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Unmet spiritual care needs impact emotional and spiritual well-being in advanced cancer patients

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Abstract

Purpose

Spiritual care is an important part of healthcare, especially when facing the crisis of advanced cancer. Do oncology inpatients receive spiritual care consistent with their needs? When inconsistent, are there deleterious effects on patient outcomes?

Methods

Patients with advanced cancer (N = 150) were surveyed during their inpatient stay at a southeastern medical center using validated instruments documenting spirituality, quality of life, mood, and satisfaction with care. Relationships between the receipt of less spiritual care than desired and patient outcomes were examined.

Results

Almost all patients had spiritual needs (91%) and the majority desired and received spiritual care from their healthcare providers (67%; 68%), religious community (78%; 73%), and hospital chaplain (45%; 36%). However, a significant subset received less spiritual care than desired from their healthcare providers (17%), religious community (11%), and chaplain (40%); in absolute terms, the number who received less care than desired from one or more sources was substantial (42 of 150). Attention to spiritual care would improve satisfaction with care while hospitalized for 35% of patients. Patients who received less spiritual care than desired reported more depressive symptoms [adjusted β (SE) = 1.2 (0.47), p = 0.013] and less meaning and peace [adjusted β (SE) = −2.37 (1.15), p = 0.042].

Conclusions

A substantial minority of patients did not receive the spiritual care they desired while hospitalized. When spiritual needs are not met, patients are at risk of depression and reduced sense of spiritual meaning and peace. Spiritual care should be matched to cancer patients’ needs.

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References

  1. Pearce MJ (2011) Addressing religion and spirituality in healthcare systems. Handbook of Religion and Psychology, A.P.A. (in press)

  2. Astrow A, Wexler A, Texeira K, He M, Sulmasy D (2007) Is failure to meet spiritual needs associated with cancer patients’ perceptions of quality of care and their satisfaction with care? J Clin Oncol 36:5753–5757

    Article  Google Scholar 

  3. Wilkelman WD, Lauderdale K, Balboni M et al (2011) The relationship of spiritual concerns to the quality of life of advanced cancer patients: preliminary findings. J Palliat Med 14:1–7

    Article  Google Scholar 

  4. Moadel A, Morgan D, Fatone A, Grennan J et al (1999) Seeking meaning and hope: self-reported spiritual and existential needs among an ethnically-diverse cancer patient population. Psychooncology 8:378–385

    Article  PubMed  CAS  Google Scholar 

  5. Williams JA, Meltzer D, Arora V, Chung G, Curlin FA (2011) Attention to inpatients’ religious and spiritual concerns: predictors and association with patient satisfaction. J Gen Intern Med 26(11):1265–1271

    Article  PubMed  Google Scholar 

  6. Association AP (1992) Ethical principles of psychologists and code of conduct. Am Psychol 47:1597–1611

    Article  Google Scholar 

  7. J.C.O.A.H. (2001) Spiritual assessment. http://www.jointcommis sion.org/Accreditation/Programs/Hospitals/Standards/FAQs/Provision+of+Care/Assessment/Spiritual_Assessment.htm. Accessed July 2011

  8. WHO (2004) Palliative care: symptom management and end of life care, http://who.int/hiv/pub/imai/genericpalliativecare082004.pdf. Accessed 22 July 2011

  9. Balboni TA, Vanderwerker LC, Block SD, Paulk ME, Lathan CS, Peteet JR, Prigerson HG (2007) Religiousness and spiritual support among advanced cancer patients and associations with end-of-life treatment preferences and quality of life. J Clin Oncol 25:555–560

    Article  PubMed  Google Scholar 

  10. Kristeller JL, Rhodes M, Cripe LD, Sheets V (2005) Oncologist assisted spiritual intervention study (OASIS): patient acceptability and initial evidence of effects. Int J Psychiatry Med 35(4):329–347

    Article  PubMed  Google Scholar 

  11. Balboni TA, Paulk ME, Balboni MJ, Phelps AC, Trice Loggers E, Wright AA, Block SD, Lewis EF, Peteet JR, Prigerson HG (2010) Provision of spiritual care to patients with advanced cancer: associations with medical care and quality of life near death. J Clin Oncol 28:445–452

    Article  PubMed  Google Scholar 

  12. Balboni TA, Balboni M, Paulk ME et al (2011) Support of cancer patients’ spiritual needs and associations with medical care costs at the end of life. Cancer 117(23):5383–5391

    Article  PubMed  Google Scholar 

  13. Koropchak CM, Pollak KI, Arnold RM, Alexander AC, Skinner CS et al (2006) Studying communication in oncologist-patient encounters: the SCOPE trial. Palliat Med 20:813–819

    Article  PubMed  Google Scholar 

  14. Peterman AH, Fitchett G, Brady M, Pharm L, Cella D (2001) Measuring spiritual well-being in people with cancer: the functional assessment of chronic illness therapy—spiritual wellbeing (FACIT-Sp). Ann Behav Med 24:49–58

    Article  Google Scholar 

  15. Galek K, Flannelly KJ, Vane A, Galek RM (2005) Assessing a patient’s spiritual needs. Holist Nurs Pract 19:62–69

    PubMed  Google Scholar 

  16. Cella D, Tulsky D, Gray G et al (1993) The Functional Assessment of Cancer Therapy Scale: development and validation of the general measure. J Clin Oncol 1:570–579

    Google Scholar 

  17. Lewinsohn PM, Seeley JR, Roberts RE, Allen NB (1997) Center for Epidemiologic Studies Depression Scale (CES-D) as a screening instrument for depression among community-residing older adults. Psychol Aging 12(2):277–287

    Article  PubMed  CAS  Google Scholar 

  18. Monroe MH, Bynum D, Susi B et al (2003) Primary care physician preferences regarding spiritual behavior in medical practice. Arch Intern Med 163:2751–2756

    Article  PubMed  Google Scholar 

  19. O'Connor M, Guilfoyle A, Breen L, Mukhardt F, Fisher C (2007) Relationships between quality of life, spiritual well-being, and psychological adjustment styles for people living with leukemia: an exploratory study. Ment Health Relig Cult 10:631–647

    Article  Google Scholar 

  20. Giese-Davis J, Collie K, Rancourt KMS, Neri E, Kraemer HC, Spiegel D (2011) Decrease in depression symptoms is associated with longer survival in patients with metastatic breast cancer: a secondary analysis. J Clin Oncol 29:413–420

    Article  PubMed  Google Scholar 

  21. Mitchell GK, Abernethy AP (2005) A comparison of methodologies from two longitudinal community-based randomized controlled trials of similar interventions in palliative care: what worked and what didn’t? J Palliat Med 8:1226–1237

    Article  PubMed  Google Scholar 

  22. Abernethy AP, Shelby-James T, Fazekas BS, Woods D, Currow DC (2006) The Australia-modified Karnofsky Performance Status (AKPS) scale: a revised scale for contemporary palliative care clinical practice. BMC Palliat Care 4:7

    Article  Google Scholar 

  23. Brucker P, Yost K, Cashy J, Webster K, Cella D (2005) General population and cancer patient norms for the Functional Assessment of Cancer Therapy-General (FACT-G). Eval Health Prof 28(2):192–211

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 2213 Elba Street, Room 115, P.O. Box 3026, Durham, NC, 27710, USA

    Michelle J. Pearce & Harold G. Koenig

  2. Duke Cancer Institute Biostatistics, Duke University Medical Center, Durham, NC, 27710, USA

    April D. Coan & James E. Herndon II

  3. Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, 27710, USA

    James E. Herndon II

  4. Duke Cancer Care Research Program, Duke University Medical Center and Duke Cancer Institute, Durham, NC, 27710, USA

    Amy P. Abernethy

  5. King Abdulaziz University, Jeddah, Saudi Arabia

    Harold G. Koenig

Authors
  1. Michelle J. Pearce
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  2. April D. Coan
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  3. James E. Herndon II
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  4. Harold G. Koenig
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  5. Amy P. Abernethy
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Corresponding author

Correspondence to Michelle J. Pearce.

Additional information

This research was supported by a grant from Duke Institute on Care at the End of Life. The findings of this study have not been presented or published elsewhere. The authors have no potential conflicts of interest. The authors have full control of all primary data and agree to allow the journal to review the data if requested.

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Pearce, M.J., Coan, A.D., Herndon, J.E. et al. Unmet spiritual care needs impact emotional and spiritual well-being in advanced cancer patients. Support Care Cancer 20, 2269–2276 (2012). https://doi.org/10.1007/s00520-011-1335-1

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  • DOI: https://doi.org/10.1007/s00520-011-1335-1

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