Spirituality, religiosity, and spiritual pain in advanced cancer patients

Marvin O. Delgado-Guay, David Hui, Henrique A. Parsons, Kathy Govan, Maxine De La Cruz, Steven Thorney, Eduardo Bruera

Research output: Contribution to journalArticlepeer-review

203 Scopus citations

Abstract

Context: Spirituality, religiosity, and spiritual pain may affect advanced cancer patients' symptom expression, coping strategies, and quality of life. Objectives: To examine the prevalence and intensity of spirituality, religiosity, and spiritual pain, and how spiritual pain was associated with symptom expression, coping, and spiritual quality of life. Methods: We interviewed 100 advanced cancer patients at the M.D. Anderson palliative care outpatient clinic in Houston, TX. Self-rated spirituality, religiosity, and spiritual pain were assessed using numeric rating scales (0 = lowest, 10 = highest). Patients also completed validated questionnaires assessing symptoms (Edmonton Symptom Assessment Scale [ESAS] and Hospital Anxiety and Depression Scale), coping (Brief COPE and Brief R-COPE), the value attributed by the patient to spirituality/religiosity in coping with cancer (Systems of Belief Inventory-15R), and spiritual quality of life (Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being-Expanded [FACIT-Sp-Ex]). Results: The median age was 53 years (range 21-85) and 88% were Christians. Almost all patients considered themselves spiritual (98%) and religious (98%), with a median intensity of 9 (interquartile range 7-10) of 10 and 9 (range 5-10) of 10, respectively. Spiritual pain was reported in 40 (44%) of 91 patients, with a median score of 3 (1-6) among those with spiritual pain. Spiritual pain was significantly associated with lower self-perceived religiosity (7 vs. 10, P = 0.002) and spiritual quality of life (FACIT-Sp-Ex 68 vs. 81, P = 0.001). Patients with spiritual pain reported that it contributed adversely to their physical/emotional symptoms (P < 0.001). There was a trend toward increased depression, anxiety, anorexia, and drowsiness, as measured by the ESAS, among patients with spiritual pain (P < 0.05), although this was not significant after Bonferroni correction. Conclusion: A vast majority of advanced cancer patients receiving palliative care considered themselves spiritual and religious. Spiritual pain was common and was associated with lower self-perceived religiosity and spiritual quality of life.

Original languageEnglish (US)
Pages (from-to)986-994
Number of pages9
JournalJournal of pain and symptom management
Volume41
Issue number6
DOIs
StatePublished - Jun 2011

Keywords

  • Spirituality
  • cancer
  • coping
  • palliative care
  • quality of life
  • religiosity
  • spiritual pain

ASJC Scopus subject areas

  • General Nursing
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

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