Association between spiritual well-being, quality of life, anxiety and depression in patients with gynaecological cancer in China

Transitional Changes of Anxiety, Pain and Other Symptoms in Cancer Patients Admitted to a Palliative Care Unit, Evaluated Using the Support Team Assessment Schedule - Japanese Version

Objective: Association between physical symptoms and psychosocial difficulties of cancer patients has been reported widely. Nevertheless, the effects of pain and other symptom control on anxiety in such patients have not been investigated well. We investigated the association of improvement of pain and other symptoms with patient anxiety, and assessed factors associated with improvement of such symptoms. Methods: Data of patients with advanced cancer admitted to a palliative care unit during August 2018 - June 2022 were analyzed retrospectively. Severity of pain, other symptoms, and anxiety was assessed by the Support Team Assessment Schedule Japanese version (STAS-J) administered at admission and after 2 weeks. Patients' physical data, their Palliative Prognostic Index (PPI) at admission, and their overall survival were collected and recorded. Results: Data of 701 patients were analyzed. Improvement of pain or other symptoms after 2 weeks was not associated with the PPI total score or actual survival (P = .105 and .999). Patients with higher anxiety on admission experienced improvement of pain or other symptoms more frequently (P = .005). Worsening of anxiety was observed less in patients who experienced improvement in pain or other symptoms after 2 weeks (P = .027). Conclusion: Pain or other symptoms of patients with advanced cancer was improved irrespective of the general condition indicated with actual survival and prognosis-predictive factors. These findings suggest the importance of pain and other symptoms' improvement and its important roles in the management of patient psychosocial problems such as anxiety.

The Relationship Between Spirituality and Religiosity with Death Anxiety Among Cancer Patients: A Systematic Review

This systematic review aimed to summarize the evidence regarding the relationship between spirituality and religiosity with death anxiety (DA) among cancer patients. This systematic review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) checklist. An extensive search was conducted on electronic databases such as Scopus, PubMed, Web of Science, Iranmedex, and Scientific Information Database (SID) via keywords extracted from Medical Subject Headings from the earliest to February 9, 2022. The quality of the included studies was assessed using the appraisal tool for cross-sectional studies (AXIS tool). Fifteen studies were selected for inclusion in this systematic review. Nine and six studies assessed the relationship between spirituality and religiosity with DA in cancer patients, respectively. Most studies had a negative relationship between spirituality (n = 8) and religiosity (n = 4) with DA. In sum, most studies showed that religion and spirituality are negatively related to DA in patients with cancer.

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.

Factors influencing resilience in patients with advanced cancer: A cross-sectional study

Background

Advanced cancer and its treatments lead to various detrimental impacts on patients. Resilience is an important ability to adapt to such adversity, but there is limited information about its influencing factors, specifically in patients with advanced cancer.

Objective

This study aimed to examine the influence of social support, depression, anxiety, hope, optimism, spiritual well-being, religious belief, and hardiness on resilience among adults with advanced cancer.

Methods

This cross-sectional research used multi-stage sampling to select 288 participants from a university hospital and three tertiary hospitals in northern Thailand. Data were collected using a demographic data collection form, the Hospital Anxiety and Depression Scale (HADS), the Thai version of the Social Support Questionnaire (SSQ), the Herth Hope Index (HHI), Life Orientation Test-Revised (LOT-R), Buddhist Belief Questionnaire, Health-Related Hardiness Scale (HRHS), and Connor-Davidson Resilience Scale (CD-RISC), from February 2021 to February 2022. Data were analyzed using descriptive statistics, Pearson correlation, and regression analysis.

Results

Depression (r = -0.47, p <0.01) and anxiety (r = -0.39, p <0.01) had a significant negative relationship with resilience. Spiritual well-being (r = 0.74, p <0.01), hope (r = 0.67, p <0.01), religious belief (r = 0.53, p <0.01), optimism (r = 0.40, p <0.01), social support (r = 0.33, p <0.01), and hardiness (r = 0.21, p <0.01) had significant positive relationships with resilience. Only hope (β = 0.29, p <0.01) and spiritual well-being (β = 0.59, p <0.01) together influenced resilience by 64.70%.

Conclusion

Spiritual well-being and hope are crucial to resilience in patients with advanced cancer. Nurses should provide spiritual support to strengthen patients' ability to adapt successfully to life with advanced cancer.

Death Anxiety, Religious Attitude and Associated Factors in Dialysis Patients, A Descriptive Study; Turkey Sample

Aim: The aim of this study is to determine the relationship between death anxiety and religious attitudes of patients receiving hemodialysis and peritoneal dialysis treatment, and to determine the differences between the two treatment groups according to the affecting factors. Method: It is a descriptive research. The study was completed with 105 individuals receiving dialysis treatment. The study universe is dialysis patients who continue their treatment in the same hospital. The sample size and power was determined by utilizing the results of another study. Descriptive characteristics form, Religious Attitude Scale and Death Anxiety Scale were used to collect data. Results: The mean age, religious attitude scale score and death anxiety scale score of the participants is 57,01 ± 12,969, 3,10 ± 0.612, and 9,55 ± 3,533, respectively. Conclusion: The religious attitude of dialysis patients is moderate and they have death anxiety. Hemodialysis patients have more death anxiety. There is a weak correlation between religious attitude and death anxiety. Recommendations: It can be suggested that nurses who care for dialysis patients, should be aware of the role of religion in the lives of dialysis patients and its relationship with health outcomes, and it may be recommended to apply holistic care for these patients to express their feelings and their concerns about death.

Spiritual well-being correlates with quality of life of both cancer and non-cancer patients in palliative care - further validation of EORTC QLQ-SWB32 in Finnish

BACKGROUND

The European Organisation for Research and Treatment of Cancer (EORTC) has developed the Spiritual Well-being Questionnaire (EORTC QLQ-SWB32), a measure of spiritual well-being validated with people receiving palliative care for cancer, although its usefulness is not restricted to that population. We aimed to translate and validate this tool in Finnish and to study the relationship between spiritual well-being (SWB) and quality of life (QOL).

METHODS

A Finnish translation was produced according to the guidelines of EORTC and included forward- and back-translations. Face, content, construct and convergence/divergence validity and reliability were studied in a prospective manner. QOL was assessed with EORTC QLQ-C30 and 15D questionnaires. Sixteen individuals participated in the pilot testing. 101 cancer patients drawn from oncology units, and 89 patients with other chronic diseases drawn from religious communities in different parts of the country participated in the validation stage. Retest was obtained from 16 individuals (8 cancer and 8 non-cancer patients). Inclusion criteria included patients with either a well-defined palliative care plan, or who would benefit from palliative care, as well as the capacity to understand and communicate in Finnish.

RESULTS

The translation appeared understandable and acceptable. Factorial analysis identified four scoring scales with high Cronbach alfa values: Relationship with Self (0.73), Relationship with Others (0.84), Relationship with Something Greater (0.82), Existential (0.81), and, additionally, a scale on Relationship with God (0.85). There was a significant correlation between SWB and QOL in all participants.

CONCLUSIONS

The Finnish translation of EORTC QLQ-SWB32 is a valid and reliable measure both for research and clinical practice. SWB is correlated with QOL in cancer and non-cancer patients undergoing palliative care or who are eligible for it.

Social functioning, depression, and quality of life among breast cancer patients: A path analysis

PURPOSE

To identify associations among social functioning, depression, and quality of life in breast cancer patients.

METHOD

A cross-sectional study was conducted. A total of 180 breast cancer patients were recruited from the surgical units in southern Taiwan hospital in 2021. Path analysis was employed to analyze the relationships between background information and social functioning, depression, and quality of life. Structural equation modeling (SEM) was used for examining the path analysis in this study.

RESULTS

The path model showed that respondents with a religious belief (ß = 0.18, p < .000) and less severe disease (ß = -0.29, p < .01) showed better social functioning. Income did not affect social functioning directly but was directly related to the social interaction dimension (ß = 0.30, p < .000). Moreover, younger age (ß = -0.29, p < .000, lower income (ß = -0.10, p < .05) and more severe disease (ß = 0.35, p < .000) increased the level of depression. Less severe disease would also result in a better quality of life (ß = -0.45, p < .000). Breast cancer patients with better social function levels have low levels of depression (ß = -0.82, p < .000) and better quality of life (ß = 0.76, p < .000).

CONCLUSION

Age, religion, income, and severity are crucial predictors of social functioning, depression, and quality of life. Furthermore, severity variables which combined clinical variables to make this variable a stronger predictor for SF, depression, and QOL.

Quality of Life in Amazonian Women during Cervical Cancer Treatment: The Moderating Role of Spirituality

This study aimed to examine the contribution of psychological variables to quality of life (QoL) of Amazonian women and to analyze the moderating role of spirituality in the relationship between psychological morbidity and Qol and between illness perception and QoL. This cross-sectional study included 119 women undergoing treatment for cervical cancer (CC). The Pearson correlation test was used to evaluate the relationship between sociodemographic, clinical, and psychological variables. To test how psychological morbidity, illness perception, and spirituality contribute to QoL, a path analysis was performed and to test the moreating role of spirituality, a moderation analysis was conducted. The results revealed that the presence of symptoms, high psychological morbidity, negative body image, and threatening illness perception were predictors of lower QoL. Spirituality moderated the relationship between psychological morbidity and QoL, and between illness perception and QoL. The moderating role of spirituality emphasizes its role as a coping strategy and should be included in cancer treatment. Interventions should target psychological morbidity, threatening illness perception, and address women's concerns with body image and sexual concerns. CC treatment should include interprofessional healthcare teams addressing the biological and psychosocial factors of Amazonian women. As a result of this study a mobile application to monitor women's health, adapted to cultural and social characteristics, was created.

The relationship between meaning of life, perceived social support, spiritual well-being and pain catastrophizing with quality of life in migraine patients: the mediating role of pain self-efficacy

BACKGROUND

Migraine is a neurological disease that has several physical and psychological complications, which is characterized by disability and impaired quality of life.

AIMS

The aim of this study was to explore the mediating role of pain self-efficacy in the relationship between meaning of life, perceived social support, spiritual well-being and pain catastrophizing with quality of life in migraine sufferers. The relationship between these factors with quality of life (QOL) was not fully explored in migraine patients.

METHOD

This study was a correlational study of structural equations. Therefore, 300 patients with migraine who referred to one of the specialized neurological treatment centers in Zanjan in 2021 were recruited based on the inclusion criteria. Patients also completed the World Health Organization Quality of Life Scale (WHOQOL-BREF), Meaning in Life Questionnaire, Multidimensional Scale of Perceived Social Support, Spiritual Well-Being Scale, Pain Catastrophizing Scale, Pain Self-Efficacy Questionnaire. Finally, the hypotheses were then analyzed with correlation coefficient and path analysis method by using SPSS-26 and LISREL-10.2 programs.

RESULTS

The results of the present study showed that pain self-efficacy has a mediating role in the relationship between meaning of life and quality of life (B = 0.015), perceived social support with quality of life (B = 0.022), spiritual well-being with quality of life (B = 0.021), as well as pain catastrophizing with quality of life (B = - 0.015).

CONCLUSION

According to the results of this study, by considering the role of self-efficacy of pain, it is possible to develop the programs to strengthen and improve the meaning of life, perceived social support, spiritual well-being and also reduce pain catastrophizing, in order to improve the quality of life of patients with migraine.

Interaction of anxiety and hypertension on quality of life among patients with gynecological cancer: a cross-sectional study

BACKGROUND

Patients with gynecological cancer are prone to anxiety, and many of them are accompanied by hypertension, which seriously affects the quality of life (QOL). The study was to explore the interaction of anxiety and hypertension on QOL, and the moderating effect of perceived social support (PSS) in the impact of anxiety and hypertension on QOL of patients with gynecological cancer.

METHODS

A cross-sectional study was conducted in 2020, and 566 patients have been collected from the Affiliated Hospital of China Medical University. The Self-Rating Anxiety Scale (SAS), the Functional Assessment of Cancer Therapy Genera tool (FACT-G), and the Multidimensional Scale of Perceived Social Support Scale (MSPSS) were used. The interaction was analyzed by additive model, and the moderating effect was conducted by regression analysis and the simple slope analysis.

RESULTS

We found that 68.8% of patients had poor QOL due to the interaction between anxiety and hypertension. The relative excess risk ratio (RERI) was 22.238 (95%CI:44.119-88.596); the attribution ratio (AP) was 0.688 (95%CI:0.234-1.142); The interaction index (S) was 3.466 (95%CI: 0.823-14.435). The interaction items of PSS and anxiety were negatively correlated with QOL (β = -0.219, P < 0.01) and explained an additional 4.0% variance (F = 68.649, Adjusted R² = 0.399, ΔR² = 0.040, P < 0.01); PSS and blood pressure interaction item was not associated with QOL (β = 0.013, F = 55.138, Adjusted R² = 0.365, ΔR² = 0.001, P = 0.730).

CONCLUSIONS

When anxiety and hypertension coexist, the QOL was affected. PSS played a moderating role in the impact of anxiety on QOL. Healthcare providers should take intervention measures to improve patients' social support to reduce the impact of anxiety on QOL.

Unmet needs in palliative care for patients with common non-cancer diseases: a cross-sectional study

Background

Non-cancer patients experience the chronic process of disease that increases the patients’ suffering as well as families’ care burden. Although two-thirds of deaths are caused by non-cancer diseases, there is a lack of studies on palliative care for non-cancer patients. This study identified the palliative care needs and satisfaction, anxiety and depression, and health-related quality of life (HRQOL) of non-cancer patients and identified the factors influencing their HRQOL.

Methods

A cross-sectional survey design was employed. Participants were 114 non-cancer patients with chronic heart failure, stroke, end-stage renal disease, or end-stage liver disease who were admitted to the general ward of a tertiary hospital in South Korea. Measures included the Palliative Care Needs and Satisfaction Scale, the Hospital Anxiety and Depression Scale, and the Medical Outcome Study 36-items Short Form Health Survey version 2. Data were analysed with descriptive statistics, independent t-tests, analyses of variance, Pearson’s correlations, and multiple linear regression analyses.

Results

The average score of palliative care needs was 3.66 ± 0.62, which falls between ‘moderate’ and ‘necessary’. Among the four domains, the average score of palliative care needs in the psychosocial domain was the highest: 3.83 ± 0.67. Anxiety was nearly in the normal range (7.48 ± 3.60; normal range = 0–7) but depression was higher than normal (9.17 ± 3.71; normal range = 0–7). Similar to patients with cancer, physical HRQOL (38.89 ± 8.69) and mental HRQOL (40.43 ± 11.19) were about 80% of the general population’s score (50 points). Duration of disease and physical performance were significant factors associated with physical HRQOL, whereas physical performance, anxiety, and depression were significant factors associated with mental HRQOL.

Conclusion

It is necessary to maintain non-cancer patients’ physical performance and assess and manage their mental health in advance for effective palliative care. This study provides relevant information that can be used to develop a tailored palliative care model for non-cancer patients.

What Aspects of Religion and Spirituality Affect the Physical Health of Cancer Patients? A Systematic Review

In recent years, the literature on the relationship between religion and spirituality (R/S) and the health of cancer patients has been flourishing. Although most studies focus on mental health, many study the physical health of these individuals. In order to summarize the findings of these studies, we reviewed the most recent research on this subject using the PubMed and PsycInfo databases. The objective of this systematic review was to recognize the primary R/S variables studied in research on physical health in cancer contexts. We found that spiritual well-being was the most-researched variable in studies of these characteristics, followed by R/S struggles and other variables such as religious coping; religious commitment or practice; or self-rated R/S. In general, R/S seems to have a positive association with the physical health of cancer patients, although the results are quite heterogeneous, and occasionally there are no relationships or the association is negative. Our results may assist in improving interventions that include spirituality in clinical settings as well as the development of holistic approaches, which may have a positive impact on the quality of life and well-being of cancer patients.

Nurse's spiritual care perception in Ethiopia: A multicenter cross-sectional study

Objectives:

Spirituality and spiritual care are the critical components of patient care. In recent years, spirituality has been indicated as a crucial but often overlooked component of patient health. Despite their benefits, several factors prevent nurses from providing spiritual care. Hence, the purpose of this study was to evaluate the current state of spiritual care perception of nurses in Southwest Ethiopia as well as the factors influencing it.

Methods:

From 1 August to 2 September 2021, an institution-based cross-sectional study was performed on nurses at five government hospitals in Southwest Ethiopia. Study participants were selected using a simple random sampling method. Data were collected using the Spirituality and Spiritual Care Rating Scale (SSCRS). The collected data were recorded into EpiData 4.1 and SPSS version 25. Simple and multivariable linear regression analyses were used to identify factors associated with spiritual care perception. Statistical significance was set at p < 0.05.

Results:

A total of 390 nurses were enrolled in the study, yielding a response rate of 96.8%. The mean score for nurses’ perception of spiritual care for patients was moderate, that is, 3.11 ± 0.78. Age (p < 0.05), clinical experience (p < 0.05), educational status (p < 0.05), and religion (p < 0.05) were significantly associated with spiritual care perceptions.

Conclusion:

Nurses’ perception of spiritual care was moderate. It is affected by nurses’ age, clinical experience, educational level, and religion. This expanding body of data should be used to notify nurse managers and nursing management personnel to provide spiritual care training, planning, and services.

Medical student acceptance on gene therapy to increase children's well-being with genetic diseases: a study in Indonesia

Aim: Gene therapy is expected to improve patients' quality of life. Medical students need to be aware about this technology as its application is becoming wider. Materials & methods: A web-based survey was conducted to measure the acceptance of Indonesian medical students regarding gene therapy. Results: Data from 621 valid responses showed that Indonesian medical students have little knowledge of this technology, with 34.4% of them ever heard of gene therapy. However, most of them support the approved gene therapy for health-related matters, but not on the non-health related matters. Their acceptance was determined by the sex, domicile and studentship status. Conclusion: Increasing medical students' knowledge of gene therapy is important to minimize the future conflict of gene therapy application.

Systems Approaches to Occupational Vocal Health: Considerations for Community Faith Leaders

Systems thinking approaches can benefit the occupational vocal health of vocally reliant workers. This paper explores community faith leaders as an example of a highly vocally reliant occupation, who may benefit from systems thinking being used to support their vocal occupational health and safety. A scoping review of the current literature regarding faith leaders' occupational voice use and vocal health is detailed, including recognised occupational hazards. This article then discusses the unique and potential use of systems thinking for facilitating faith leaders' vocal occupational health and safety. Rather than using a solely clinical perspective, the sociotechnical systems approach and the biopsychosocial-spiritual approach are noted as particularly pertinent for this occupational group.

The assessment of spirituality between cancer and chronic inpatients: a cross-sectional study

PURPOSE

Spiritual well-being had a protective effect on quality of life in cancer, due to the cultural, regional, and custom differences; it was rarely been discussed between cancer and chronic diseases in Chongqing, China. We aimed at comparing the level of spirituality in two groups and discussing its factors of subjects with cancer at county regions.

METHODS

A cross-sectional questionnaire survey was distributed to 630 inpatients who received treatment between January and December 2020 in Chongqing University Three Gorges Hospital. In addition to basic demographic data, spirituality was measured using the Chinese version of Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp-12). The mean, standard deviation, independent t-tests, ANOVA, and multiple regression were used for statistical description and analysis.

RESULTS

Significant differences were found between cancer and chronic diseases in total scores of FACIT-Sp-12 and each domain (P < 0.05). The meaning, peace, faith, and total scores in cancer were 11.21 ± 3.38, 10.66 ± 4.46, 11.43 ± 3.54, and 33.3 ± 10.35, respectively, which were lower than chronic diseases (13.00 ± 3.21, 12.95 ± 4.76, 12.66 ± 3.64, 38.61 ± 10.88, respectively). The spiritual well-being had significant differences in gender, character, and emotional with spouse for cancer (P < 0.05). The male and extravert character were significantly associated with a greater spiritual well-being.

CONCLUSION

The study shows a medium level of spiritual well-being in cancer, which stands the population with lower economic and education in county regions. It suggests that under the current nursing mode, we should provide specifically spiritual care to the female, introvert, and those with poor relationship with spouses and create a harmonious doctor-patient environment to improve the spiritual well-being.

Social Support and Spiritual Well-Being of Patients With Esophageal Cancer Aged Over 50 Years: The Mediating Role of Rumination

BACKGROUND

Spiritual well-being plays an important role in helping patients cope with disease. Previous studies have investigated the association between social support and spiritual well-being, whereas few studies have explored the relationship in patients with esophageal cancer (EC), and the mechanisms behind this pathway have not been thoroughly examined.

OBJECTIVE

This study aimed to explore the relationship between social support and spiritual well-being of Chinese patients with EC aged over 50 years and to analyze whether the relationship was mediated by rumination.

METHODS

A cross-sectional survey was conducted with 197 EC patients. Participants completed the general information questionnaire, the Functional Assessment of Chronic Illness Therapy-Spiritual Scale, the Chinese Event Related Rumination Inventory, and the Perceived Social Support Scale (PSSS).

RESULTS

Results demonstrated that social support of patients with EC aged over 50 years was positively correlated with spiritual well-being and deliberate rumination and negatively correlated with intrusive rumination; spiritual well-being was positively associated with deliberate rumination and negatively correlated with intrusive rumination. The effect of social support on spiritual well-being was partially mediated by deliberate rumination and intrusive rumination.

CONCLUSIONS

The findings suggest that interventions directed toward enhancing social support and deliberate rumination and reducing the level of intrusive rumination may help patients with EC aged over 50 years improve spiritual well-being.

Spiritual Well-Being for Croatian Cancer Patients: Validation and Applicability of the Croatian Version of the EORTC QLQ-SWB32

Spiritual well-being is a recognized predictor of health-related quality of life in palliative patients. No research in Croatia has yet addressed this field. This study, the first of its kind in Croatia, validated a Croatian translation of the EORTC QLQ-SWB32 measure of spiritual well-being with curative Croatian oncology patients and assessed its use and value. The study was conducted between July 2019 and January 2020 at the Department of Radiotherapy and Oncology, University Hospital Rijeka, with 143 cancer patients, using the linguistically validated Croatian version of the measure. All patients found the measure acceptable. Confirmatory factor analysis aligned with the structure found in previous studies. Cronbach’s alpha confirmed internal consistency. Female participants scored higher on the RSG (Relationship with Someone or Something Greater), RG (Relationship with God), and EX (Existential) scales, and on Global-SWB. Patients with breast and gynecological tumors scored higher on RG. Older patients scored lower on RSG, RG and EX. Retirees and those with below-average incomes scored lower on EX. Participants who identified as having no religion scored lower on RSG. Stage I cancer patients scored higher on RG. The Croatian version of the EORTC QLQ-SWB32 is an acceptable, valid, and reliable measure of SWB for Croatian cancer patients.

Associations of Spiritual Well-Being and Hope with Health Anxiety Severity in Patients with Advanced Coronary Artery Disease

Background and Objectives: Health anxiety is one of the most common problems in patients with coronary artery disease. The present study tested whether health anxiety severity could be predicted by spiritual well-being and hope in patients with advanced coronary artery disease. Materials and Methods: In a cross-sectional study, 100 patients with advanced coronary artery disease were recruited from hospitals and healthcare centers in Iran. Patients completed self-report scales, including the Spiritual Well-Being Scale, Adult Hope Scale, and Short Health Anxiety Inventory. Hierarchical multiple regression analyses were used to empirically explore the relations among variables. Results: Results indicated that patients who reported higher levels of hope (β = 0.42, p < 0.01) and spiritual well-being (β = 0.20, p < 0.05) reported lower levels of health anxiety. Agency (β = 0.58, p < 0.01) scores were a significant negative predictor of health anxiety severity. Additionally, religious spirituality scores (β = 0.28, p < 0.01) were shown to significantly negatively predict health anxiety level. However, the pathways components of hope and existential spirituality were not significant predictors. Conclusion: The findings of the present study indicate that spiritual well-being and hope could be important factors in determining health anxiety for adults with coronary artery disease, and their role is worthy of further exploration to help improve health anxiety for patients with coronary artery disease.

Experience of symptom control, anxiety and associating factors in a palliative care unit evaluated with Support Team Assessment Schedule Japanese version

Various physical and psychosocial difficulties including anxiety affect cancer patients. Patient surroundings also have psychological effects on caregiving. Assessing the current status of palliative care intervention, specifically examining anxiety and its associated factors, is important to improve palliative care unit (PCU) patient quality of life (QOL). This study retrospectively assessed 199 patients admitted to a PCU during August 2018–June 2019. Data for symptom control, anxiety level, disease insight, and communication level obtained using Support Team Assessment Schedule Japanese version (STAS-J) were evaluated on admission and after 2 weeks. Palliative Prognostic Index (PPI) and laboratory data were collected at admission. Patient anxiety was significantly severer and more frequent in groups with severer functional impairment (p = 0.003) and those requiring symptom control (p = 0.006). Nevertheless, no relation was found between dyspnea and anxiety (p = 0.135). Patients with edema more frequently experienced anxiety (p = 0.068). Patient survival was significantly shorter when family anxiety was higher after 2 weeks (p = 0.021). Symptoms, edema, and disabilities in daily living correlate with patient anxiety. Dyspnea is associated with anxiety, but its emergence might be attributable mainly to physical factors in this population. Family members might sensitize changes reflecting worsened general conditions earlier than the patients.

Spiritual Care for Individuals with Cancer: The Importance of Life Review as a Tool for Promoting Spiritual Well-Being

OBJECTIVE

To discuss spirituality in the context of cancer, focusing on the use of life review as a tool to help promote spiritual well-being among individuals with cancer.

DATA SOURCES

Literature regarding spirituality and life review of the author in cancer care provided the foundation for this article.

CONCLUSION

Reliance on spirituality as an untapped supportive resource may surprise patients and their families when dealing with a diagnosis of cancer. Coming to terms with advancing disease can be a time of internal and spiritual growth. It is important that all members of the health care team make efforts to understand that spirituality is part of the journey that the person with advanced cancer is going through and that life review is one way to promote spiritual well-being among patients with advanced cancer.

IMPLICATIONS FOR NURSING PRACTICE

Nurses are ideally placed to provide spiritual care. Using life review, nurses can assist individuals coming to terms with their diagnosis and can positively impact spiritual and psychosocial well-being.

Associations between the spiritual well-being (EORTC QLQ-SWB32) and quality of life (EORTC QLQ-C30) of patients receiving palliative care for cancer in Cyprus

Background

Spiritual well-being is increasingly investigated in relation to patients’ perceived quality of life and is generally thought as having the potential to support patients with cancer who receive palliative care. Until recently, questionnaires used to assess spiritual well-being were developed mainly in the US. The purpose of this study was to translate and use the EORTC- SWB32, a newly developed tool, validated recently in 4 continents, 14 countries, and in 10 languages, to explore relationships of spiritual well-being with quality of life in patients with cancer.

Methods

One hundred four patients participated in this study with an average age of 59 years. Of those, 79% were dealing with metastatic cancer. Data collection took place in three oncology centers from two large cities in Cyprus. The acceptability of the translated items was tested. Two questionnaires were employed for the assessment of quality of life and spiritual well-being, developed by the same organization: the EORTC QLQ-C30 and the EORTC QLQ-SWB32. The scores for each tool were analyzed separately and correlations between the two measures were explored.

Results

Patients found the items of the SWB32 tool easy to understand and answer. They attested that filling the questionnaire prompted thoughts about their own spirituality. The mean score for Global Spiritual Well-Being was 60.4 (SD = 23.7) and it was associated with the mean scores in the scales “Emotional functioning” and “Cognitive functioning” of the EORTC-QOL-C30 (0.42 and 0.40 respectively, p < 0.01). The mean score for the “Relationship with God” scale (74.9, SD = 29.7) reported by the Cypriot patients is high and compatible with the homogenous spiritual orientation of the island’s population.

Conclusions

All subscales of the SWB32 tool demonstrated good internal consistency in this study. Significant associations were observed between dimensions of quality of life and spiritual well-being. Additionally, the participants found the items easy to answer consistent with the tool’s suggested clinical utility which lays the ground for the application of targeted interventions to enhance spiritual well-being.

Exploring the relationship between spiritual well-being and death anxiety in patients with gynecological cancer: a cross-section study

Background

In recent years, spiritual well-being has gradually gained the attention of health care providers in China, especially those in oncology departments, who have recognized the importance of improving spiritual well-being in cancer patients. Since most of the current research on spiritual well-being has been carried out in areas with religious beliefs, this study was conducted in the context of no development of formal religion. The purpose of this study was to explore the relationship between death anxiety and spiritual well-being and the related factors of spiritual well-being among gynecological cancer patients.

Methods

This cross-section study was conducted among 586 gynecological cancer patients. The European Organization for Research and Treatment for Cancer Quality of Life Questionnaire-spiritual well-being32 (EORTC QLQ-SWB32) and Templer's Death Anxiety Scale (T-DAS) were used to measure spiritual well-being and death anxiety. The Multiple Linear Regression Model was used to determine the relationship between spiritual well-being and death anxiety.

Results

For all participants, the highest QLQ-SWB32 centesimal score was 75.13 on the Relationship with Other scale, and the lowest was 60.33 on the Relationship with Someone or Something Greater Scale. The mean Death Anxiety score was 5.31 (SD 3.18). We found that Relationship with Someone or Something Greater was the only scale not associated with death anxiety. Overall, patients with lower death anxiety have a higher level of spiritual well-being. Besides, a high Relationship with Other score was associated with living with a partner (B = 2.471, P < 0.001) and married (B = -6.475, P = 0.001). Patients with higher Global-SWB were retired (B = 0.387, P = 0.019).

Conclusions

Our study found that the spiritual well-being of patients with gynecological cancer in China was no worse than in other countries with religious beliefs and patients with lower death anxiety have a higher level of spiritual well-being. Clinical staff should pay attention to the spiritual health of cancer patients, and spiritual care should be regarded as an essential element in cancer care.

The Relationship between Coronavirus Anxiety, Mindfulness and Spiritual Health in Patients with Cancer: A Survey in Southeast Iran

OBJECTIVE

The sudden outbreak of COVID-19 has caused major health problems, including anxiety in cancer patients worldwide. Spiritual health and mindfulness are considered as factors affecting anxiety. This study addressed the relationship between COVID-19 anxiety, spiritual health and mindfulness in patients with cancer.

METHODS

One hundred and eighty-four cancer patients participated in this cross-sectional study. The data were collected with convenience sampling method from two oncology centers from 15 June to 15 July 2020 in the southeast Iran. Patients completed the Demographic and Clinical Characteristics Form, Corona Disease Anxiety Scale (CDAS), The Freiburg Mindfulness inventory-Short Form (FMI-SF) and Spiritual Health Scale.

RESULTS

According to the psychological symptom subscale (CDAS), 61.4% of the participants had moderate to severe anxiety. According to the physical symptom subscale, 38% of the participants had moderate to severe anxiety. No significant association was found between corona disease anxiety and mindfulness/spiritual health (p>0.05).

CONCLUSION

The results of this study showed high levels of mental and physical anxiety and worries about COVID-19 disease in cancer patients, which led to challenges in their lives. It is necessary to review and implement effective interventions in future studies to prevent anxiety and its consequences in cancer patients.