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.

Spiritual well-being and associated factor among adult cancer patients in Hawassa University Comprehensive Specialized Hospital, Oncology Center, Hawassa, Ethiopia

Background

Spiritual well-being has been shown to boost resistance to mental health crises in cancer patients during the diagnosis and treatment process, but there is a paucity of studies about spirituality in cancer patients, which may make it difficult for healthcare clinicians to assess spirituality and provide spiritual care.

Objective

The aim of this study was to assess the level of spiritual well-being and associated factors among cancer patients in HUCSH Oncology Center in 2022.

Methods and materials

An institution-based cross-sectional study was done from May 30 to June 30, 2022 among 267 cancer patients, and the respondents were selected by a simple random sampling technique. Data was collected by using standardized interviewer-administered questionnaires (FACIT sp12). Data was entered using Epi data version 4.6, and analysis was carried out by using Statistical Package for Social Science version 25. Bivariate and multivariate logistic regression was conducted to determine the relationship between the independent and dependent variables. The strength of association was tested by using p-value at 95% CI. Ethical clearance was obtained from the Institutional Review Board of Hawassa University College of Medicine and Health Science. During data collection, the purpose of the study was clearly explained to the patients, and consent was obtained.

Result

A total of 267 cancer patients were included in the study. There was 100% response rate. Majority of the patients (80.5%) were in a poor spiritual well-being state. Mental distress (AOR = 0.246; 95% CI: 0.114-0.531) and religious education (AOR = 1.288; 95% CI: 1.438-9.142) were factors significantly associated with spiritual well-being among cancer patients.

Conclusion and recommendation

This study showed that more than two-thirds of patients had poor spiritual well-being. Mental distress and religious education were factors associated with spiritual well-being. Attention should be given by nurses of the center for spiritual well-being assessment in clinical practices favoring holistic care in the center.

The Relationship between Distress Tolerance and Spiritual Well-Being towards ARV Therapy Adherence in People Living with HIV/AIDS

A crucial factor in the success of treatment for patients with Human Immunodeficiency Virus (HIV) is adherence to antiretroviral (ARV) therapy among People Living with HIV/AIDS (PLWHA). Adherence issues remain a persisting problem with multifaceted causes. There are many studies on variables related to ARV therapy adherence, but no study has been found on spiritual well-being and distress tolerance in ARV therapy adherence. This study aims to determine the relationship between distress tolerance and spiritual well-being on adherence to ARV therapy in PLWHA. This research used a quantitative approach with a cross-sectional design. The sample collection process followed a consecutive sampling technique, with data gathered from 129 participants at the South Lampung Regional General Hospital located in Indonesia. Data collection was conducted using three questionnaires administered by the interviewer, which assessed distress tolerance using the Miller-Smith Rating Scale For Stress Tolerance (MSRS-ST), evaluated spiritual Well-Being using the Spiritual Well-Being Scale (SWBS), and gauged ARV therapy adherence using the Medication Adherence Rating Scale (MARS). Data analysis using a simple logistic regression with a 95% confidence interval (CI) showed a significant relationship between distress tolerance (p-value 0.002) and spiritual well-being (p-value 0.036) towards ARV therapy adherence in PLWHA. The results of multiple logistic regression yielded distress tolerance as the most dominant and influential variable in this research. Distress tolerance and spiritual well-being impact adherence to ARV therapy in PLWHA. Suggestions for healthcare services should consider these factors to decrease the risk of non-adherence to therapy and inadvertently heighten mortality risk.

When Movement Therapy Meets Spirituality: A Quasi-Experiment

Depression is a public health issue in older adults. This study followed a participatory train-the-trainer approach to develop the Movement-based x 'Elderspirituality-Fu Le Man Xin' intervention. Additionally, a quasi-experimental design was followed to evaluate the effectiveness of the intervention. Data were collected from pre-and post-intervention assessments. A total of 135 older adults with depressive symptoms were recruited, 77 received the intervention and 58 received an active control intervention. Repeated measures ANCOVA showed that the 'Movement-based x 'Elderspirituality-Fu Le Man Xin' intervention significantly reduced depression in cognitively sound participants (F(1, 73) = 62.346, p < .001).

The association of prognostic awareness with quality of life, spiritual well-being, psychological distress, and pain severity in patients with advanced cancer: Results from the APPROACH Study in Indonesia

BACKGROUND AND OBJECTIVES

Advanced cancer patients' understanding of their illness is key for making informed treatment decisions. Despite the known importance of patients' awareness of their disease prognosis, it is debatable whether this awareness is positively, negatively, or not associated with clinical and psychological outcomes among patients with advanced cancer. This paper aims to determine the prevalence of and factors associated with prognostic awareness and its association with quality of life (QoL), spiritual well-being, pain control, and psychological distress in patients with advanced cancer in Indonesia.

METHODS

This cross-sectional questionnaire-based survey was part of a multicountry study titled "Asian Patient Perspectives Regarding Oncology Awareness, Care and Health (APPROACH)." Patients were asked what they knew about their cancer and treatment. QoL and spiritual well-being were measured using the Functional Assessment of Cancer Therapy - General (FACT-G) and Functional Assessment of Chronic Illness Therapy - Spiritual Well-being (FACIT-Sp) questionnaire. Psychological distress experienced by patients was recorded via the Hospital Anxiety and Depression Scale. Pain severity was also assessed. Data from 160 patients were analyzed using descriptive statistics and multivariable regression models.

RESULTS

Of the 160 patients who participated, 55 (34.4%) were unaware of their cancer stage. Those who were aware of their stage of cancer were younger than those who were not aware (45.7 years vs 50.4 years, p = .015). There was no significant difference in spiritual well-being and other domains of QoL between those who were aware and those who were not aware of their advanced cancer stage. There was also no significant difference in anxiety depression or pain severity, even after adjustment for demographic and clinical characteristics.

SIGNIFICANT OF RESULTS

Given the high prevalence of patients who wrongly thought their cancer was curable, more could be done to improve disease and prognostic understanding among patients with advanced cancer in Indonesia. Those who were aware of their advanced cancer stage did not have a poorer QoL, nor did they have more anxiety or depression than those who were unaware. This finding suggests that concerns about the negative impact of prognostic disclosure may be unfounded.

Mental Health and Well-Being in Racial or Ethnic Minority Individuals After Using a Faith and Prayer Mobile App (Pray.com): Feasibility and Preliminary Efficacy Trial

BACKGROUND

Research is needed on how faith and prayer apps fit within the values of racial and ethnic minority (REM) groups, as well as whether such apps are effective in promoting mental health and well-being.

OBJECTIVE

This study aims to determine the feasibility and preliminary effectiveness of using the mobile app Pray.com on mental health and well-being among REM participants.

METHODS

This study was a single-group (N=77), 4-week feasibility trial in REM groups (65/77, 84% Black or African American). Participants were asked to use the Pray.com app at no cost for at least 5 times per week for 5 minutes per day. Participants completed questionnaires at the baseline and postintervention time points. Feasibility questionnaires were only completed at the postintervention time point, including qualitative interviews (n=15). The feasibility questions included acceptability (ie, satisfaction, intent to continue use, perceived appropriateness, and fit within culture), demand (ie, self-reported app use, expressed interest, and perceived demand), and practicality (ie, ease or difficulty of use, ability to use the app, and cost-effectiveness). Frequency and descriptive statistics were used to analyze feasibility outcomes. Changes in dependent variables were analyzed using paired-sample 2-tailed t tests. Partial correlations were conducted to explore the association between app use and outcomes, controlling for baseline scores.

RESULTS

Participants reported (54/72, 75% responded with "very likely" or "likely" to the feasibility questions) that they perceived the Pray.com app as acceptable. These findings were supported by qualitative interviews (n=15). Most participants (62/72, 86%) did not meet the app use prescription but expressed interest in using the app in the future and perceived demand for it in their communities. In addition, participants reported that the app was easy to use and perceived it to be inexpensive (US $7.99). Participants reported improved mental health (ie, stress and depressive and anxiety symptoms) and well-being (ie, satisfaction with life, spiritual well-being, religious commitment, and racial or ethnic identity development) at postintervention despite relatively low average levels and high variability of app use (average total of 45.83, SD 111.90 min over the course of the study). Greater app use was significantly associated with improvements in mental health and spiritual well-being. However, app use and study methodology limitations suggest that the study results may not accurately capture the full impact of Pray.com use.

CONCLUSIONS

This is the first study to assess the feasibility of a faith and prayer app for mental health and well-being in a sample of REM individuals. Our findings suggest that the use of a faith and prayer app (ie, Pray.com) could be feasible and significantly impactful for the improvement of mental health symptoms and well-being in REM individuals and their communities, especially Black and African American individuals with a Christian affiliation. Further research is warranted.

Enhancing End-of-Life Care Through Yoga

This editorial explores the integration of yoga into end-of-life care, emphasizing its potential to enhance the quality of life, comfort, and dignity of patients. Rooted in over 5,000 years of history, yoga's holistic approach, encompassing physical, mental, and spiritual practices, aligns seamlessly with the goals of end-of-life care. We discuss the benefits of incorporating yoga's diverse practices, such as physical postures, breathing exercises, and meditation, particularly in palliative care settings. These practices offer significant improvements in physical health, psychological well-being, and spiritual fulfillment, especially pertinent for older adults and patients with serious illnesses like HIV and cancer. The philosophical underpinnings of yoga, emphasizing acceptance, harmony, and peace, provide a framework for a dignified and peaceful transition, resonating deeply with the concept of a 'good death'. However, challenges exist in integrating yoga into end-of-life care, including limited research, cultural and religious considerations, physical and emotional limitations of patients, and logistical constraints within healthcare settings. Ethical considerations are also paramount, focusing on patient-centered approaches, respect for individual beliefs, informed consent, and patient autonomy. The editorial concludes by underscoring the need for further research to evaluate the long-term effects of yoga in end-of-life care and to establish comprehensive ethical guidelines. The integration of yoga offers a multifaceted approach to address not only physical discomfort but also provide emotional and spiritual solace for terminally ill patients, thereby enhancing the overall quality of end-of-life care.

[Symptom Distress, Social Support, Spiritual Well-Being, and Quality of Life Among Women With Gynecologic Cancer]

BACKGROUND

Women with gynecological cancers experience physical and mental distress due to their diagnosis, surgery, adjuvant chemotherapy, and radiotherapy, all of which have adverse physical, mental, social, and spiritual impacts on their quality of life.

PURPOSE

This study was designed to examine the correlations among symptom distress, social support, spiritual well-being, and quality of life as well as the predictors of quality of life in women with gynecological cancers.

METHODS

This was a cross-sectional correlational study. A total of 91 women with gynecologic cancer were recruited from a medical center in central Taiwan. A demographic characteristics questionnaire, the World Health Organization Quality of Life Brief Questionnaire Taiwanese version, the Chinese Modified Symptom Distress Scale, the Chinese Simplified Social Support Scale, and the Spiritual Well-Being Scale were used for data collection. Correlation and multiple regression analyses were performed on the data.

RESULTS

Symptom distress was found to correlate negatively with spiritual well-being as well as with the physical health, psychological health, and environmental health domains of quality of life. Social support and spiritual well-being were found to correlate positively with all four domains of quality of life. Social support was identified as the main predictor of quality of life.

CONCLUSIONS / IMPLICATIONS FOR PRACTICE

Symptom distress, social support, and spiritual well-being should be incorporated into nursing education to improve medical staff awareness of these issues and promote the timely evaluation of patient needs. Moreover, medical staff should provide appropriate social and spiritual support and multi-disciplinary care as well as make referrals when necessary to related support groups to improve clinical care quality to enhance patient quality of life.

The six-domain well-being framework in oral health sciences: A pathway from theory to practice

OBJECTIVES

Well-being is a complex and multifaceted construct that has gained popularity in oral health sciences education. Maintaining students' well-being is essential for their academic performance and quality of life. While many definitions and frameworks of well-being exist, their applicability to oral health sciences education remains unknown. This study aimed to evaluate the applicability of the Feeney and Collins's framework of well-being to oral health sciences education by exploring students' perceptions and experiences in the University of British Columbia METHODS: An Interpretive Description approach was used to conduct semi-structured interviews with dental and dental hygiene students. Interviews were transcribed, and transcripts were coded and analyzed with guidance from Feeney and Collins's well-being and thriving framework using content analysis. Domains were inductively developed within and beyond the organizing categories of the chosen framework.

RESULTS

Thirty-one oral health sciences students participated in the study. Study data can largely be explained by the five well-being domains suggested by Feeney and Collins: physical, psychological, eudaimonic, subjective, and social. Spirituality and gratitude emerged as an additional domain that contributes to students' well-being. Interdomain relationships were observed. The social domain seemed to contribute to all other well-being domains; while the subjective domain seemed to be shaped by all other domains CONCLUSIONS: Feeney and Collins's framework seemed to be useful to understand and conceptualize well-being in oral health sciences education but needed to be expanded to include spirituality and gratitude. Further evidence is needed to explore the applicability of this framework in other health professional education disciplines.

Measuring Spiritual Well-being using a numerical rating scale: Additional evidence of the validity of the Well-being Numerical Rating Scales (WB-NRSs)

The Well-being Numerical Rating Scales (WB-NRSs) can be used to assess rapidly and accurately different types of well-being. However, the spiritual well-being scale showed slightly weaker psychometric properties. This study aimed to further investigate its suitability in measuring spiritual well-being. Participants (N = 270, age: M = 32.98; SD = 15.64; 67% females) were administered a questionnaire including spiritual well-being, gratitude, compassionate love, and personality traits measures. A network analysis (based on correlations) was used to display graphically the pattern of relationships among the measured constructs (i.e. the nomological net). Results provided evidence that the scale measures spiritual well-being as defined in the literature, that is, a component distinct from faith and compassionate love, but connected to meaning in life, quality of relationships, personality traits, and gratitude. These findings confirm the WB-NRSs is a psychometrically sound and easy-to-use tool with clear benefits for both research and clinical assessment.

The Relationship Between Psychache and Suicide Risk With Spiritual Well-Being Levels of Patients Diagnosed With Depression

BACKGROUND: Depression has long been accepted as a serious disability and burden globally, while suicide is a misunderstood and complex cause of death. Psychache is the psychological variable most strongly associated with suicidality. Spirituality is considered an important buffer against stressful events and may help people overcome distress and difficulties. AIMS: This study aims to determine how psychache and suicide risk are related to levels of spiritual well-being in patients with depression. METHODS: Data were collected using the Suicide Probability Scale, the Psychache Scale, and the Spiritual Well-Being Scale. The sample study consisted of 150 Turkish patients diagnosed with depression and receiving psychiatric care. RESULTS: It was found that higher level of spiritual well-being led to decreased risk of suicide and lower level of psychache. Suicide risk increased in parallel to the increasing levels of psychache (p < .001). CONCLUSIONS: It was observed that higher levels of spiritual well-being may promote a significantly lower risk of suicide and lower levels of psychache. Likewise, increasing levels of psychache may lead to an increase in suicide risk.

The Cinderella of positive psychology: spiritual well-being as an emerging dimension of flourishing in pastoral work

PURPOSE

The invaluable, yet challenging role of pastors in the community signifies the need to understand and care for their well-being. Well-being, conceptualized in the multidimensional construct of flourishing, does not explicitly include spiritual well-being, yet, it is the foundation of pastors' well-being. In this article we aim to describe pastors' spiritual well-being and in so doing, highlight its fundamental importance in pastors' flourishing in the ministry.

METHODS

Positioned in the interpretive pragmatic paradigm, data were gathered and analysed from three focus groups with 18 pastors in the Dutch Reformed Church and the Uniting Reformed Church of South Africa. Interactive qualitative analysis was applied, and results were conceptually refined through narrative synthesis.

RESULTS

Four themes were constructed to describe pastors' spiritual well-being namely: i) an altruistic calling; ii) discipleship iii) seasons of the ministry; and iv) ethics.

CONCLUSION

The findings highlight the importance and essence of the spiritual aspects predominant to pastors' well-being. Attending to spiritual well-being will enhance their resilience and constructive coping and is integral to their way of flourishing at work. This proposes an extension of the flourishing framework to include spiritual well-being as an explicitly conceptualized sub-dimension for application to the study's Christian pastoral context.

Reappraising personal values in cancer: Meaning-in-life adaptation, meaningfulness, and quality of life

OBJECTIVE

This study explores the reappraisal of personal values among people with cancer post-diagnosis and its connections to meaningfulness, encompassing personal meaning and sense of meaning, and various dimensions of quality of life.

METHODS

A total of 144 patients with diverse cancer types and a control group comprising 158 healthy adults with similar demographic characteristics completed the Valued Living Questionnaire-Perceived Change, the Personal Meaning Profile-Brief, the Portrait Values Questionnaire, and the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being.

RESULTS

Cancer patients displayed a substantial values reappraisal compared to healthy adults. They reported an increased significance of social areas and self-transcendental values, including close relationships (family, partner, and friends), spirituality, citizenship, and universalism, as well as an increased importance of self-care and self in general. Conversely, cancer patients assigned less importance to work and self-enhancement values such as stimulation, power, and achievement. Cluster analysis revealed that patients who reappraised their values exhibited higher meaningfulness and better indicators of quality of life, including spiritual and physical well-being, compared to patients who did not modify their value system.

CONCLUSIONS

These findings underscore the importance of assessing and promoting meaning-in-life adaptability among people with cancer, with potential applications in meaning-centered therapies and interventions aimed at enhancing psychological flexibility.

Spiritual Well-Being Among Users and Non-Users of Psychedelics: A Cross-Sectional Study

This study evaluated the psychometric properties of the Spiritual Well-Being Scale (SWBS) in a Brazilian sample. We analyzed spiritual well-being, defined as existential well-being (EWB) and religious well-being (RWB), among individuals with varying religious and spiritual experiences, both users and non-users of psychedelics. The online cross-sectional survey was conducted in Brazil, from April to June 2022. The psychometric analyses demonstrated reliability and validity based on the internal structure and the relationship with satisfactory external variables concerning the RWB and EWB factors of the SWBS. Validity evidence was shown for both factors (RWB, EWB) with adequate reliability ratings. However, the RWB factor, which was entirely replicated, demonstrated the best group differentiation and internal consistency. Although both factors showed validity, the RWB factor exhibited superior psychometric indices for validity, group discrimination, and reliability. Regarding psychedelics, the association with RWB and EWB demonstrates a U-shaped pattern, as participants who never use these substances typically exhibit higher RWB and EWB indices, succeeded by frequent users. This finding underscores the need for additional studies to further explore the intricate interplay between psychedelics and spiritual well-being.

The Mediating Role of Psychological Resilience in the Relationship Between Spiritual Well-Being and Supportive Care Needs in Women With Breast Cancer

Objective

The aim of this study was to examine the mediating role of psychological resilience as part of the effect of spiritual well-being in the supportive care needs of women with breast cancer.

Materials and Methods

Cross-sectional design. The Connor-Davidson Resilience Scale Short Form, the Spiritual Well-Being Scale, and the Supportive Care Needs Survey Short Form were completed women with breast cancer treated at the oncology clinic of a university hospital. For the mediation model, Bootstrap methods with PROCESS Macro were used.

Results

The study was conducted with 126 breast cancer patients. A significant negative, moderate relationship was found between supportive care needs and psychological resilience (r = -0.560). There was a significant negative, but weak relationship between supportive care needs and spiritual well-being (r = -0.385). The indirect effect of spiritual well-being on supportive care needs was significant, thus, psychological resilience was shown to have a mediating effect on the relationship between spiritual well-being and supportive care needs [b = -0.370, 95% confidence interval (- 0.5568, -0.1911)].

Conclusion

Psychological resilience appears to contribute to a reduction in supportive care needs of breast cancer patients by affecting spiritual well-being.

A Prospective Cohort Study of Medical Decision-Making Roles and Their Associations with Patient Characteristics and Patient-Reported Outcomes among Patients with Heart Failure

OBJECTIVE

Among patients with heart failure (HF), we examined 1) the evolution of patient involvement in decision making over 2 y, 2) the association of patient characteristics with decision-making roles, and 3) the association of decision-making roles with distress, spiritual well-being, and quality of physician communication.

METHODS

We administered the survey every 4 mo over 24 mo to patients with New York Heart Association class 3/4 symptoms recruited from inpatient clinics. The decision-making roles were categorized as no patient involvement, physician/family-led, joint (with family and/or physicians), patient-led, or patient-alone decision making. The associations between patient characteristics and decision-making roles were assessed using a mixed-effects ordered logistic regression, whereas those between patient outcomes and decision-making roles were investigated using mixed-effects linear regressions.

RESULTS

Of the 557 patients invited, 251 participated in the study. The most common roles in decision making at baseline assessment were "no involvement" (27.53%) and "patient-alone decision making" (25.10%). The proportions of different decision-making roles did not change over 2 y (P = 0.37). Older age (odds ratio [OR] = 0.97; P = 0.003) and being married (OR = 0.63; P = 0.035) were associated with lower involvement in decision making. Chinese ethnicity (OR = 1.91; P = 0.003), higher education (OR = 1.87; P = 0.003), awareness of terminal condition (OR = 2.00; P < 0.001), and adequate self-care confidence (OR = 1.74; P < 0.001) were associated with greater involvement. Compared with no patient involvement, joint (β = -0.58; P = 0.026) and patient-led (β = -0.59; P = 0.014) decision making were associated with lower distress, while family/physician-led (β = 4.37; P = 0.001), joint (β = 3.86; P < 0.001), patient-led (β = 3.46; P < 0.001), and patient-alone (β = 3.99; P < 0.001) decision making were associated with better spiritual well-being.

CONCLUSION

A substantial proportion of patients was not involved in decision making. Patients should be encouraged to participate in decision making since it is associated with lower distress and better spiritual well-being.

HIGHLIGHTS

The level of involvement in medical decision making did not change over time among patients with heart failure. A substantial proportion of patients were not involved in decision making throughout the 24-mo study period.Patients' involvement in decision making varied by age, ethnicity, education level, marital status, awareness of the terminal condition, and confidence in self-care.Compared with no patient involvement in decision making, joint and patient-led decision making were associated with lower distress, and any level of patient involvement in decision making was associated with better spiritual well-being.

Examining the Burden of Self-Blame Attribution Among Women With Cervical Cancer

Background:Self-blame for past sexual behaviors or for the personal character may be associated with the development of cervical cancer. Purpose: Aims were to understand the burden of self-blame attribution (SBA) among women with cervical cancer by (1) examining relationships between SBA, psychological distress (PD), and spiritual well-being (SWB); (2) determining differences between behavioral (BSB) and characterological self-blame (CSB) attribution; and (3) describing associations between SBA and unwanted past sexual experiences. Methods: Women attending a cancer center in the southeastern United Stats (N = 106) completed an online survey including a demographic questionnaire and three instruments: (1) SBA for Cancer Scale; (2) Psychological Distress Subscale of the Psychological Adjustment to Cancer Scale-Self Report; and (3) Functional Assessment of Cancer Therapy-Spiritual Well-being. Results: Women with cervical cancer, 26-64 years of age, identified moderate levels of SBA, PD, and SWB. Relationships were found between PD, BSB and CSB, and unwanted sexual experiences. Significant inverse correlations between religious faith, BSB, unwanted sexual experiences, and SWB were noted. Unwanted sexual experiences were a significant predictor of SBA. Conclusion: SBA places women at risk for increased burden. Recognizing SBA in vulnerable cancer survivors is important to providing holistic nursing care.

Loneliness, spiritual well-being, and death perception, as well as their risk factors in urological cancer patients

Cancer patients commonly suffer from loneliness, poor spiritual status, and fear of death; however, these evaluations are rarely revealed in urological cancer patients. Thus, this study aimed to assess the loneliness, spiritual well-being, and death perception, as well as their risk factors in urological cancer patients. A total of 324 urological (including renal, bladder, and prostate) cancer patients and 100 healthy controls were included. The University of California and Los Angeles loneliness scale (UCLA-LS), functional assessment of chronic illness therapy-spiritual well-being (FACIT-Sp), and death attitude profile-revised (DAP-R) scores were evaluated. The results showed that the UCLA-LS score was higher, but the FACIT-Sp score was lower in urological cancer patients than in healthy controls. According to the DAP-R score, fear of death, death avoidance, and approaching death acceptance were elevated, but neutral acceptance was lower in urological cancer patients than in healthy controls. Among urological cancer patients, the UCLA-LS score was highest but the FACIT-Sp score was lowest in bladder cancer patients; regarding the DAP-R score, fear of death and death avoidance were highest, but approaching death acceptance was lowest in bladder cancer patients. Interestingly, single/divorced/widowed status, bladder cancer diagnosis, higher pathological grade, surgery, systemic treatment, and local treatment were independent factors for higher UCLA-LS score or lower FACIT-Sp score. In conclusion, urological cancer (especially bladder cancer) patients bear increased loneliness and reduced spiritual well-being; they also carry higher fear of death, death avoidance, and approaching death acceptance but lower neutral acceptance of death.

Spiritual Well-Being and Death Anxiety: A Cross-Sectional Study Among Iranian Patients With Acute Coronary Syndrome

Acute coronary syndrome (ACS) patients experience a tremendous psychological burden, typically in the form of death worry due to acute medical conditions and the possibility of mortality. The unfavourable conditions of ACS patients cause them to reconsider the meaning of life and their spiritual well-being. This study evaluated the association between death anxiety and spiritual well-being in a total of 241 ACS patients in Shahroud, northeast of Iran. The data were collected using the Templer Death Anxiety Scale, and the Spiritual Well-being Scale by convenience sampling method. All patients indicated a high degree of death anxiety, and roughly half reported a moderate level of spiritual well-being. There was a significant and direct correlation between death anxiety and spiritual well-being levels. Older age, single status, and non-smoking were other predictors of good spiritual well-being. A multidisciplinary health team should identify and implement approaches to promote spiritual well-being and reduce mental suffering.

Health-related quality of life in women with various levels of spiritual health

This study investigates for the first time the relationship between spiritual health (SH) and health-related quality of life (HRQoL) in different periods of life in healthy women, which could be important in the current critical post-pandemic situation. We recruited data from 2238 healthy women in the Tehran Lipid and Glucose Study (TLGS) framework, performed a cross-sectional study, and divided them into four age groups: 1) 20-34, 2) 35-44, 3) 45-54, and 4) 55≤ years. HRQoL and SH were measured using Short-Form 12-Item Health Survey version 2 and spiritual health inventory in Muslim adults (SHIMA-48). We defined low and high SH as the first and third tertile of SHIMA-48 scores. Most participants were in the first age group (39 percent), were married (74.7 percent), and were housewives (74.7 percent). The mean mental component summary score and its domains were directly associated with age. This subscale was significantly higher in individuals with high SH scores in all age groups. However, except for general health, other physical subscales did not differ significantly between the two levels of SH among the age groups studied. Results indicate higher HRQoL, especially mental health, in healthy women with increased spiritual well-being. This finding can be used in programs to improve psychological health in women.

Determinants of Spiritual Well-Being That Impact Breast Cancer Patients' Quality of Life

Background: Breast cancer affects patients' quality of life, which is influenced by the body's functional abilities and the patients' spiritual well-being. Currently, there is no research on the spiritual determinants that affect quality of life in the Indonesian context. Purpose: This research analyzes the determinants of spiritual well-being in terms of breast cancer patients' quality of life using the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp). Methods: A cross-sectional study was conducted with 112 participants who were selected using purposive sampling. Women with breast cancer who had a Palliative Performance Scale version 2 score of 60 and who were able to read and write were included. The instruments used included the RAND SF-36 Quality of Life Questionnaire, which was modified to the Indonesian context and was used to survey breast cancer patients (Cronbach coefficient of >0.90), in addition to the FACIT-Sp (Cronbach coefficient of 0.768). The multivariate data were analyzed using logistic regression. Results: The determinants of spiritual well-being for the participants' quality of life included meaning (odds ratio of 0.436) and peace (odds ratio of 0.303). Conclusion: The meaning and peace domains of spiritual well-being significantly affect breast cancer patients' quality of life.

The relationship between self-care, spiritual well-being and coping strategies in patients with type 2 diabetes mellitus

Background

Diabetes is one of the most common diseases in the world. The most important underlying cause of death in diabetic patients is the lack of self-care and management. However, there is little known about the influence of coping strategies and spiritual well-being (SWB) on self-care in diabetic patients.

Aims

This study aimed to investigate the relationship between self-care activities with coping strategies and spiritual well-being (SWB) in patients with type 2 diabetes mellitus (T2DM).

Methods

In this descriptive-analytical study, we selected 236 patients with T2DM referred to the diabetes hospital clinics in the southwest of Iran. Inclusion criteria were patients diagnosed with T2DM, with the age group ranging 20-80 years, literate, not suffering from severe and debilitating complications of diabetes and lacking acute psychological illness. Exclusion criteria included refusing to complete questionnaires and cognitive or emotional impairment. Instruments include the demographic questionnaire, Summary of Diabetes Self-Care Activities, Lazarus and Folkman's Coping Strategies Questionnaire and the Spiritual Well-Being Scale (SWBS; developed by Paloutzian and Ellison). To examine the relationship between variables, the Pearson correlation and multiple stepwise regression analysis were used.

Results

The findings of this study on 236 patients with T2DM (53.25 ± 10.91) including 76 (32.2%) males and 160 (67.8%) females showed the majority of participants were female, the age group was between 41 and 60 years (68.22%), had a Diploma (63.98%), were insured (63.55%) and had a moderate economic situation (55.93%). There was a direct and significant correlation between self-care activities and coping strategies (r = 0.163, p < 0.05), and only a problem-focused coping strategy was considered as a predictor variable of self-care (p < 0.01). There was a direct and significant correlation between self-care and SWB (r = 0.385, p < 0.01).

Conclusion

The results of this study showed that there is a significant relationship between self-care and the problem-focused dimension of coping strategies and SWB in patients with T2DM.

Factors associated with life satisfaction in systemic sclerosis: Examining the moderating roles of social support and spiritual well-being

Objectives

Systemic sclerosis often has a significant impact on an individual's quality of life. Life satisfaction is a subjective expression of well-being and a key component of quality of life. We examined the associations between functional limitations, social support, and spiritual well-being with life satisfaction and investigated the moderating roles of social support and spiritual well-being on the relationship between functional limitations and life satisfaction in people with systemic sclerosis.

Methods

Data were drawn from the baseline University of California Los Angeles Scleroderma Quality of Life Study. Participants completed questionnaires that included demographics, depressive symptoms, functional limitations, social support, and spiritual well-being. The Satisfaction with Life Scale was used to evaluate overall life satisfaction. Data were analyzed using a hierarchical linear regression.

Results

Of 206 participants (84% female, 74% White, 52% limited cutaneous subtype, 51% early disease), 38% reported being dissatisfied with their lives. Functional limitations (β = -0.19, p = 0.006), social support (β = 0.18, p = 0.006), and spiritual well-being (β = 0.40, p < 0.001) were associated with life satisfaction, with spiritual well-being emerging as the strongest statistical contributor. However, social support and spiritual well-being did not significantly moderate the relationship between functional limitations and life satisfaction (p = 0.882 and p = 0.339, respectively).

Conclusion

Spiritual well-being is particularly important in understanding life satisfaction in people with systemic sclerosis. Future longitudinal research is needed to assess and examine spiritual well-being and its impact on life satisfaction in a larger and more diverse systemic sclerosis sample.

Breaking New Ground in Palliative Care: Examining the Impact of Al Ain – Palliative Care Outreach Program on Patients With Advanced Cancer in the United Arab Emirates

Introduction

This study aimed to evaluate the effectiveness of the Palliative Outreach Program in improving the quality of palliative care for patients with advanced cancer in a Tertiary Hospital in the Al Ain region of the United Arab Emirates (UAE).

Methods & Material

One hundred patients who met the inclusion criteria were included in the study and administered the patient version of the Consumer Quality (CQ) Index Palliative Care Instrument to assess their perception of the quality of care they received. The demographics, diagnosis, and questionnaire responses were analyzed to determine the effectiveness of the Palliative Outreach Program.

Results

A total of one hundred patients met the criteria for the study. Most patients were above 50, female, female, Non-Emiratis, and had high school certificates. The top three cancer diagnoses were breast (22%), lung (15%), and head & neck (13%). The patients reported high levels of support from their caregivers regarding physical, psychological, and spiritual well-being, as well as information and expertise. The mean scores for most variables were favorable, except for information (mean = 2.9540, SD= 0.25082) and general appreciation (mean = 6.7150, sd = 0.82344). Overall, the patients rated the care they received positively, with high mean scores for physical/psychological well-being (mean = 3.4950, SD = 0.28668), autonomy (mean = 3.7667, SD= 0.28623), privacy (mean = 3.6490, SD = 0.23159), and spiritual well-being (mean =3.7500, SD = 0.54356). The patients would recommend their caregivers to others in similar situations.

Discussion

The findings demonstrate that the Palliative Outreach Program effectively improves the quality of palliative care for patients with advanced cancer in the UAE. The CQ Index Palliative Care Instrument proved a novel method for assessing palliative care quality from patients' perspectives. However, there is room for improvement in providing more favorable information and general appreciation outcomes. Caregivers should focus on all areas to enhance their physical/psychological well-being, autonomy, privacy, spiritual well-being, expertise, and general appreciation of their patients.

Conclusion

In conclusion, the Palliative Outreach Program is an effective intervention to improve the quality of palliative care for patients with advanced cancer in the UAE. The patients reported high levels of support from their caregivers in all aspects of care, except for information and general appreciation. These findings provide valuable insights into the effectiveness of palliative care interventions and highlight the need for continued efforts to improve the quality of care for patients with advanced cancer.

Investigating the relationship between spiritual well-being, resilience, and depression: a cross-sectional study of the elderly

BACKGROUND

Mental health of the elderly is one of the health problems in most societies. This study aimed to investigate the relationship between spiritual well-being (SWB), resilience, and depression among the elderly.

METHODS

This descriptive-correlational study was conducted on 384 elderly selected by convenience-sampling method. Abbreviated Mental Test (AMT), SWB, Connor-Davidson Resilience Scale (CD-RISC), and Geriatric Depression Scale (GDS) were used to collect the data. Pearson correlation coefficient, analysis of variance and independent t-test were used to analyze the data. A path analysis was also run to test the direct and indirect effects of SWB and resilience on the depression variable.

RESULTS

The results showed a statistically significant positive correlation between SWB and resilience (r = 0.458, P < 0.001), a statistically significant negative correlation between SWB and depression (r = -0.471, P < 0.001) and between resilience and depression (r = -0.371, P < 0.001). Path analysis showed that SWB and resilience directly affected depression while SWB indirectly affected depression.

CONCLUSIONS

The results indicated there was an inverse relationship between SWB and resilience with depression. Religious programs and appropriate educational programs can help improve SWB and promote resilience in the elderly, which will reduce their depression symptoms.

A mHealth-Supported Volunteer-Assisted Spiritual Well-Being Intervention for Discharged Older Patients: A Tripartite Collaboration

Spiritual well-being (SWB) is a key construct in a holistic health model. This study applied a theory-driven mobile health-supported volunteer-assisted self-help (mVS) intervention to enhance SWB for discharged older patients through a medical-social-academia tripartite collaboration. This study followed a quasi-experimental design, conducted from 2017 to 2019. Data were collected from pre- and post-intervention assessment and Clinical Management System under the Hospital Authority in Hong Kong. SWB was assessed by the Spirituality Scale for Chinese Elders with seven domains, a validated scale suitable for the non-religious context. A total of 161 discharged older patients were recruited, 101 received the mVS intervention and 60 received standardized usual volunteer visits. mVS intervention was assisted by volunteers supported by a corresponding mobile application Fu Le Man Xin. The final analysis included 137 older patients living in Hong Kong aged 61 to 94 years. Repeated measures ANOVA showed mVS intervention significantly enhanced two domains of SSCE: meaning of life (F(1, 64) = 4.029, p = .049) and relationship with others (F(1, 57) = 6.428, p = .014). This study shows that mVS intervention is a feasible medical-social-academia tripartite collaboration that improves two domains of the SWB of discharged older patients: meaning of life and relationship with others.

Religious Practices and Spiritual Well-Being of Schizophrenia: Muslim Perspective

Purpose

To explore religious activities and its functions on the spiritual wellbeing of Muslim patients with schizophrenia.

Patients and Methods

Semi-structured in-depth interviews were conducted in six schizophrenia inpatients and two female nurses. Document analysis of the standard operating procedure related to patients' spiritual needs fulfilment and patients' medical records were also undertaken in order to triangulate data and to get insights about patient spiritual and religious activity. Thematic analysis was used to analyse data.

Results

Five themes and 12 sub themes were revealed from the study data. The five themes elicited from the study namely frequency, timing, barriers to perform religious activities, impact on health status and negative effects if not performing the religious activities. Religious activities such as salat and dhikr for schizophrenia inpatients are still performed five times a day and when they are not getting period. Feeling upset, restless, happy, grateful, and when they are missing their family was the common reason why patients perform the religious activities. The main barriers to performing salat and dhikr for example: insufficient prayer tools and Al-Qur'an, as well as patients' physical conditions. Religious activities such as salat and dhikr positively impact patients' physical and mental health status, mindfulness, and concentration. Negative impacts physical and emotional are released when patients did not perform salat and dhikr.

Conclusion

The findings show that salat and dhikr which perform on time and regularly have a positive impact on the physical and mental health of schizophrenia inpatients. The author might recommend the mental health hospital provide adequate worship or prayer equipment (gown and Al-Qur`an) for patients.

Relationship between spiritual well-being and spiritual intelligence with mental health in students

OBJECTIVES

To investigate the relationship between spiritual well-being and spiritual intelligence with mental health in students.

METHODS

This descriptive-analytical study was conducted among 277 students (110 boys and 167 girls) through convenience sampling. The data collection instruments in this study included a spiritual well-being questionnaire, King's spiritual intelligence questionnaire, and Goldberg's general health questionnaire. After being entered into SPSS statistical software, the data were analyzed using descriptive and analytical.

RESULTS

The results of multivariate regression analysis using the step-by-step method showed that spiritual well-being predicts 14% of the variance of students' mental health. Also, on the scale of spiritual well-being, the two dimensions of communication with oneself and communication with others were predictors for the social functioning dimension of mental health. Also, among the subscales of spiritual well-being, the subscale of connection with God had an inverse and significant relationship with anxiety and physical health (p<0.05), and an inverse and significant relationship were observed between the subscale of connection with self with anxiety and depression (p<0.05).

CONCLUSIONS

The results of the present study confirm that spiritual well-being and spiritual intelligence affect mental health and its dimensions.

Spirituality in people with advanced chronic obstructive pulmonary disease - challenge for more effective interventions, support, and healthcare education: Mini-review

More recently there has been a growing interest in spirituality in medicine, especially in the field of palliative care, oncology, intensive care, and cardiology. However, according to literature, it seems to be a limited number of researches on how healthcare professionals should provide spiritual care (SC) for people with non-malignant lung diseases and what kind of education for them enables them to do it efficiently. This mini-review aims to provide an overview of current knowledge of an area of spirituality and SC for people with advanced chronic obstructive pulmonary disease, including spiritual well-being and religious/spiritual coping, their relations with the quality of life and symptom burden, exercise capacity and daily functioning, mental health, or medication adherence. It also analyses the use of interventions to meet patients' spiritual needs and patients' expectations regarding SC provided by professional careers. Based on the literature authors try to show the fields that should be improved and proposed future research directions.

The effectiveness of Meaning-Centered Group Psychotherapy on improving spiritual well-being and reducing anxiety in Iranian male cardiovascular patients

BACKGROUND AND PURPOSE

Cardiovascular diseases (CVDs) are the most important cause of death in Iran and the Kermanshah province. One of the most important problems that cardiovascular patients are dealing with is the psychological consequences of their illness. This study aimed at investigating the effectiveness of Meaning-Centered Group Psychotherapy (MCGP) intervention in improving spiritual well-being and reducing anxiety in cardiovascular patients.

MATERIALS AND METHODS

The study population included all patients referred to specialized cardiovascular centers in Kermanshah province in 2019. The participants consisted of 30 patients who were randomly assigned into experimental and control groups after the primary and secondary screening. The experimental group received routine treatment + MCGP (8 weeks and 90-120 min per session) and the control group only received routine treatment. The dependent variables were assessed by Spiritual Well-Being Scale and Beck Anxiety Inventory before and after receiving the treatment and 2 months after the treatment. ANCOVA and multivariate analysis of covariance were applied to the data through SPSS-22. IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp.

RESULTS

The results of covariance analysis showed that MCGP increased spiritual/existential well-being and decreased anxiety in the experimental group (P < 0.001), while no significant difference was traced in the control group.

CONCLUSION

The findings of this randomized controlled trial provide good evidence for the effectiveness of MCGP as a treatment to improve the psychological and spiritual/existential distress in patients with CVDs.

Spiritual Well-Being, Depression, Anxiety, and Stress in Indonesian Muslim Communities During COVID-19

Purpose

This study investigated how spirituality as a defensive factor of psychological well-being reduces anxiety among Indonesian Muslims during the pandemic COVID-19.

Patients and Methods

Data were collected from 538 Indonesian Muslims through a survey using the spiritual well-being and depression, anxiety and stress (DAS-21) and examined using structural equation model (SEM) analysis.

Results

The empirical results indicate that spirituality is a factor that increases happiness, psychological well-being and mental health among Indonesian Muslims.

Conclusion

The study also concluded that spirituality positively and significantly reduces anxiety, depression, and stress. This finding confirms that the spiritual beliefs of Indonesian Muslims can play a significant role in improving mental health during pandemic. This study can control mental illness based on spirituality theory and practice.

A Descriptive and Phenomenological Exploration of the Spiritual Needs of Chinese Children Hospitalized with Cancer

Spiritual well-being is the fourth dimension of health, as equally important as physical, mental, and social well-being. The shadow of death associated with cancer triggers children to explore their personal values, meanings, and life goals throughout the illness trajectory, enabling them to identify their unique spiritual needs. Chinese children are generally non-religious, unlike Western children, which affects their spiritual needs. To address the literature gaps, we applied a qualitative, descriptive, phenomenological approach for exploring the spiritual needs of Chinese children hospitalized with cancer. Purposive sampling was conducted in two public hospitals with special wards for pediatric oncology patients in Hunan Province, China. Consequently, 22 children, hospitalized with cancer, were recruited and individually interviewed using a semi-structured interview format. We conducted a thematic analysis of the interview transcripts. Four important themes were identified: the need for self-exploration, inner needs, need for a connection with others, and need for a connection with gods, supernatural powers, and fictional characters. We found that culture significantly influenced the spiritual needs of Chinese children with cancer. Hope was a key factor motivating the children to continue cancer treatment. To address their unique spiritual needs, culturally specific interventions should be developed and incorporated into their care to enhance their spiritual well-being.

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.

Examination of Pandemic Awareness, Death Anxiety, and Spiritual Well-Being in Elderly Individuals

This study aimed to examine the relationships between the variables of pandemic awareness, death anxiety, and spiritual well-being and reveal whether the participants' perceptions of pandemic awareness, death anxiety, and spiritual well-being differed according to various sociodemographic characteristics. The study population is comprised of individuals aged 65 years and over in Edirne, Turkey. The data obtained from 449 people in the study were analyzed using various statistical methods. According to the results of the regression analysis performed in the study, the increase in the participants' pandemic awareness was found to reduce their death anxiety and increase their spiritual well-being statistically. Moreover, the increase in the participants' death anxiety statistically reduced their spiritual well-being.

Global emotional and spiritual well-being and resilience of Advanced Practice Nurses during the COVID-19 pandemic: A cross-sectional study

Aim

To evaluate the impact of the COVID‐19 pandemic on the emotional and spiritual well‐being and resilience of a global sample of Advanced Practice Nurses.

Design

A web‐based cross‐sectional mixed methods study. Survey data were collected from Advanced Practice Nurses globally over a 2‐month period ending on 31 August 2020.

Methods

The Warwick‐Edinburgh Mental Well‐being Scale, FACIT‐12 Spiritual Well‐being Scale and Connor‐Davidson Resilience Scale 10 were used to quantify emotional and spiritual well‐being and resilience of Advanced Practice Nurses' globally. The survey was distributed internationally using snowball sampling via a secure platform (Qualtrics). Results were analysed using various bivariate tests for associations and group differences.

Results

Nine hundred and twenty‐eight Advanced Practice Nurses from 53 countries participated in the study. Study participants reported meaningfully lower scores in resilience and emotional well‐being compared with non‐pandemic scores. Participants from countries with well‐developed Advanced Practice Nurses roles reported lower resilience and well‐being scores compared with those from countries where Advanced Practice Nurses roles are still being developed. Each scale revealed significant positive associations with the other scales.

Conclusions

Emotional and spiritual well‐being and resilience of Advance Practice Nurses has been significantly impacted during the COVID‐19 pandemic. Regardless of their work location, work hours, credential or demographics, the APNs in our study reported lower levels of resilience and mental well‐being compared with typical scores on the instruments.

Spiritual Well-Being and Its Relationship with Patient Characteristics and Other Patient-Reported Outcomes in Peritoneal Dialysis Patients: Findings from the PDOPPS

BACKGROUND

Spiritual well-being (SWB), an individual's understanding of the meaning and purpose of life, may help patients with chronic or terminal illnesses cope with their disease. This study aimed to assess SWB in patients on peritoneal dialysis (PD), as well as its relationship with patient characteristics and patient-reported outcomes (PRO).

METHODS

The data were obtained from questionnaires that formed part of the PD Outcomes and Practice Patterns Study (PDOPPS). Measures used in this study were SWB scores derived from the WHO Quality of Life, Spirituality, Religiousness, and Personal Beliefs (WHOQOL-SRPB) tool including 32 items from 8 facets; physical (PCS) and mental component summary (MCS) scores of the 12-Item Short-Form Health Survey (SF-12), Center of Epidemiologic Studies Depression Scale-10 (CES-D-10) scores, burden of kidney disease scores, and functional status scores.

RESULTS

Overall, 529 out of 848 participants (62%) completely responded to the questionnaires and were included in the analysis. Over two-thirds of PD patients (70%) had moderate or higher SWB scores. The SWB scores were significantly lower in patients with age > 65 years and unemployed status. SWB scores positively correlated with higher PCS, MCS, burden of kidney disease scores, and functional status scores, while negatively correlated with depression scores by CES-D-10 scale. Patients who reported significant depressive symptoms (CES-D-10 score ≥ 10) had significantly lower SWB scores.

CONCLUSION

Better SWB was significantly associated with better health-related QOL (HRQOL) and the absence of depressive symptoms. SWB may be an essential consideration in the delivery of high-quality PD.

Psychometric Analysis of the Shortened Version of the Spiritual Well-Being Scale on the Slovak Population (SWBS-Sk)

This study was focused on verifying the factor structure of the shortened version of the Spiritual Well-Being Scale (SWBS) on a representative sample of adult Slovak citizens (N = 1018, 49% men, age 18-85 years, and mean age 46.2). The shortened version of the SWBS consists of 10 items divided into two subscales: religious well-being (RWB) and existential well-being (EWB). Results of confirmatory factor analysis (CFA) showed insufficient parameters of the full two-factor model due to three negatively formulated items. After their exclusion, the two-factor model was found to be valid in the Slovakian population (χ (13) = 53.1, p < 0.001, χ2/df = 4.1, CFI = 0.999, TLI = 0.999, RMSEA = 0.055, and SRMR = 0.028). The reliability of the final version of the SWBS-Sk, consisting of seven positively worded items, is high, with α = 0.86 and ω = 0.94. Religious respondents and women scored significantly higher on the whole scale (p = 0.001) as well as on the two subscales (p < 0.05). A higher age was associated with a higher RWB score (p = 0.001) and a lower EWB score (p = 0.002). The shortened version of the SWBS-Sk consisting of positively worded items was found to be valid and reliable for further use in the Slovak environment.

Factors associated with distress among female cancer survivors at the workplace: A cross-sectional study

OBJECTIVES

This study aimed to investigate the levels of fatigue, social support, spiritual well-being, and distress of female cancer survivors at the workplace, and identify factors associated with distress.

METHODS

One hundred and eighty-two working female cancer survivors participated from the outpatient ward in two medical institutions in South Korea and they completed questionnaires assessing their general characteristics, fatigue, social support (colleagues and superiors), and spiritual well-being distress (existential and religious well-being). The data were analyzed using descriptive statistics, T-test, one-way ANOVA, correlation, and multiple linear regression with SPSS /WIN18 version.

RESULTS

Most of the participants were breast and thyroid cancer (78.5%), married (46.2%), working periods below 10 years (62.7%) and the average age was 49.7 years. Distress positively correlated with fatigue and significant predictors of distress were "type of work" and "main source of household income" among general characteristics, fatigue, religious well-being, and existential well-being.

CONCLUSIONS

Our findings suggest that integrated program including educational and practical factors to reduce fatigue and increase spiritual well-being (i.e., peace, faith, meaning, et al.) can decrease distress. Whereas, the "ambivalence" of God accompanied by high religious well-being (i.e., punishment, abandon, blame, and so on) can rather increase distress. The development of an integrated management system of distress at work can be applied as a practical factor to improve job satisfaction, organizational performance, and quality of life.

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.

Predictors of Spiritual Well-Being in Family Caregivers for Individuals with Parkinson's Disease

Background: Parkinson's disease (PD) is a common neurodegenerative illness that causes disability through both motor and nonmotor symptoms. Family caregivers provide substantial care to persons living with PD, often at great personal cost. While spiritual well-being and spirituality have been suggested to promote resiliency in caregivers of persons living with cancer and dementia, this issue has not been explored in PD. Objective: The aim of this study was to identify predictors of spiritual well-being in PD patients' caregivers. Design: A cross-sectional analysis was performed. Our primary outcome measure, the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp), was measured in caregivers alongside measures of patient quality of life, symptom burden, global function, grief, and spiritual well-being and caregiver mood, burden, and perceptions of patient quality of life. Univariate correlation and multiple regression were used to determine associations between predictor variables and caregiver FACIT-Sp. Setting/Subjects: PD patient/caregiver dyads were recruited through three academic medical centers in the United States and Canada and regional community support groups. Results: We recruited 183 dyads. Patient faith, symptom burden, health-related quality of life, depression, motor function, and grief were significant predictors of caregiver spiritual well-being. Predictive caregiver factors included caregiver depression and anxiety. These factors remained significant in combined models, suggesting that both patient and caregiver factors make independent contributions to caregiver spiritual well-being. Conclusions: The present study suggests that both patient and caregiver factors are associated with spiritual well-being in PD. Further study is needed to understand the causal relationship of these factors and whether interventions to support caregiver spiritual well-being improve outcomes for caregivers or patients. Clinicaltrials.gov registration NCT02533921.

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.

The Impact of the COVID-19 Pandemic on Resident Physicians Well-Being in the Surgical and Primary Care Specialties in the United States and Canada

Purpose: The COVID-19 pandemic disrupted the professional, social, and spiritual activities of resident physicians around the world, impacting wellness and personal relationships. Moreover, social distancing caused significant limitations or shutdown of places of worship, including churches, synagogues, mosques, etc. Our goal was to survey resident physicians in primary care and surgical subspecialties in the United States (U.S.) and Canada and to examine the effect of the COVID-19 pandemic on their well-being.

Methods: An international cross-sectional study was performed in November 2020, using an anonymous survey of programs in the U.S. and Canada, containing 20 questions to assess the impact of the pandemic on resident participation in social and spiritual activities and the effects on their wellness, and personal relationships. The emails with survey links attached were sent to individual program coordinators from accredited residency training programs in the United States and Canada. This consisted of programs accredited by the American Osteopathic Association (AOA), The Royal College of Physicians and Surgeons of Canada (RCPSC), and the Accreditation Council of Graduate Medical Education (ACGME). The survey was evenly divided among surgical programs (General Surgery, Neurological Surgery, Orthopedic Surgery, Urological Surgery, and Integrated Surgical Residency Programs such as Plastic Surgery, Cardiothoracic Surgery, Pediatric Surgery, and Vascular Surgery) as well as primary care programs (Internal Medicine and Family Medicine).

Results: A total of 196 residents, 60 primary care residents, and 136 surgery residents participated in the study. Ninety-six participants (49%) were female, and 98 of the participants (50%) were male, with the remainder two residents identifying as “Other.” Of the primary care residents, the majority (39, 65%) were female. Conversely, the majority (77, 57%) of surgery residents were male.

Conclusion: The COVID-19 pandemic has affected the social lives, relationships, and spiritual well-being of both surgical and primary care resident physicians. However, primary care residents reported significantly greater engagement in personal relationships and were more likely to express feelings of mental and physical exhaustion, prohibiting social attendance.

Health promotion behaviours of pregnant women and spiritual well-being: Mediatory role of pregnancy stress, anxiety and coping ways

AIM

Little is known about the link between spiritual well-being and health promotion behaviours in pregnant women. The study aimed to explore the direct and indirect effects of spirituality on health promotion behaviours with the mediatory roles of pregnancy stress, anxiety and coping ways.

DESIGN

Cross-sectional.

METHODS

Two hundred women aged above 18 years completed Spiritual Well-Being scale (SWBS), State-Anxiety Inventory (SAI), Promoting Lifestyle Profile (HPLP), Prenatal Coping Inventory (Nu-PCI) and Revised Prenatal Distress Questionnaire (NuPDQ).

RESULTS

Spirituality directly and negatively affected the state anxiety (β = -.41; p < .001) and NuPDQ (β = -.36; p < .001). Health promotion behaviours were negatively related to state anxiety (β = -.36; p < .001) and positively to planning-preparation coping (β = .23; p = .001). Spirituality had a significant indirect effect on health promotion behaviours (β = .33; p < .001), mediated through its association with state anxiety and planning-preparation coping. Thus, health professionals are proposed to consult pregnant women on the benefits of spirituality for improving healthy behaviours.

Two Factor Structures Possible for the FACIT-Sp in Patients With Heart Failure

CONTEXT

The Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp) is a 12-item measure of spiritual well-being in chronic illness originally developed in patients with cancer. The overall scale, a two-factor model (meaning/peace, faith), and a three-factor model (meaning, peace, faith) have been proposed for the FACIT-Sp, and consensus on the best factor structure has not been reached. In addition, the factor structure of the FACIT-Sp has not been considered in patients with heart failure.

OBJECTIVES

To examine the factor structure of the FACIT-Sp in heart failure patients.

METHODS

A confirmatory factor analysis framework was used to test three competing models on 217 patients with heart failure using data from the CASA (Collaborative Care to Alleviate Symptoms and Adjust to Illness) trial. The overall scale (single factor), two-factor, and three-factor models were tested using baseline data, then confirmed with 12-month data. Model modifications were made based on empirical inspection of baseline data and replicated using 12-month data. Cronbach's alpha and correlations with measures of quality of life and psychological health were examined.

RESULTS

All three models had strong factor loadings on all items except the negatively worded items. The two-factor and three-factor models fit reasonably well after modifications, but the single factor did not fit well (1/2/3-factor: RMSEA 0.14/0.09/0.06, CFI 0.85/0.93/0.97, SRMR 0.09/0.05/0.04). Internal consistency was sufficient for all factors.

CONCLUSION

The two-factor and three-factor models were supported in heart failure patients. The three-factor model demonstrated better statistical fit but was not more interpretable.

KEY MESSAGE

This study investigated the factor structure of the FACIT-Sp in patients with heart failure. The two-factor and three-factor models were supported, but the single factor model was not. Negatively worded items did not perform well.

Spiritual Well-Being, Social Support, and Financial Distress in Determining Depression: The Mediating Role of Impact of Event During COVID-19 Pandemic in Iran

This study investigates the relationship between spiritual well-being, social support, and financial distress with depressive symptoms due to the COVID-19 pandemic. A path analysis was used to analyze data collected from 1,156 Iranian participants via an online survey. The results showed that spiritual well-being and social support were negatively related to depressive symptoms and financial distress. The impact of COVID-19 events showed negative associations with depressive symptoms. In addition, the link between spiritual well-being and financial distress with depressive symptoms was partially mediated by the impact of events.

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.

A systematic review and meta-analysis of effects of psychosocial interventions on spiritual well-being in adults with cancer

Objective

Spiritual well-being (SpWb) is an important dimension of health-related quality of life for many cancer patients. Accordingly, an increasing number of psychosocial intervention studies have included SpWb as a study endpoint, and may improve SpWb even if not designed explicitly to do so. This meta-analysis of randomized controlled trials (RCTs) evaluated effects of psychosocial interventions on SpWb in adults with cancer and tested potential moderators of intervention effects.

Methods

Six literature databases were systematically searched to identify RCTs of psychosocial interventions in which SpWb was an outcome. Doctoral-level rater pairs extracted data using Covidence following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Standard meta-analytic techniques were applied, including meta-regression with robust variance estimation and risk-of-bias sensitivity analysis.

Results

Forty-one RCTs were identified, encompassing 88 treatment effects among 3883 survivors. Interventions were associated with significant improvements in SpWb (g = 0.22, 95% CI [0.14, 0.29], p < 0.0001). Studies assessing the FACIT-Sp demonstrated larger effect sizes than did those using other measures of SpWb (g = 0.25, 95% CI [0.17, 0.34], vs. g = 0.10, 95% CI [-0.02, 0.23], p = 0.03]. No other intervention, clinical, or demographic characteristics significantly moderated effect size.

Conclusions

Psychosocial interventions are associated with small-to-medium-sized effects on SpWb among cancer survivors. Future research should focus on conceptually coherent interventions explicitly targeting SpWb and evaluate interventions in samples that are diverse with respect to race and ethnicity, sex and cancer type.

Psychosocial and Functional Predictors of Mental Disorder among Prostate Cancer Survivors: Informing Survivorship Care Programs with Evidence-Based Knowledge

Recent research has revealed that prostate cancer (PCa) survivors are facing a silent epidemic of mental disorder. These findings are not surprising when the side effects of highly effective current treatment modalities are considered. Here, we assess the association between urinary function and quality of life indicators to mental disorder among survivors of PCa. This is a cross sectional examination of an analytical sample of 362 men with a history of PCa residing in the Maritimes who took a survey assessing social, physical and health-related quality of life indicators between 2017 and 2021. Mental disorder was assessed using Kessler's Psychological Distress Scale (K-10). Predictor variables included emotional, functional, social/family and spiritual well-being, measured by Functional Assessment of Cancer Therapy-Prostate (FACT-P), and urinary function was measured by International Prostate Symptom Score (IPSS). Multivariate logistic regression analysis evaluated the contribution of predictors while controlling for age, income, survivorship time (months) since diagnosis, relationship status and treatment modality. Mental disorder was identified among 15.8% of PCa survivors in this sample. High emotional (aOR = 0.81, 95% CI: 0.69-0.96) and spiritual well-being (aOR = 0.88, 95% CI: 0.81-0.96) were protective factors against mental disorder. Men who screened positive for moderate to severe urinary tract symptoms had three times higher odds (aOR = 3.02, 95% CI: 1.10, 8.32) of screening positive for mental disorder. Men who were on active surveillance or radical prostatectomy with or without added treatment had higher (aOR = 5.87, 95% CI: 1.32-26.13 or aOR = 4.21, 95% CI: 1.07-16.51, respectively) odds of screening positive for mental disorder compared to men who received radiation treatment with or without hormonal therapy for their PCa diagnosis. Unmet emotional and spiritual needs, increased urinary problems and some forms of treatment (e.g., active surveillance or surgery) were associated with mental disorder among PCa survivors. The development of survivorship care programs and support systems that focus on the long-term effects of PCa treatments and the consequences of unmet psychosocial needs of patients during the survivorship journey are critically needed.

Treatment Regret, Mental and Physical Health Indicators of Psychosocial Well-Being among Prostate Cancer Survivors

Prostate cancer (PCa) patients and survivors are at high risk of mental health illness. Here, we examined the contribution of treatment regret, mental and physical health indicators to the social/family, emotional, functional and spiritual well-being of PCa survivors. The study assessed 367 men with a history of PCa residing in the Maritimes Canada who were surveyed between 2017 and 2021. The outcomes were social/family, emotional, functional and spiritual well-being (FACT-P,FACIT-Sp). Predictor variables included urinary, bowel and sexual function (UCLA-PCI), physical and mental health (SF-12), and treatment regret. Logistic regression analyses were controlled for age, income, and survivorship time. Poor social/family, emotional, functional and spiritual well-being was identified among 54.4%, 26.5%, 49.9% and 63.8% of the men in the sample. Men who reported treatment regret had 3.62, 5.58, or 4.63 higher odds of poor social/family, emotional, and functional well-being, respectively. Men with low household income had 3.77 times higher odds for poor social/well-being. Good mental health was a protective factor for poor social/family, emotional, functional, or spiritual well-being. Better physical and sexual health were protective factors for poor functional well-being. Seeking to promote PCa patients' autonomy in treatment decisions and recognizing this process' vulnerability in health care contexts is warranted.

Servant Leadership Stimulates Spiritual Well-Being Through Team Trust in a Female Religious Context

This study investigates how female religious leaders nurture spiritual well-being in religious sisters. Specifically, we examined how servant leadership fosters spiritual well-being [Gifts and Fruits of the Spirit (GFSp)] through, respectively, the mediating role of team trust and reduced occurrence of team conflicts. Quantitative survey data were collected from 453 religious sisters (followers) within a Catholic Women Religious Institute in Nigeria. Using structural equation modeling, results showed that servant leadership is positively related to team trust and negatively related to team conflict. Further findings showed that servant leadership indirectly fosters spiritual well-being: Gifts of the Spirit (GSp), and Fruits of the Spirit (FSp), through the mediating role of team trust, however not through reduced team conflict. Theoretical and practical implications are discussed.