1
|
Heuschkel G, Fischer von Weikersthal L, Junghans C, Zomorodbakhsch B, Stoll C, Prott FJ, Fuxius S, Micke O, Richter A, Sallmann D, Büntzel J, Hoppe C, Huebner J. Spirituality in Oncology: Relations between Spirituality, Its Facets, and Psychological and Demographic Factors in Cancer Patients in Germany. Oncol Res Treat 2024; 47:123-134. [PMID: 38325341 DOI: 10.1159/000535919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 12/06/2023] [Indexed: 02/09/2024]
Abstract
INTRODUCTION Cancer diagnoses are constantly increasing in clinical practice. Therefore, more and more patients are interested in how they can actively participate in the process of treatment. Spirituality represents a hidden issue of the population, which counts as a branch of complementary and alternative treatment. Therefore, the aim of our study was to investigate whether there are associations between spirituality and demographic and psychosocial factors, as well as religious beliefs, in cancer patients. METHODS We conducted a survey with 451 participants in 10 oncology centers between March and July 2021. A composition of the following 9 different questionnaires was used to collect data on spirituality, demographics, resilience, self-efficiency, life satisfaction, and sense of coherence: Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp12), General Life Satisfaction Short Scale (L-1), Resilienzskala Kurzform (RS-13), Sense of Coherence Scale - Leipziger Kurzform (SOC-L9), Allgemeine Selbstwirksamkeit Kurzskala (AKSU), Adolescent Food Habits Checklist, Likert-Scale of daily activities, questionnaire of the Working group Prävention und Integrative Onkologie (PRiO), and personal opinion on the cause of the disease. Calculated data and analyzed group differences using ANOVA Bonferroni were used to test associations between spirituality and the variables studied. For more detailed examination of spirituality, we took a closer look at the different components of spirituality - peace, meaning, and faith - and their relation to each other (three-factor spirituality analyses). RESULTS Higher spirituality scores in total as well as meaning, peace, and faith were each associated with higher levels of resilience and life satisfaction. Higher religious belief was found to be associated with higher spiritual attitudes. High personal self-efficiency was found in people with higher spiritual beliefs in general as well as higher meaning and peace. Meaning and peace emerge as essential components of spiritual well-being and show a stronger association with expressions of general spirituality than faith. CONCLUSION Spirituality takes a crucial role among the resources of life-threatening diseases. As such, further research is needed to expand and integrate patient options into a modernized concept of care. Our data indicate that higher spiritual well-being is associated with a more tolerant approach to illness. Thus, addressing spiritual needs in therapy is associated with better psychological adjustment to the individual situation and reduces negative distress. To promote spiritual needs in the future, cognitive as well as affective components of spirituality should be emphasized.
Collapse
Affiliation(s)
- Gina Heuschkel
- Klinik für Innere Medizin II, Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | | | | | | | | | | | - Stefan Fuxius
- Onkologische Schwerpunktpraxis Heidelberg, Heidelberg, Germany
| | | | - Achim Richter
- Inselsberg Klinik Wicker GmbH and Co. OHG, Bad Tabarz, Germany
| | | | - Jens Büntzel
- Klinik für HNO-Erkrankungen, Kopf-Hals-Chirurgie, Interdisziplinäre Palliativstation, Südharz Klinikum Nordhausen, Nordhausen, Germany
| | - Catalina Hoppe
- Klinik für Innere Medizin II, Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - Jutta Huebner
- Klinik für Innere Medizin II, Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| |
Collapse
|
2
|
Tark A, Estrada LV, Stone PW, Baernholdt M, Buck HG. Systematic review of conceptual and theoretical frameworks used in palliative care and end-of-life care research studies. Palliat Med 2023; 37:10-25. [PMID: 36081200 PMCID: PMC10790406 DOI: 10.1177/02692163221122268] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Frameworks are the conceptual underpinnings of the study. Both conceptual and theoretical frameworks are often used in palliative and end-of-life care studies to help with study design, guide, and conduct investigations. While an increasing number of investigators have included frameworks in their study, to date, there has not been a comprehensive review of frameworks that were utilized in palliative and end-of-life care research studies. AIM To summarize conceptual and theoretical frameworks used in palliative and end-of-life care research studies. And to synthesize which of eight domains from the National Consensus Project's Clinical Practice Guidelines for Quality Palliative Care (fourth edition) each framework belongs to. DESIGN Systematic review. DATA SOURCES Four electronic databases (EMBASE, the Cumulative Index to Nursing and Allied Health, PsychINFO, and PubMed) were searched from July 2010 to September 2021. RESULTS A total 2231 citations were retrieved, of which 44 articles met eligibility. Across primary studies, 33,801 study participants were captured. Twenty-six investigators (59.1%) proposed previously unpublished frameworks. In 10 studies, investigators modified existing frameworks, mainly to overcome inherent limitations. In eight studies, investigators utilized existing frameworks referenced in previously published studies. There were eight orientations identified among 44 frameworks we reviewed (e.g. system, patient, patient-doctor). CONCLUSIONS We examined palliative and end-of-life research studies to identify and characterize conceptual or theoretical frameworks proposed or utilized. Of 44 frameworks we reviewed, 21 studies (47.7%) were aligned with a Clinical Practice Guideline's single domain, while the rest two or more of eight guidelines in quality palliative care domains.
Collapse
|
3
|
Huang LT, Tai CY, Longcoy J, McMillan SC. The Mutual Effects of Perceived Spiritual Needs on Quality of Life in Patients With Advanced Cancer and Family Caregivers. J Hosp Palliat Nurs 2021; 23:323-330. [PMID: 34185726 PMCID: PMC8243389 DOI: 10.1097/njh.0000000000000758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Perceived spiritual needs may increase when patients with advanced cancer and their family caregivers are confronted with the challenges of physical and psychological distress. Given the intertwined relationships between patients and family caregivers, their interdependence should be considered to understand how perceived spiritual needs affect the quality of life of their own and of their partner. This study used the Actor-Partner Interdependence Model as the conceptual model to investigate the mutual effects of perceived spiritual needs on the quality of life in patients with advanced cancer and their family caregivers after being admitted to hospice. This cross-sectional study used the baseline data of a large clinical trial and identified that patients with cancer and their family caregivers perceived similar spiritual needs associated with the community and outlook needs and had fewer unmet spiritual needs. After controlling for partner effects, perceived outlook needs shown in patients significantly predicted their own functional well-being and social/spiritual well-being. Outlook and community needs perceived by family caregivers also significantly predicted their own mental health. Although partner effects were not shown as expected, the findings provide insight into the mutuality of spirituality and demonstrate the necessity of providing timely and ongoing spiritual assessment and care.
Collapse
Affiliation(s)
- Li-Ting Huang
- College of Nursing, University of Illinois at Chicago
| | - Chun-Yi Tai
- School of Nursing, National Taipei University of Nursing and Health Sciences
| | - Joshua Longcoy
- Center for Community Health Equity, Rush University Medical Center
| | | |
Collapse
|
4
|
Drageset J, Haugan G, Tranvåg O. Crucial aspects promoting meaning and purpose in life: perceptions of nursing home residents. BMC Geriatr 2017; 17:254. [PMID: 29084511 PMCID: PMC5661934 DOI: 10.1186/s12877-017-0650-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 10/19/2017] [Indexed: 11/11/2022] Open
Abstract
Background Meaning and purpose in life are fundamental to human beings. In changing times, with an aging population and increased life expectancy, the need for health care services and long-term care is likely to grow. More deeply understanding how older long-term care residents perceive meaning and purpose in life is critical for improving the quality of care and the residents’ quality of life. The purpose of this study was to explore crucial aspects promoting nursing home residents’ experience of meaning and purpose in everyday life. Method An exploratory hermeneutical design with qualitative interviews for collecting data. Results Four key experiences were found to promote meaning and purpose in life: 1) physical and mental well-being, 2) belonging and recognition, 3) personally treasured activities and 4) spiritual closeness and connectedness. Conclusion In supporting meaning and purpose in life of nursing home residents, the residents’ everyday well-being should be a central focus of care and facilitate personally treasured activities. Focused attention should also be given to the meaning-making power of experiencing belonging, recognition and spiritual connectedness.
Collapse
Affiliation(s)
- Jorunn Drageset
- Department of Nursing, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Inndalsveien 28, N-5005, Bergen, Norway. .,Centre for Elderly and Nursing Home Medicine, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
| | - Gørill Haugan
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway.,Center for Health Promotion Research, Norwegian University of Science and Technology, Trondheim, Norway
| | - Oscar Tranvåg
- Department of Nursing, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Inndalsveien 28, N-5005, Bergen, Norway.,Centre for Elderly and Nursing Home Medicine, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Norwegian National Advisory Unit on Women's Health, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| |
Collapse
|
5
|
Vespa A, Giulietti MV, Spatuzzi R, Fabbietti P, Meloni C, Gattafoni P, Ottaviani M. Validation of Brief Multidimensional Spirituality/Religiousness Inventory (BMMRS) in Italian Adult Participants and in Participants with Medical Diseases. JOURNAL OF RELIGION AND HEALTH 2017; 56:907-915. [PMID: 27516173 DOI: 10.1007/s10943-016-0285-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
UNLABELLED This study aimed at assessing the reliability and construct validity of Brief Multidimensional Measure of Religiousness/Spirituality (BMMRS) on Italian sample. SAMPLE 353 Italian participants: 58.9% affected by different diseases and 41.1% healthy subjects. The results of descriptive statistics of internal consistency reliabilities (Chronbach's coefficient) of the BMMRS revealed a remarkable consistency and reliability of different scales DSE, SpC, SC, CSC, VB, SPY-WELL and a good Inter-Class Correlations ≥70 maintaining a good stability of the measures over the time. BMMRS is a useful inventory for the evaluation of the principal spiritual dimensions.
Collapse
Affiliation(s)
- Anna Vespa
- Scientific and Technological Area, Department of Neurology, INRCA-IRCCS National Institute of Health and Science on Aging, Via della Montagnola n. 81, Ancona, Italy.
| | - Maria Velia Giulietti
- Department of Neurology, INRCA-IRCCS National Institute of Health and Science on Aging, Via Della Montagnola n. 108, Ancona, Italy
| | - Roberta Spatuzzi
- Palliative Care Unit, San Carlo Hospital, Via Potito Petrone, 85100, Potenza, Italy
| | - Paolo Fabbietti
- Biostatistical Center, INRCA-IRCCS National Institute of Health and Science on Aging, Via della Montagnola n. 81, Ancona, Italy
| | - Cristina Meloni
- National Institute of Health and Science on Aging, Via della Montagnola n. 81, Ancona, Italy
| | - Pisana Gattafoni
- Clinic of Internal Medicine and Geriatric, INRCA-IRCCS National Institute of Health and Science on Aging, via Della Montagnola n. 108, Ancona, Italy
| | - Marica Ottaviani
- INRCA-Department of Neurology, INRCA-IRCCS National Institute of Health and Science on Aging, Via Della Montagnola n. 108, Ancona, Italy
| |
Collapse
|
6
|
Bulduk S, Usta E, Dinçer Y. The Influence of Skill Development Training Program for Spiritual Care of Elderly Individual on Elderly Care Technician Students' Perception of Spiritual Support. JOURNAL OF RELIGION AND HEALTH 2017; 56:852-860. [PMID: 27129702 DOI: 10.1007/s10943-016-0248-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Spiritual care means helping an individual protect, maintain and gain all the dimensions of his/her existence. Elderly care technicians face numerous cases or crisis situations in which elderly individuals from different backgrounds question the meaning and value of life. Elderly care technicians must acknowledge that the spirituality is an important element in the way an elderly individual receives healthcare and they must be equipped for this matter. This study was conducted in order to examine the influence of "Skill Development Training Program for Spiritual Care of Elderly Individual," which was carried out with students from elderly care program, on the perception of spirituality support in a pretest-posttest quasi-experimental study design with control group. As the data collection form, "Spiritual Support Perception" (SSP) scale was used. The mean scores of the intervention group after the training and after one month are 50.39 ± 5.34 and 51.13 ± 4.98, respectively, and those of the control group are 43.16 ± 4.83 and 42.72 ± 4.48. A statistically significant difference was found between the mean scores of the intervention group from the pretest and the posttests immediately after the training and one month after the training (f = 94.247, p = 0.001). In the control group, however, there was no significant change in the SSP mean scores (f = 0.269, p = 0.77). As a result, this study pointed out the necessity of such training programs for healthcare professionals to make a distinction between their professional duties and their own personalities in order to offer spiritual care to the elderly individual.
Collapse
Affiliation(s)
- Serap Bulduk
- Düzce University, Sağlık Hizmetleri Meslek Yüksekokulu Konuralp Yerleşkesi, 81620, Düzce, Türkiye.
| | - Esra Usta
- Düzce University, Sağlık Hizmetleri Meslek Yüksekokulu Konuralp Yerleşkesi, 81620, Düzce, Türkiye
- Sakarya University, Sağlık Bilimleri Enstitüsü, Hemşirelik Doktora Programı, Esentepe Kampüsü, 54187, Sakarya, Türkiye
| | - Yeliz Dinçer
- Düzce University, Sağlık Hizmetleri Meslek Yüksekokulu Konuralp Yerleşkesi, 81620, Düzce, Türkiye
- İstanbul Üniversity, Sağlık Bilimleri Enstitüsü, Kadın Sağlığı ve Hastalıkları Hemşireliği Doktora Programı, Cerrahpaşa Tıp Fakültesi Kampüsü, İstanbul, Türkiye
| |
Collapse
|
7
|
Abstract
Spirituality is salient to persons nearing the end of life (EOL). Unfortunately, researchers have not been able to agree on a universal definition of spirituality reducing the effectiveness of spiritual research. To advance spiritual knowledge and build an evidence base, researchers must develop creative ways to describe spirituality as it cannot be explicitly defined. A literature review was conducted to determine the common attributes that comprise the essence of spirituality, thereby creating a common ground on which to base spiritual research. Forty original research articles (2002 to 2012) focusing on EOL and including spiritual definitions/descriptions were reviewed. Analysis identified five attributes that most commonly described the essence of spirituality, including meaning, beliefs, connecting, self-transcendence, and value.
Collapse
|
8
|
|
9
|
Reinert KG, Koenig HG. Re-examining definitions of spirituality in nursing research. J Adv Nurs 2013; 69:2622-34. [PMID: 23600849 PMCID: PMC4232181 DOI: 10.1111/jan.12152] [Citation(s) in RCA: 92] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2013] [Indexed: 11/30/2022]
Abstract
AIM To discuss the definition of spirituality and its limitations for nursing research. It proposes a definition that will capture more accurately the role of spirituality in health outcomes. BACKGROUND Studies have increasingly examined spirituality in nursing research as a coping mechanism attenuating the negative impact of traumatic stress on mental health. Existing definitions of spirituality in nursing research include elements of positive emotional states (meaning, purpose, general well-being) which confound mental health outcomes. DATA SOURCES Medline and CINAHL databases were searched from 2007-2011 for research articles examining spirituality definitions and measures used by nurse researchers. DISCUSSION An analysis of the definitions of spirituality in nursing research reveals inconsistencies and confounding mental health concepts. The authors propose defining spirituality in the context of religious involvement when conducting research, while using a broader definition of spirituality when providing spiritual care. They argue such definition provides a more appropriate method of measuring this concept in research aimed at evaluating mental health outcomes while preserving the currently used patient-defined definition of spirituality when providing spiritual care. NURSING IMPLICATIONS A consistent definition of spirituality in nursing research evaluating mental health outcomes, distinct from 'spiritual care' in a clinical setting, is essential to avoid tautological results that are meaningless. Appropriate definitions will enable nursing researchers to more clearly identify resilience mechanisms and improved health outcomes in those exposed to traumatic stress. CONCLUSION A definition of spirituality that focuses on religious involvement provides a more uniform and consistent measure for evaluating mental health outcomes in nursing research.
Collapse
|
10
|
Haugan G. Meaning-in-life in nursing-home patients: a valuable approach for enhancing psychological and physical well-being? J Clin Nurs 2013; 23:1830-44. [DOI: 10.1111/jocn.12402] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Gørill Haugan
- Faculty of Nursing; Sør-Trøndelag University College; Research Centre for Health Promotion and Resources; HIST & NTNU; Trondheim Norway
| |
Collapse
|
11
|
Haugan G. The relationship between nurse-patient interaction and meaning-in-life in cognitively intact nursing home patients. J Adv Nurs 2013; 70:107-20. [DOI: 10.1111/jan.12173] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Gørill Haugan
- Faculty of Nursing; Research Centre for Health Promotion and Resources, HIST & NTNU; Sør-Trøndelag University College; Trondheim Norway
| |
Collapse
|
12
|
Haugan G, Rannestad T, Hammervold R, Garåsen H, Espnes GA. The relationships between self-transcendence and spiritual well-being in cognitively intact nursing home patients. Int J Older People Nurs 2013; 9:65-78. [DOI: 10.1111/opn.12018] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2011] [Accepted: 10/07/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Gørill Haugan
- Faculty of Nursing; Sør-Trøndelag University College; Trondheim Norway
- Research Centre for Health Promotion and Resources; HIST/NTNU; Trondheim Norway
| | - Toril Rannestad
- Sør-Trøndelag University College; Trondheim Norway
- Research Centre for Health Promotion and Resources; HIST/NTNU; Trondheim Norway
| | - Randi Hammervold
- Trondheim Business School; Sør-Trøndelag University College; Trondheim Norway
| | - Helge Garåsen
- Faculty of Medicine and Health and Welfare Services; Norwegian University of Science and Technology; Trondheim, Norway
| | - Geir A. Espnes
- Department of Social Work and Health Science; NTNU Dragvoll; Trondheim Norway
- Sør-Trøndelag University College; Trondheim Norway
- Research Centre for Health Promotion and Resources; HIST/NTNU; Trondheim Norway
| |
Collapse
|
13
|
Buck HG, McMillan SC. A psychometric analysis of the spiritual needs inventory in informal caregivers of patients with cancer in hospice home care. Oncol Nurs Forum 2012; 39:E332-9. [PMID: 22750903 DOI: 10.1188/12.onf.e332-e339] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To test the validity and reliability of the Spiritual Needs Inventory (SNI) in measuring the spiritual needs of informal caregivers of patients with cancer in hospice home care. DESIGN A subanalysis of a longitudinal, randomized hospice clinical trial. SETTING Two hospices in the southwestern United States. SAMPLE 410 informal caregivers of patients with cancer in hospice home care. METHODS To test the hypotheses, Pearson and Spearman correlations, principal factor analysis with oblique rotation, and coefficient alpha were conducted. MAIN RESEARCH VARIABLES Spiritual needs, depression, social support. FINDINGS The SNI showed a small but significant positive correlation with the social support (p = 0.003). A three-factor solution of the SNI accounted for about 55% of the variability. The first factor captured a traditional religious measure, with the original patient-reported subscales of inspiration, spiritual activities, and religion collapsing into this one factor. The second and third factors were similar to the original patient study. Cronbach alpha for the total scale was 0.88. The factor alphas ranged from 0.68-0.89. CONCLUSIONS The current study provides early evidence for the validity and reliability of the SNI in informal caregivers of patients with cancer in hospice home care. Additional testing in other populations is recommended. IMPLICATIONS FOR NURSING Use of the SNI with hospice caregivers could aid nurses in the identification of spiritual needs, enabling the development of plans of individualized, high-quality care.
Collapse
Affiliation(s)
- Harleah G Buck
- School of Nursing, Pennsylvania State University, University Park, USA
| | | |
Collapse
|
14
|
Haugan G, Hanssen B, Moksnes UK. Self-transcendence, nurse-patient interaction and the outcome of multidimensional well-being in cognitively intact nursing home patients. Scand J Caring Sci 2012; 27:882-93. [DOI: 10.1111/scs.12000] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Accepted: 09/16/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Gørill Haugan
- Faculty of Nursing; Sør-Trøndelag University College HIST; Trondheim Norway
- Research Centre for Health Promotion and Resources HIST/NTNU; Trondheim Norway
| | - Brith Hanssen
- Faculty of Nursing; Sør-Trøndelag University College HIST; Trondheim Norway
| | - Unni K. Moksnes
- Faculty of Nursing; Sør-Trøndelag University College HIST; Trondheim Norway
- Research Centre for Health Promotion and Resources HIST/NTNU; Trondheim Norway
| |
Collapse
|
15
|
Relationship between self-care and health-related quality of life in older adults with moderate to advanced heart failure. J Cardiovasc Nurs 2012; 27:8-15. [PMID: 21558868 DOI: 10.1097/jcn.0b013e3182106299] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Heart failure (HF) patients who follow the treatment regimen and attend to symptoms before they escalate are assumed to have better health-related quality of life (HRQOL) than those with poor self-care, but there are few data available to support or refute this assumption. OBJECTIVE The objective of the study was to describe the relationship between HF self-care and HRQOL in older (≥65 years old) adults with moderate to advanced HF. METHODS Self-care was measured using the 3 scales (maintenance, management, and confidence) of the Self-care of Heart Failure Index. Scores range from 0 to 100, with higher numbers indicating better self-care. Health-related quality of life was measured with the Minnesota Living With Heart Failure Questionnaire, a 2-subscale (physical and emotional) instrument. Lower numbers on the Minnesota Living With Heart Failure Questionnaire indicate better HRQOL. Pearson correlations, independent-samples t-tests, and linear and logistic regression modeling were used in the analysis. RESULTS In 207 adults (72.9 [SD, 6.3] years), New York Heart Association class III (82%) or IV, significant linear associations were observed between self-care confidence and total (r = -0.211; P = .002), physical (r = -0.189; P = .006), and emotional HRQOL (r = -0.201; P = .004). Patients reporting better (below median) HRQOL had higher confidence scores compared with patients reporting above-median HRQOL scores (58.8 [19.2] vs 52.8 [19.6]; P = .028). Confidence was an independent determinant of total (βs = -3.191; P = .002), physical (βs = -2.346; P = .002), and emotional (βs = -3.182; P = .002) HRQOL controlling for other Self-care of Heart Failure Index scores, age, gender, and New York Heart Association class. Each 1-point increase in confidence was associated with a decrease in the likelihood that patients had worse (above median) HRQOL scores (odds ratio, 0.980 [95% confidence interval, 0.963-0.998]) with the same controls. No significant associations were found between self-care maintenance or management and HRQOL. CONCLUSIONS The degree of individual confidence in HF self-care is related to HRQOL, but self-reports of specific maintenance and management behaviors are not. Interventions that improve self-care confidence may be particularly important in older adults with moderate to advanced HF.
Collapse
|
16
|
Abstract
PURPOSE: While quality of life is the focus of care in hospices, limited research has been conducted on the quality of life of cancer patients in hospice home care. The purpose of this study was to explore the predictors of quality of life of older adults who are receiving hospice care in their homes. METHODS: A secondary analysis of data from a larger study was conducted using linear regression and including the following predictor variables: age, functional status, number of symptoms endorsed, overall symptom distress, pain intensity, and depressive symptoms. The outcome variable was quality of life. RESULTS: The sample consisted of 533 adults with an average age of 78.1 years (SD=7.4). A regression model that included symptom distress, number of symptoms, depression, and functional status accounted for 46% of the variance in quality of life. Pain, age, and caregiver depression did not contribute to predicting quality of life and therefore were not included in the final model. CONCLUSIONS AND IMPLICATIONS: Because both physical symptoms and depression are predictors of quality of life, a continued focus is needed on these factors by those providing care to older adults with cancer near the end of life.
Collapse
|
17
|
Current World Literature. Curr Opin Support Palliat Care 2010; 4:207-27. [DOI: 10.1097/spc.0b013e32833e8160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|