-being was reported to be poor, and changes in spiritual well-being were predicted by age, educational level, marital status, comorbidity, symptom status, and health perception. The results can be applied to patients with heart failure and may serve as a guide for assessment and interventions for improving spiritual well-being.

CLINICAL RELEVANCE

This study mainly concludes that symptom status and perceived health status affect spiritual well-being in heart failure patients. Symptom relief and improvement in perceived health status interventions may help enhance spiritual well-being in this population. Future studies are needed to investigate the different predictor's effects on spiritual well-being and examine whether symptom management and health status-enhancing interventions result in improved spiritual well-being in the heart failure population.

REPORTING METHOD

This study was reported following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross-sectional studies.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

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.

Investigation into the Relationship Between Women's Thoughts, Stigmatizing Attitudes, Beliefs, and Behaviors on Voluntary Abortion and Spiritual Well-Being in Turkiye

INTRODUCTION

Although abortion can be implemented within the framework of legal rules and practices, the issue of abortion in socio-cultural, philosophical, and religious terms is one of the crucial issues that has been discussed since the existence of humanity. This study aims to examine the relationship between women's thoughts on voluntary abortion, their stigmatizing attitudes, beliefs, behaviors, and their spiritual well-being in Turkiye.

METHOD

The sample of this analytical-cross-sectional study consisted of 300 women between the ages of 18 to 49 who had a telephone. Data were collected with the "Questionnaire Form, Functional Assessment of Chronic Illness Therapy Spirituality Well-Being (FACIT-Sp), and the Stigmatizing Attitudes, Beliefs and Actions Scale Toward Abortion (SABAS)."

RESULTS

The findings showed that 30.3% of the women participating in this study had voluntary abortions. The FACIT-Sp total score of women who had voluntary abortion (12.58 ± 7.99) was significantly lower than those who did not have an abortion (29.02 ± 6.36), and the SABAS total score was not associated with having a voluntary abortion. A weak, positive linear relationship was found between FACIT-Sp and SABAS total scores (r = .115, p < .05).

DISCUSSION

Study findings showed that there was a significant relationship between having had a voluntary abortion and a lower spiritual well-being score and there was a positive relationship between spiritual well-being and stigmatizing attitudes, beliefs, and behaviors toward abortion.

Exploring the associations between resilience and psychological well-being among South Africans during COVID-19

Resilience pertains to an individual's ability to withstand, adapt, and recuperate from adversity and stress. As the world grapples with unprecedented challenges such as the COVID-19 pandemic, understanding the relationship between resilience and psychological well-being becomes essential. Preliminary observations suggest that those with a higher resilience tend to have better psychological well-being, indicating a possible symbiotic relationship between the two. This study was structured using a cross-sectional survey design. A convenience sampling technique was employed, including 631 respondents in South Africa. Data collection took place between June 11 and July 9, 2022, facilitated through a Google Forms questionnaire. This questionnaire encompassed various instruments, namely a biographical questionnaire, the CD-RISC 10, the WHO Well-being Index, the FACIT-Sp-12, and the PMHS. The findings from the collected data highlighted a strong correlation between resilience and overall well-being during the COVID-19 pandemic. This elevation in resilience can be instrumental in augmenting psychological well-being. As such, interventions or programs aimed at enhancing individual and community well-being might benefit from incorporating elements that bolster resilience, especially during periods of global adversity.

The Relationship Between Spiritual Well-Being and Post-Traumatic Growth in Turkish Patients Undergoing Solid Organ Transplantation

This study was conducted to determine the relationship between spiritual well-being and post-traumatic growth in solid organ transplant patients. This cross-sectional study was conducted with 366 patients who presented to the organ transplantation polyclinic of a university hospital between September 2021 and February 2022 in Turkey. The mean Post-Traumatic Growth Inventory and Spiritual Well-Being Scale scores of solid organ transplant patients were 81.33 ± 20.28 and 37.18 ± 8.69, respectively. There was a significant positive correlation between post-traumatic growth and spiritual well-being. According to linear regression analysis, spiritual well-being, gender, marital status, transplanted organ, donor type, and previous mental disorders were statistically significant predictive factors that affected post-traumatic growth. Spiritual well-being was an important variable that affected post-traumatic growth in solid organ transplant patients. Therefore, healthcare providers can provide individualized psychosocial-spiritual care and counseling services that increase post-traumatic growth in patients after organ transplantation.

A Descriptive Study of Spiritual Well-Being and Foot Care Practices Administered to Turkish Patients Diagnosed with Type 2 Diabetes

The aim of the study is the determination of factors affecting the moral well-being of individuals with type 2 diabetes, their foot care behaviors, and the relationship between their spiritual well-being and foot care behaviors. This is a descriptive and relationship-seeking study. The population of the study was comprised of patients with type 2 diabetes who continued their treatment in the same hospital. The sample group consisted of 157 people determined by power analysis (0.05 margin of error, 0.85 power, and 0.447 effect size). For data collection, the Participant Information Form, Spiritual Well-being Scale, and the Foot Care Behavior Scale were used. The mean age of the participants was 59.50 ± 4.858, the body cure index was 29.97 ± 4.233, the foot care awareness score was 51.04 ± 9.884, and the spiritual well-being score was 19.44 ± 7.423. The spiritual well-being subdimension scores were as follows: meaning: 5.17 ± 3.226, belief: 9.79 ± 4.277, and peace and tranquility: 4.48 ± 2.608. Foot care awareness and spiritual well-being scores of the patients were moderate. Individuals' awareness of foot care is affected by their willingness to use medication and to receive education about diabetes; while the income level affects their moral well-being. There is a weak and positive relationship between the two scale scores. It would be appropriate to address the patients spiritually and to provide care with an integrated understanding of care. The adoption of foot care by nurses will make nursing more visible and will be effective for the protection of public health.

The Relationship Between Spiritual Well-Being, Life Satisfaction and Hope in Elderly Individuals in Turkey

Life satisfaction and hope are important features in elderly individuals. Spiritual well-being is thought to affect life satisfaction and hope in the elderly. This study was conducted to determine the association between spiritual well-being and life satisfaction and hope in elderly persons. This study followed a cross-sectional design. The sample size of the study was 1383 individuals aged 65 or older. The Spiritual Well-Being Scale (FACIT-Sp), Satisfaction with Life Scale, and Hope Scale were administered to participants. Results indicated that spiritual well-being was significantly associated with life satisfaction and hope (p < 0.05). A limitation of this finding is the possible contamination of the measure of spiritual well-being with indicators of meaning and peace that could explain the relationship between spiritual well-being and hope. The spiritual well-being scale used in this research included indicators of meaning and peace that could explain the relationship between spiritual well-being and hope.

The effect of physical and psychological symptoms on spiritual well-being and emotional distress in inpatient cancer patients

PURPOSE

This study was conducted to examine the effects of physical and psychological symptoms seen in inpatient cancer patients on spiritual well-being and emotional distress.

METHOD

This descriptive and cross-sectional study was conducted with 98 cancer patients treated in oncology, haematology, and stem cell services at a university hospital between April and June 2022. Socio-demographic characteristic form, Karnofsky performance scale, Nightingale Symptom Assessment Scale, Hospital Anxiety and Depression Scale, distress thermometer and spiritual well-being scale were used to collect data. Statistical analyses were made by taking the descriptive features of the data.

RESULTS

It was determined that 55.1% of the patients were diagnosed with cancer for more than one year, 53.1% receiving treatment for more than one year, 61.2% were diagnosed with haematological cancer, and 62.2% were treated only with chemotherapy. Cancer type (p<0.01), treatment (p<0.05) and Karnofsky scores (p<0.01) had an effect on the spiritual well-being and distress scores. It was determined that 39.8% of the patients were in the yellow zone of the distress thermometer, could not manage their stress well and needed psychological support. As the psychological symptoms of the patients increased, their spiritual well-being declined (r=-0.447, p<0.01), and as their physical (r=0.222, p<0.05) and psychological (r=0.311, p<0.01) symptoms increased, their distress scores increased.

CONCLUSION

It is anticipated that identifying the problems that patients have and making interventions to solve those problems by oncology nurses would significantly contribute to the patient's spiritual well-being and emotional distress.

Effect of mindfulness-based therapy on spiritual well-being in breast cancer patients: a randomized controlled study

BACKGROUND

Spiritual well-being is directly related to the quality of life in breast cancer patients. Mindfulness-based therapy interventions can decrease distress levels in women with breast cancer, while improving spiritual well-being.

OBJECTIVE

To investigate the effect of mindfulness-based therapy on spiritual well-being in breast cancer patients.

METHODS

This randomized controlled clinical trial was conducted in accordance with the Consolidated Standards of Reporting Trials. A total of 70 participants were enrolled from September, 2021 to July, 2022. Primary outcome included spiritual well-being, and secondary outcome included quality of life. The data were collected using the Patient Sociodemographic and Medical Data Form and Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (SpWB) (FACIT-Sp Version 4). In the statistical analysis, the independent sample t test and paired sample t test were used to examine the intervention effect on primary and secondary outcomes, according to numbers, percentage, mean, standard deviation, and conformity to normal distribution.

RESULTS

The average age of the therapy group was 42.22 ± 6.86, and the control group was 41.64 ±  6.04. The average score of meaning (12.25 ± 3.03), overall score average of the spiritual well-being (31.56 ± 8.90), the emotional well-being (13.46 ± 5.78) and physical well-being (16.71 ± 5.59), and overall average score of the quality of life (66.98 ± 17.72) of the therapy group was statistically significantly higher (p < 0.05).

CONCLUSION

The mindfulness-based training may enhance the spiritual well-being and quality of life of breast cancer patients. Nurses should be encouraged for mindfulness-based training sessions to make it a widespread practice, and to regularly evaluate the results.

TRIAL REGISTRATION

NCT05057078 (date: September 27, 2021).

Demoralization and spirituality in oncology: an integrative systematic review

OBJECTIVE

To synthesize the scientific findings on demoralization and spirituality in the oncology context.

METHODS

This is an integrative systematic review, in line with the PRISMA 2020 guidelines, as proposed by Whittemore and Knalf (2005). The MEDLINE via PubMed, Scopus, Web of Science, APA PsycNet, CINAHL, Cochrane Library, EMBASE, and LILACS databases were searched without limitations regarding language or year of publication. The studies were screened for inclusion according to the predefined eligibility criteria. Data extraction and evidence quality assessment were performed.

RESULTS

Out of the 1587 articles evaluated, 10 studies were included in this review. In general, it was found that demoralization tends to increase with the proximity of death and seems to be inversely related to spirituality, with spiritual well-being being a protective factor against demoralization, while the non-fulfillment of spiritual needs is related to increased demoralization in people with cancer. Furthermore, even among caregivers of people with advanced cancer, demoralization seems to be associated, among other factors, with spiritual suffering. These results should be analyzed with caution, considering that the studies included in this review are all observational studies, which prevents establishing cause and effect relationships.

CONCLUSIONS

Demoralization tends to increase with growing frailty and the proximity of death in people with cancer, and it seems to be inversely related to spirituality, both in these patients and in their caregivers.

The Effect of Spiritual Well-being on Hope in Immobile Patients Suffering From Paralysis Due to Spinal Cord Injuries

This study aimed to determine the effect of spiritual well-being on hope in immobile patients suffering from paralysis due to spinal cord injuries. The sample size of this cross-sectional study was determined to be 100 immobile patients suffering from paralysis due to spinal cord injuries via power analysis. "Descriptive Characteristics Form," "Spiritual Well-being Scale," and "Dispositional Hope Scales" were used to collect the data. It was determined that participants' spiritual well-being scores were 22.25 ± 9.62 and their hope scores were 29.53 ± 9.83. There was a weak but positive correlation between the total scores on the hope scale and the spiritual well-being scale (p = 0.001, r = 0.477). Among immobile patients suffering from paralysis due to spinal cord injury, spiritual well-being levels accounted for 22% of the variance in hope levels (p = 0.001, R² = 0.22). This study showed that as patients' spiritual well-being levels increased, their hope levels also increased.

Correlation of spiritual well-being with hope and depression in oncology patients: The case of Turkey

PURPOSE

This study was conducted to determine the correlation between spiritual well-being and hope and depression in oncology patients.

DESIGN AND METHODS

The sample of the study consisted of 210 cancer patients. For data collection, a Patient Information Form, the FACIT-Sp-12 Scale, the Beck Hopelessness Scale, and the Beck Depression Inventory were used.

FINDINGS

The patients had mean scores of 32.02 ± 5.14 for spiritual well-being, 4.15 ± 4.17 for hopelessness, and 16.05 ± 8.29 for depression. A negative relationship was determined between spiritual well-being and hopelessness and depression, and a positive and significant relationship was found between depression and hopelessness.

PRACTICE IMPLICATIONS

Oncology patients should be given psychosocial care that supports their spiritual well-being and hope, and depression symptoms should be well known and given importance.

An Investigation of Pain Beliefs, Pain Coping, and Spiritual Well-Being in Surgical Patients

This study investigated pain beliefs, pain coping, and spiritual well-being in surgical patients. The study adopted a cross-sectional, descriptive, and correlational research design. The sample consisted of 213 voluntary patients admitted to a surgery clinic between April and November 2019. Data were collected using a demographic characteristics questionnaire, the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale-12 item (FACIT-Sp-12), the Pain Beliefs Questionnaire (PBQ), and the Pain Coping Questionnaire (PCQ). Number, percentage, mean, and Spearman's correlation were used for analysis. Participants had a total FACIT-Sp-12 score of 25.99 ± 8.43. They had a mean PBQ "organic beliefs" and "psychological beliefs" subscale score of 4.44 ± 0.64 and 4.96 ± 0.68, respectively. They had a mean PCQ "self-management," "helplessness," "conscious coping attempts," and "medical remedies" subscale score of 15.83 ± 6.15, 9.41 ± 4.63, 8.72 ± 3.66, and 7.46 ± 5.33, respectively. Spiritual well-being was weakly and positively (r = 0.445, p < 0.000) correlated with self-management and moderately and negatively correlated (r = - 0.528, p < 0.000) with helplessness. Participants with higher organic and psychological beliefs had lower spiritual well-being. The results indicate that nurses should evaluate both pain and spiritual well-being in patients.

Does Spiritual Well-Being Affect Death Anxiety and Psychological Resilience in Cancer Patients?

This study was conducted to research the effects of spiritual well-being on death anxiety and psychological resilience in cancer patients. This cross-sectional, descriptive and correlational study was carried out with 260 cancer patients who were admitted to oncology and haematology outpatient clinic of a university hospital in east of Turkey between October 2021 and April 2022. The data were collected by using "Personal Information Form", "Spiritual Well-being Scale (FACIT-sp), Death Anxiety Scale (DAS) and The Brief Resilience Scale (BRS). It was found that mean DAS total score of cancer patients was 12.51 ± 3.39, while their mean FACIT-sp total score was 26.10 ± 6.93 and their mean BRS total score was 16.1 ± 7.05. It was found that FACIT-sp total score affected DAS and BRS total score positively, while DAS total score affected BRS total score negatively (p < .001). It was found that cancer patients had moderate level of spiritual well-being and psychological resilience and high level of death anxiety. It was also found that death anxiety and psychological resilience of cancer patients increased as their spiritual well-being levels increased. Psychological resilience was found to decrease as death anxiety increased.

The Relationship Between Spiritual Care Levels of Turkish Nurses with the Spiritual Well-Being of Their Patients: An Exploratory Study

The aim of this study was to determine the relationship between spiritual well-being of patients with the spiritual care levels of nurses. This descriptive and cross-sectional study was conducted between July and August 2019. The sample was composed of 63 nurses from one university hospital and 142 patients receiving care at the department of internal medicine of the hospital. For data collection, the information form and "Spirituality and Spiritual Care Rating Scale" were applied to the nurses, personel information form and "FACIT Spiritual Well-Being Scale" were used for the patients. For data analysis, the descriptive statistics, Spearman correlation analysis, Mann-Whitney U and Kruskal-Wallis tests were used. The mean age of the nurses was 37.44 ± 6.95 years, and 88.9% were female. The mean age of the patients was 55.04 ± 15.86 years, and 57.7% were female. 89.4% of the patients stated that nurses provided spiritual care. A positive correlation was found between item scores on two scales (r = 0.264, p < 0.001). As the level of spirituality and spiritual care of nurses increases, the level of spiritual well-being of patients increases as well.

The Effect of COVID -19 Crisis on Hopelessness, Loneliness and Spiritual Well-Being of Patients with Type 1 and Type 2 Diabetes in Turkey

This study aims to examine the relationship between the levels of hopelessness, loneliness, and spiritual well-being of patients with Type 1 and Type 2 diabetes during the process of COVID-19 outbreak. The study was carried out with diabetic patients living in three different cities that are in the Eastern Anatolia region of Turkey between the dates of 15 of November and 30 of November 2020. The sample of the study consisted of 500 (Type 1, n = 218, Type 2, n = 282) diabetes patients. Data were collected using a demographic information form, Beck Hopelessness Scale (BHS), Loneliness Scale (UCLA-LS), and Spiritual Well-being Scale (FACIT-Sp). While the mean scores of hopelessness and loneliness of type 1 patients were below the moderate level, the mean scores of their spiritual well-being were found to be above the moderate level. Moreover, while the mean scores of hopelessness and loneliness in type 2 patients were below the moderate level, the mean scores of their spiritual well-being were found above the moderate level. A significant relationship was found between Type 1 and Type 2 diabetes patients' levels of hopelessness, loneliness, and spiritual well-being during the COVID-19 outbreak. It was found that as the spiritual well-being levels of Type 1 and Type 2 diabetic patients increased, the levels of their loneliness and hopelessness decreased. It is recommended that mass communication that includes spiritual care practices can be used effectively to reduce diabetes patients' levels of loneliness and hopelessness during the pandemic. In addition, while providing care to diabetes patients, it can be suggested that health professionals offer a holistic approach with initiatives that will increase diabetes patients' spiritual well-being.

The Effect of COVID-19 Outbreak on Older Adults' Hopelessness, Loneliness and Spiritual Well-Being in Turkey

The aim of this study was to determine the hopelessness, loneliness and spiritual well-being of older adults and the relationship between these three concepts during the COVID-19 pandemic. This research used a cross-sectional, descriptive approach. Data were collected between October 13 and November 13, 2020, with 476 individuals over 65 years living in three different cities in Turkey. Data were collected using a demographic information form, Beck Hopelessness Scale (BHS), Loneliness Scale (UCLA-LS) and Spiritual Well-being Scale (FACIT-Sp). During the COVID-19 outbreak, it was found that there was a significant negative relationship between hopelessness, loneliness and spiritual well-being of older adults. In this study, it was found that during the COVID-19 pandemic, the level of hopelessness and loneliness among older adults was below the average score, and their spiritual well-being levels were moderate. Based on the findings of the present study, it is recommended that practices which increase hope, strengthen social ties and spiritual support, should be implemented for older individuals during the COVID-19 pandemic period or any other times during which social distancing is mandatory.

Does Spiritual Well-Being Affect Medication Adherence in Individuals Diagnosed with Mental Illness in Turkey?

Spiritual well-being has been evaluated as an important factor for both physical and mental recovery. The aim of this study was to determine the correlation between spiritual well-being and medication adherence in individuals diagnosed with mental illness. The study was conducted as a correlational descriptive study. The study sample consisted of 410 individuals diagnosed with mental illness. The study was conducted in the psychiatry clinic of a university hospital. The data were collected using a descriptive information form, the spiritual well-being scale, and the Morisky medication adherence scale. There was a statistically significant positive correlation between spiritual well-being and treatment adherence (r = 0.856, p = 0.002). Patient spiritual well-being was significant in explaining medication adherence (R² = 0.48, p = 0.000). This study showed that spiritual well-being affected medication adherence in individuals diagnosed with mental illness.

The relationship between spiritual well-being, hope and depression in gynecologic oncology patients

The authors' aim in this study was to determine the relationship between spiritual well-being, hope and depression in gynecologic oncology patients. This is a descriptive and correlational study. The patients received a total of 41.59 ± 12.11 points from the Spiritual Well-Being Scale, 5.57 ± 4.19 points from the Beck Hopelessness Scale, and 14.92 ± 11.61 points from the Beck Depression Scale. Gynecologic oncology patients had high spiritual well-being levels and low hopelessness and depression levels, and their hopelessness and depression levels decreased and hope levels increased as their spiritual well-being levels increased.

Validation of the FACIT-Sp-12 in a Dutch cohort of patients with advanced cancer

OBJECTIVE

Although the Dutch Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being 12 Item Scale (FACIT-Sp-12) has been used in several Dutch studies, no study has assessed the measurement properties of the translation. The aim of this study was to perform an item-reduction analysis, confirmatory factor analysis (CFA), test of reliability, and test of convergent validity.

METHODS

From the baseline data of a cohort study on experienced quality of care and quality of life (eQuiPe study), 400 advanced cancer patients without missing values on any of the variables were selected. In addition to demographic and religious/spiritual characteristics, study measures included the FACIT-Sp-12 and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC-QLQ-C30).

RESULTS

Item reduction analysis showed that Items 4 and 8 had low correlations to the total scale (<0.30). Items 6 and 7, and Items 9, 10, and 11 were highly correlated (>0.75). CFA indicated a good fit for a three-factor structure with Meaning, Peace and Faith, and good Cronbach's α coefficients for the total as well as the subscales (0.71-0.86). The removal of Items 4, 8, and 12 further improved the goodness of fit and Cronbach's α coefficients. Convergent validity was adequate with the EORTC-QLQ-C30.

CONCLUSION

Our analysis of the FACIT-Sp-12 revealed serious questions about three items and concerns about the Faith subscale. These problematic items deserve further attention so should be interpreted with care when using this scale. A future study could look into the items and test possible replacements.

The relationships between fear of cancer recurrence, spiritual well-being and psychological resilience in non-metastatic breast cancer survivors during the COVID-19 outbreak

OBJECTIVES

This study examines the relationships between fear of cancer recurrence (FCR), spiritual well-being (SWB) and psychological resilience in breast cancer survivors during the COVID-19 outbreak, and investigates to what extent breast cancer survivors' sociodemographic characteristics affect FCR, SWB and psychological resilience levels.

METHODS

The study was conducted at Canakkale University Hospital in Turkey. Included in the study were 82 non-metastatic breast cancer patients whose clinical outcomes were followed-up after primary treatment, but suspended due to the COVID-19 outbreak. FCR, SWB and psychological resilience were assessed using the FCR inventory-short form (FCRI-SF), SWB scale and the brief resilience scale (BRS), respectively.

RESULTS

The mean scores of breast cancer survivors concerning FCR, SWB, and psychological resilience were 17.77 ± 5.38, 36.20 ± 6.21 and 20.01 ± 4.51, respectively. A significant negative correlation was noted between the scores of FCR and SWB and psychological resilience (r = -0.329, p < 0.001 and r = -0.316, p = 0.004, respectively). Additionally, a significantly positive correlation was identified between psychological resilience and SWB (r = 0.501, p = 0.003). A hierarchical linear regression analysis with FCRI-SF as the dependent variable, and SWB and BRS as explanatory variables, indicated that SWB affects FCRI-SF scores and is a potential predictor of FCR. A mediation analysis revealed that SWB partially mediated the relationship between psychological resilience and FCR.

CONCLUSION

Breast cancer survivors with high SWB and psychological resilience scores experience less FCR, despite their failure to maintain the medical follow-up due to the COVID-19 outbreak. Efforts should be made to increase the psychological resilience and SWB of patients diagnosed with breast cancer.

Evaluation of the reliability and validity of Functional Assessment Of Chronic Illness Therapy-Spiritual Well-Being-Expanded in elderly patients with chronic orthopaedic diseases

BACKGROUND

The Functional Assessment Of Chronic Illness Therapy-Spiritual Well-Being-Expanded (FACIT-Sp-Ex) scale can simultaneously evaluate the quality of life and spiritual health level of patients with chronic orthopaedic diseases. We performed the FACIT-Sp-Ex scale in Chinese, and tested its reliability and validity in patients with chronic orthopaedic diseases.

METHODS

There were 249 patients with chronic orthopaedic diseases who were selected for the questionnaire survey. AMOS 23.0 and SPSS 25.0 were used for statistical analysis to calculate the reliability and validity of the Chinese version of the scale.

RESULTS

The Chinese version of FACIT-Sp-Ex scale showed that root mean square error of approximation (RMSEA) was 0.06. Cronbach's alpha coefficient was 0.83, the subscale was 0.72 ~ 0.82. The meaning, peace, relational subscales and total scale of the FACIT-Sp-Ex were negatively correlated with hospital anxiety and depression scale (HADS) and positively correlated with health-related quality of life (HRQOL). All four subdomains were inversely associated with HADS anxiety symptoms, the peace and relational subscales were inversely associated with HADS depressive symptoms. Elderly female patients score higher than male patients in faith subscale. The highest-scoring disease in FACIT-Sp-Ex faith scale was osteoarthritis, which in FACIT-Sp-Ex total scale are piriformis syndrome and osteoarthritis.

CONCLUSION

The Chinese version of FACIT-Sp-Ex scale has good reliability and validity, which can be used as an evaluation tool for the spiritual status and quality of life of Chinese elderly chronic orthopaedic patients.

Relationship between symptom burden, medication adherence and spiritual well-being in patients with chronic obstructive pulmonary disease

AIMS AND OBJECTIVES

To investigate the relationship between symptom burden, medication adherence and spiritual well-being in patients with chronic obstructive pulmonary disease (COPD).

BACKGROUND

The relationship between spirituality and medication adherence has been investigated in different chronic conditions. However, the relationship between symptom burden, medication adherence and spiritual well-being in patients with COPD has not been explored.

DESIGN

A descriptive correlational study design was adopted.

METHODS

A total of 112 patients with COPD were included in the study. Data were collected using the COPD Assessment Test (CAT), the Adherence to Refills and Medications Scale-7 (ARMS-7) and the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp). The data were analysed using descriptive and correlational statistics. The Strengthening the Reporting of Observational studies in Epidemiology (STROBE) Checklist was used.

RESULTS

The CAT score was significantly higher in patients on long-term oxygen therapy and those who had more than three comorbid conditions (p < .05). The mean score of ARMS-7 was significantly associated with age (p < .05). Current smokers had higher ARMS-7 and lower FACIT-Sp scores (p < .001). The FACIT-Sp score was negatively and moderately associated with the CAT and ARMS-7 scores (p < .001).

CONCLUSION

This study concluded that individuals with higher spiritual well-being had lower symptom burden and higher medication adherence. The need for long-term oxygen therapy and a high number of comorbid conditions were associated with increased symptom burden. Current smokers had lower spiritual well-being and medication adherence.

RELEVANCE TO CLINICAL PRACTICE

Spiritual well-being should be evaluated when assessing symptom burden and medication adherence in clinical practice. In addition, further studies examining the causal relationship between symptom burden, spiritual well-being and medication adherence in different populations are warranted.

The assessment of spiritual well-being in cancer patients with advanced disease: which are its meaningful dimensions?

BACKGROUND

Spirituality is particularly important for patients suffering from life-threatening illness. Despite research showing the benefits of spiritual assessment and care for terminally ill patients, their spiritual needs are rarely addressed in clinical practice. This study examined the factor structure and reliability of the Functional Assessment of Chronic Illness Therapy-Spiritual (FACIT-Sp) in patients with advanced cancer. It also examined the clinical meaning and reference intervals of FACIT-Sp scores in cancer patients subgroups through a literature review.

METHODS

A forward-backward translation procedure was adopted to develop the Italian version of the FACIT-Sp, which was administered to 150 terminally ill cancer patients. Exploratory factor analysis was used for construct validity, while Cronbach's α was used to assess the reliability of the scale.

RESULTS

This study replicates previous findings indicating that the FACIT-Sp distinguish well between features of meaning, peace, and faith. In addition, the internal consistency of the FACIT-Sp was acceptable. The literature review also showed that terminal cancer patients have the lowest scores on the Faith and Meaning subscales, whereas cancer survivors have the highest scores on Faith.

CONCLUSIONS

The Italian version of the FACIT-Sp has good construct validity and acceptable reliability. Therefore, it can be used as a tool to assess spiritual well-being in Italian terminally ill cancer patients. This study provides reference intervals of FACIT-Sp scores in newly diagnosed cancer patients, cancer survivors, and terminally ill cancer patients and further highlights the clinical meaning of such detailed assessment.

The Spirituality in End-of-Life Cancer Patients, in Relation to Anxiety, Depression, Coping Strategies and the Daily Spiritual Experiences: A Cross-Sectional Study

This study aimed to investigate "Faith" and "Meaning/Peace" dimensions of the functional assessment of chronic illness therapy-spiritual well-being scale (FACIT-Sp-12) in relation to coping strategies, anxiety and depression, and to analyze the relationship between FACIT-Sp-12 and the daily spiritual experience scale in end-of-life cancer patients. A sample of 152 participants were involved. The daily spiritual experiences correlated the most with "Faith" subscale. Moreover, religious coping, depression and daily spiritual experiences resulted "Faith" significant predictors, while depression, anxiety, self-distraction, positive reframing and behavioral disengagement were "Meaning/Peace" subscale's significant predictors. These findings highlighted the considerable impact of the daily spiritual experiences on patients' spiritual well-being.

Determining the spiritual well-being of patients with spinal cord injury

Context/Objective: The present study was designed to determine the spiritual belief levels of patients with spinal cord injury as well as to examine the socio-demographic factors that affect their spiritual beliefs.Design: This study was designed as a descriptive study.Setting: The physical therapy and rehabilitation unit of a city Education and Research hospital.Participants: All patients over the age of 18 years who have had spinal cord injuries.Outcome Measures: Data for the study were collected using a questionnaire and the FACIT-Spiritual Well-Being Scale.Results: People with SCI in the eastern region of Turkey demonstrate moderately high levels of spiritual well-being. A significant correlation was identified between socio-demographic characteristics, such as age, marital status, level of income, status of receiving care, and duration of diagnosis, and the spiritual well-being of patients with spinal cord injury. While previous studies have been conducted in Christian communities, the current study was the first to be conducted in a Turkish (primarily Muslim) community. Therefore, the current study will significantly contribute to the literature an explanation of the spiritual well-being of patients with spinal cord injuries in Muslim communities.Conclusions: Degree of spiritual well-being in Turkey is similar to other regions studied to date. Spiritual well-being is important in coping with the physical, social, economic, and emotional problems experienced by patients after a spinal cord injury. Healthcare professionals are encouraged to support the spiritual needs of their patients.