Spiritual well-being as a dimension of quality of life for patients with advanced cancer and AIDS and their family caregivers: Results of a longitudinal study

Purpose: To evaluate the association between quality-of-life (QOL) impairment as reported by patients and QOL impairment as judged by nurses or physicians, with and without consideration of spiritual well-being (SWB). Patients and Methods: A total of 163 patients with advanced cancer were enrolled onto a therapeutic trial, and cross-sectional data were derived from clinical and demographic questionnaires obtained at baseline, including assessment of patient QOL and SWB. Clinicians rated the QOL impairment of their patients as mild, moderate, or severe. Clinician-estimated QOL impairment and patient-derived QOL categories were compared. Correlation coefficients were estimated to associate QOL scores using different instruments. The analysis of variance method was used to compare Functional Assessment of Cancer Therapy–General scores on categorical variables. Results: There was no significant association between self-assessment scores and marital status, education level, performance status, or predicted life expectancy. However, a strong relationship between SWB and QOL was noted (P < .0001). Clinician-estimated QOL impairment matched the level of patient-derived QOL correctly in approximately 60% of cases, with only slight variation depending on the method of categorizing patient-derived QOL scores. The accuracy of clinician estimates was not associated with the level of SWB. Interestingly, a subset analysis of the inaccurate estimates revealed an association between lower SWB and clinician underestimation of QOL impairment (P = .0025). Conclusion: Clinician estimates of QOL impairment were accurate in more than 60% of patients. SWB is strongly associated with QOL, but it is not associated with the overall accuracy of clinicians’ judgments about QOL impairment.

Download Full-text

Spiritual well-being associated with personality traits and quality of life in family caregivers of cancer patients

Supportive Care in Cancer ◽

10.1007/s00520-018-4107-3 ◽

2018 ◽

Vol 26 (8) ◽

pp. 2633-2640 ◽

Cited By ~ 4

Author(s):

Anna Vespa ◽

Roberta Spatuzzi ◽

Fabiana Merico ◽

Marica Ottaviani ◽

Paolo Fabbietti ◽

...

Keyword(s):

Quality Of Life ◽

Personality Traits ◽

Cancer Patients ◽

Family Caregivers ◽

Well Being ◽

Spiritual Well Being

Download Full-text

Pilot Randomized Controlled Trial of Individual Meaning-Centered Psychotherapy for Patients With Advanced Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2011.36.2517 ◽

2012 ◽

Vol 30 (12) ◽

pp. 1304-1309 ◽

Cited By ~ 203

Author(s):

William Breitbart ◽

Shannon Poppito ◽

Barry Rosenfeld ◽

Andrew J. Vickers ◽

Yuelin Li ◽

...

Keyword(s):

Quality Of Life ◽

Advanced Cancer ◽

Symptom Burden ◽

Well Being ◽

Treatment Assessment ◽

Spiritual Well Being ◽

Secondary Outcomes ◽

Anxiety Depression

Purpose Spiritual well-being and sense of meaning are important concerns for clinicians who care for patients with cancer. We developed Individual Meaning-Centered Psychotherapy (IMCP) to address the need for brief interventions targeting spiritual well-being and meaning for patients with advanced cancer. Patients and Methods Patients with stage III or IV cancer (N = 120) were randomly assigned to seven sessions of either IMCP or therapeutic massage (TM). Patients were assessed before and after completing the intervention and 2 months postintervention. Primary outcome measures assessed spiritual well-being and quality of life; secondary outcomes included anxiety, depression, hopelessness, symptom burden, and symptom-related distress. Results Of the 120 participants randomly assigned, 78 (65%) completed the post-treatment assessment and 67 (56%) completed the 2-month follow-up. At the post-treatment assessment, IMCP participants demonstrated significantly greater improvement than the control condition for the primary outcomes of spiritual well-being (b = 0.39; P <.001, including both components of spiritual well-being (sense of meaning: b = 0.34; P = .003 and faith: b = 0.42; P = .03), and quality of life (b = 0.76; P = .013). Significantly greater improvements for IMCP patients were also observed for the secondary outcomes of symptom burden (b = −6.56; P < .001) and symptom-related distress (b = −0.47; P < .001) but not for anxiety, depression, or hopelessness. At the 2-month follow-up assessment, the improvements observed for the IMCP group were no longer significantly greater than those observed for the TM group. Conclusion IMCP has clear short-term benefits for spiritual suffering and quality of life in patients with advanced cancer. Clinicians working with patients who have advanced cancer should consider IMCP as an approach to enhance quality of life and spiritual well-being.

Download Full-text

The Need for Culturally Congruent Psychosocial Care for Muslims With Advanced Cancer in Non-Muslim Majority Settings

Journal of Global Oncology ◽

10.1200/jgo.18.53500 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 115s-115s

Author(s):

M. Lazenby ◽

Z. Alward ◽

R. Gatarny ◽

C. Ayash ◽

F. Gany

Keyword(s):

Quality Of Life ◽

Advanced Cancer ◽

Functional Assessment ◽

Psychosocial Care ◽

Well Being ◽

Beliefs And Practices ◽

Culturally Congruent ◽

Spiritual Well Being ◽

Muslim Majority

Background: Little is known about the psychosocial care experience of Muslims who are in treatment of advanced cancer in non-Muslim majority settings. Aim: To describe the experience of Muslims who are in treatment of advanced cancer in a non-Muslim majority setting and to identify beliefs and practices for culturally congruent psychosocial care. Methods: This cross-sectional study, which is in progress, uses a semistructured interview guide and self-report questionnaires with Muslim patients ≥ 21 years who are in treatment of stage III or IV cancer at an academic cancer center in the northeast of the United States. Analysis of interviews is by grounded theory and of questionnaires by frequencies, percentages, and measures of central tendency and dispersion for quality of life: Functional Assessment of Cancer Therapy-General (FACT-G; range 0-108) with subscales: Physical Well-Being (PWB [range 0-28]), Social Well-Being (SWB [range 0-28]), Emotional Well-Being (EWB [range 0-24]), and Functional Well-Being (FWB [range 0-28]; higher scores reflect better quality of life Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp [range 0-48]), with subscales: peace (range 0-16), meaning (range 0-16), and faith (range 0-16); higher scores reflect better spiritual well-being. Distress Thermometer (DT; 0 = no distress, 10 = worst distress). Hospital Anxiety and Depression Scale (HADS), with subscale: anxiety (0-21) and depression (0-21); higher scores reflect worse condition. Results: Eleven (female, n=5 [45.5%]) Muslim patients from 10 countries of origin with a mean age of 55.2 (±10.9) years who were in treatment of breast, colorectal, gastric, lung, ovarian, prostate, melanoma and lymphoma cancers (Stage 4, n=8 [72.7%]) have been interviewed to date. Mean scores were: FACT-G 85.6 (±17.9) (PWB 22.3 [±5.1], SWB 23.8 [±3.8], EWB 18.6 [±4.5], FWB 20.7 [±6.7]; FACIT-Sp 123.8 (±24.6) (peace 11.6 [±4.5], meaning 13.7 [±3.1], faith 12.9 [±3.8]), DT 2.13 (SD 2.58); HADS anxiety 3.9 (±3.2) and depression 3.8 (±3.7). Four universal themes emerged: (1) Faithful Muslims must seek and submit to treatment. (2) Spiritual practices (prayer and other traditional healing practices) are sources of meaning. (3) Psychosocial care in a non-Muslim majority setting is often presented in ways incongruent with Muslims' beliefs and practices. (4) Psychosocial care would be acceptable if congruent with Muslims' beliefs and practices. Conclusion: Presenting psychosocial care as part of routine cancer treatment and, in non-Muslim majority settings, delivering psychosocial care that is culturally congruent with Islamic beliefs and practices, may increase the acceptability of psychosocial care among Muslims who are in treatment of advanced cancer.

Download Full-text

Efficacy of Meaning-Centered Psychotherapy in adult patients with advanced cancer: A systematic review and meta-analysis

Psicooncología ◽

10.5209/psic.77752 ◽

2021 ◽

Vol 18 (2) ◽

pp. 227-244

Author(s):

Natalia Dietrich ◽

Andrés Estradé ◽

Juan Antonio Cruzado

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Clinical Trials ◽

Psychological Distress ◽

Advanced Cancer ◽

Meta Analysis ◽

Well Being ◽

Adult Patients ◽

Spiritual Well Being

Objective: We conducted a PRISMA-compliant systematic review of clinical trials, and a meta-analysis of randomised clinical trials (RCTs) of manualised Meaning-Centered Psychotherapy (MCP) interventions for adult advanced cancer patients. We searched seven databases for trials published in English and Spanish, until March 27, 2021. Results: Seven trials were included in the systematic review, and four in the meta-analysis. The systematic review favoured the effectiveness of MCP for the improvement of spiritual well-being, quality of life (QoL), sense of meaning and psychological distress, although inconsistencies between the trials were found. In pre-post meta-analytic estimates, MCP had a superior therapeutic effect than control conditions for spiritual well-being (d=0.52, p<0.001), QoL (d=0.60, p<0.001), anxiety symptoms (d=-0.47, p<0.001), depressive symptoms (d=-0.50, p<0.001) and desire for hastened death (d=-0.28, p<0.001). No differences were observed in between-group comparisons. MCP was not associated with an increased risk of abandonment at post-treatment (OR=0.86, p=0.57). Conclusion: Manualised MCP interventions are a promising treatment for the improvement of spiritual well-being and quality of life and the reduction of psychological distress in adult patients with advanced cancer. The evidence base is still in an emerging state and should be expanded by higher methodological quality studies.

Download Full-text

Poster #T60 SERVICE SATISFACTION AND SPIRITUAL WELL-BEING AS PREDICTORS OF QUALITY OF LIFE AMONG PATIENTS WITH SCHIZOPHRENIA: A LONGITUDINAL STUDY USING A STRUCTURAL EQUATION MODEL APPROACH

Schizophrenia Research ◽

10.1016/s0920-9964(14)70877-1 ◽

2014 ◽

Vol 153 ◽

pp. S310

Author(s):

Giovanni De Girolamo ◽

Mariangela Lanfredi ◽

Valentina Candini ◽

Chiara Buizza ◽

Clarissa Ferrari ◽

...

Keyword(s):

Quality Of Life ◽

Longitudinal Study ◽

Structural Equation Model ◽

Structural Equation ◽

Well Being ◽

Equation Model ◽

Service Satisfaction ◽

Spiritual Well Being ◽

Model Approach

Download Full-text

Meaning-Centered Group Psychotherapy: An Effective Intervention for Improving Psychological Well-Being in Patients With Advanced Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2014.57.2198 ◽

2015 ◽

Vol 33 (7) ◽

pp. 749-754 ◽

Cited By ~ 226

Author(s):

William Breitbart ◽

Barry Rosenfeld ◽

Hayley Pessin ◽

Allison Applebaum ◽

Julia Kulikowski ◽

...

Keyword(s):

Quality Of Life ◽

Group Psychotherapy ◽

Outcome Measures ◽

Advanced Cancer ◽

Well Being ◽

Physical Symptom ◽

Symptom Distress ◽

Spiritual Well Being ◽

Hastened Death

Purpose To test the efficacy of meaning-centered group psychotherapy (MCGP) to reduce psychological distress and improve spiritual well-being in patients with advanced or terminal cancer. Patients and Methods Patients with advanced cancer (N = 253) were randomly assigned to manualized eight-session interventions of either MCGP or supportive group psychotherapy (SGP). Patients were assessed before and after completing the treatment and 2 months after treatment. The primary outcome measures were spiritual well-being and overall quality of life, with secondary outcome measures assessing depression, hopelessness, desire for hastened death, anxiety, and physical symptom distress. Results Hierarchical linear models that included a priori covariates and only participants who attended ≥ three sessions indicated a significant group × time interaction for most outcome variables. Specifically, patients receiving MCGP showed significantly greater improvement in spiritual well-being and quality of life and significantly greater reductions in depression, hopelessness, desire for hastened death, and physical symptom distress compared with those receiving SGP. No group differences were observed for changes in anxiety. Analyses that included all patients, regardless of whether they attended any treatment sessions (ie, intent-to-treat analyses), and no covariates still showed significant treatment effects (ie, greater benefit for patients receiving MCGP v SGP) for quality of life, depression, and hopelessness but not for other outcome variables. Conclusion This large randomized controlled study provides strong support for the efficacy of MCGP as a treatment for psychological and existential or spiritual distress in patients with advanced cancer.

Download Full-text

The impact of patient quality of life and spirituality upon caregiver depression for those with advanced cancer

Palliative & Supportive Care ◽

10.1017/s1478951512000570 ◽

2012 ◽

Vol 11 (5) ◽

pp. 389-396 ◽

Cited By ~ 11

Author(s):

Sara L. Douglas ◽

Barbara J. Daly

Keyword(s):

Quality Of Life ◽

Advanced Cancer ◽

Well Being ◽

Comprehensive Cancer Center ◽

Medium Size ◽

Caregiver Depression ◽

Spiritual Well Being ◽

Prospective Longitudinal ◽

The Relationship

AbstractObjective:Little is known about relationships between patient spiritual well-being and caregiver outcomes for those with advanced cancer. We were interested in examining the relationship between patient physical quality of life (QOL) and caregiver depression and to also evaluate whether patient spiritual well-being (SWB) played a mediating role in this relationship.Method:This is a prospective longitudinal study that was conducted in the outpatient clinics at a university-affiliated comprehensive cancer center. 226 patients with Stage III or IV cancer (lung, GI, GYN) and their primary caregivers were interviewed upon enrollment into the study and three months later. Measures of spirituality, health-related quality of life, and physical functioning were included in the interviews.Results:Key findings were that the relationship between patient physical QOL and caregiver depression was inverse and moderate (β = −0.24, p = 0.004) and that patient SWB (meaning/peace) played a significant (p = 0.02) and medium-size role (β = −0.31) in mediating the relationship between patient physical QOL and caregiver depression. The nature of these relationships was stable over time.Significance of results:Patients' spirituality is central to their coping and adjusting to cancer. It is this aspect of patient overall quality of life that mediates the relationship to caregiver well-being. The most potent intervention for caregiver depression may be attending to patient spiritual distress.

Download Full-text

Mutual Effects of Depression on Quality of Life in Patients and Family Caregivers

10.1188/19.onf.208-216 ◽

2019 ◽

pp. 208-216

Keyword(s):

Quality Of Life ◽

Family Caregivers ◽

Advanced Cancer ◽

Structural Equation ◽

Well Being ◽

Equation Modeling ◽

Cross Sectional ◽

For Profit ◽

Patients With Cancer

Objectives: To elucidate the importance of mutual effects within dyads by examining the contribution of depression on quality of life (QOL) in patients with advanced cancer and their family caregivers (FCs). Sample & Setting: 716 patients with advanced cancer paired with their FCs at two large, private not-for-profit hospices. Methods & Variables: A descriptive, cross-sectional design with the baseline data of a randomized hospice clinical trial was used. Structural equation modeling helped examine four hypotheses by integrating the features of the Actor-Partner Interdependence Model. Variables included QOL and depression. Results: Depression in patients with cancer and their FCs exhibited significant actor effects on an individual’s QOL after controlling for the partner effects. Among the spousal pairs, depression in FCs exhibited a positive partner effect on the functional well-being of patients with cancer, indicating that depressive symptoms occurring in FCs may increase patients’ functional well-being. Implications for Nursing: This study suggests the importance of consistent assessment in emotional well-being for dyads with cancer because their concerns may be transmitted to each other.

Download Full-text

Exploring the relationship between spiritual well-being and quality of life among patients newly diagnosed with advanced cancer

Palliative & Supportive Care ◽

10.1017/s1478951514000820 ◽

2014 ◽

Vol 13 (4) ◽

pp. 927-935 ◽

Cited By ~ 23

Author(s):

Mei Bai ◽

Mark Lazenby ◽

Sangchoon Jeon ◽

Jane Dixon ◽

Ruth McCorkle

Keyword(s):

Quality Of Life ◽

Advanced Cancer ◽

Functional Assessment ◽

Common Factor ◽

Well Being ◽

Newly Diagnosed ◽

Spiritual Well Being ◽

The Impact ◽

Over Time

AbstractObjective:In our context, existential plight refers to heightened concerns about life and death when people are diagnosed with cancer. Although the duration of existential plight has been proposed to be approximately 100 days, evidence from longitudinal studies raises questions about whether the impact of a diagnosis of advanced cancer may require a longer period of adjustment. The purpose of our study was to examine spiritual well-being (SpWB) and quality of life (QoL) as well as their interrelationship in 52 patients with advanced cancer after 100 days since the diagnosis at one and three months post-baseline.Method:The study was designed as a secondary data analysis of a cluster randomized clinical trial involving patients with stage 3 or 4 cancer undergoing treatment. SpWB was measured using the 12-item Functional Assessment of Chronic Illness Therapy–Spiritual Well-Being Scale (FACIT–Sp–12); common factor analyses revealed a three-factor pattern on the FACIT–Sp–12. Quality of life was measured with the Functional Assessment of Cancer Therapy–General (FACT–G). We limited our sample to participants assigned to the control condition (n = 52).Results:SpWB and QoL remained stable between one and three months post-baseline, which were a median of 112 and 183 days after diagnosis, respectively. SpWB was found to be associated with QoL more strongly than physical and emotional well-being. Peace and Meaning each contributed unique variance to QoL, and their relative importance shifted over time. Faith was positively related to QoL initially. This association became insignificant at three months post-baseline.Significance of results:This study underscores the significance of SpWB for people newly diagnosed with advanced cancer, and it highlights the dynamic pattern of Peace, Meaning, and Faith in association with QoL. Our results confirm that patients newly diagnosed with advanced cancer experience an existential crisis, improve and stabilize over time. Future studies with larger samples over a longer period of time are needed to verify these results.

Download Full-text