Validation of the Spiritual Distress Scale in Portuguese Cancer Patients Undergoing Chemotherapy: A Methodological Study

Spiritual distress and religious involvement among cancer patients receiving chemotherapy: A longitudinal study

PURPOSE

To determine the trajectories of spiritual distress and religious involvement among cancer patients during chemotherapy.

METHODS

A prospective longitudinal study was conducted over 15 months with quarterly data collection, in a total of with five cut points. Data collection was applied a questionnaire that embraced sociodemographic characteristics, clinical profile, Spiritual Distress Scale, and Belief into Action Scale. Regarding, data analysis was performed univariate, bivariate, and multivariate statistics, and the study was approved by the Ethics Committee.

FINDINGS

From the 322 cancer patients at the beginning, the attrition rate was 17.5% in the last time point. Most of participants were women (56.6%), with an average age of 60.3 years, and had a religious affiliation (93.7%). Statistically significant values were found of spiritual distress and religious involvement across the five cuts. At the end of 3 months after starting chemotherapy, the highest value of spiritual distress and the lowest value of religious involvement were reached.

CONCLUSIONS

Cancer patients who are submitted to chemotherapy, after 3 months of treatment experience the peak of spiritual distress and the lowest value of religious involvement. This critical period for nurses' is required a massive approach regarding spiritual and religious needs.

IMPLICATIONS FOR NURSING PRACTICE

Therefore, knowing the trajectories of spiritual distress and religious involvement during a certain period allows for the anticipating of planning of nursing therapeutic interventions in order to promote spiritual health and spiritual well-being outcomes in cancer patients.

Prevalence, defining characteristics, and predictors of the nursing diagnosis of spiritual distress in cancer patients undergoing chemotherapy: A longitudinal study

INTRODUCTION

Cancer patients are exposed to several types of treatments, including chemotherapy. In this context, patients experience several nursing diagnoses, including spiritual distress. The definition of the diagnosis of spiritual distress is grounded in lack of meaning and purpose in life, a sense of suffering, and a feeling of disconnected.

PURPOSE

The aim of this study was to determine the prevalence, sensitivity, specificity, and predictors of the nursing diagnosis of spiritual distress of cancer patients undergoing chemotherapy.

DESIGNS

The study used a longitudinal questionnaire design with quarterly data collection points over a 12-month period. Participants were recruited through random sampling, in an outpatients' setting in one oncology day unit in Portugal.

FINDINGS

The highest prevalence of spiritual distress was found at 3 months after patients started chemotherapy. The highest value of specificity was lack of meaning in life and express suffering, and the highest values of sensitivity concerned spiritual distress diagnosis. The predictors of spiritual distress were express suffering, alienation, questioning meaning in life, lack of serenity, questioning the meaning of suffering, hopelessness, and lack of meaning in life.

CONCLUSIONS

Spiritual distress is a human response that is current in patients undergoing chemotherapy, and the highest prevalence seems to occur at 3 months after commencing chemotherapy. Express suffering and lack of meaning in life play the role not only of defining characteristics (DC) in this study, but also of predictors in the diagnosis of spiritual distress.

CLINICAL RELEVANCE

The identification of the prevalence, predictors, sensitivity, and specificity of the DC of the nursing diagnosis of spiritual distress in cancer patients undergoing chemotherapy may facilitate nurses' clinical reasoning and improve the planning of nursing care in clinical practice in order to improve spiritual well-being in cancer patients.

Spiritual Distress in Patients With Cancer Initiating Chemotherapy: A Cross-Sectional Study

PURPOSE

To assess spiritual distress in patients with cancer who were initiating chemotherapy.

METHODS

This was a quantitative, observational, cross-sectional study. Data collection was conducted between February and June of 2019. The Spiritual Distress Scale (SDS) was administered to 332 patients with cancer.

FINDINGS

Most participants (56.6%) were female, with the mean age at 60.3 years (SD = ±11.73). The mean SDS score was 56.6 (SD = ±13.39), with 30% of the participants reporting moderate and 9.6% reporting high levels of spiritual distress. Younger age (β = -0.687, p = .008) and participants having no religious affiliation were predictors of SDS (β = -8.322, p = .035) in patients with cancer initiating chemotherapy.

CONCLUSIONS

Given the degree of spiritual distress reported, this study provides further evidence to support the need for nurses to assess spirituality in order to provide holistic care inclusive of spiritual domain.

CLINICAL RELEVANCE

These results are relevant to clinical practice and indicate a need for nurses to use the clinical reasoning process to assess spiritual distress and to plan nursing interventions aimed at meeting the spiritual needs of patients with cancer who are initiating chemotherapy.