Effect of Spirituality-Based Palliative Care on Pain, Nausea, Vomiting, and the Quality of Life in Women with Colon Cancer: A Clinical Trial in Southern Iran

The contribution of spirituality and religiousness to the quality of life of cancer patients treated with radiotherapy in Ghana: a cross-sectional study

Cancer is one of the leading causes of morbidity and mortality globally. A significant proportion of all patients with cancer require radiotherapy as part of their treatment. Cancer can be very terrifying for patients undergoing radiotherapy, especially when it undermines their ability to hope or cope. In Ghana, where religious and spiritual beliefs play a significant role in many individuals' lives, understanding how these factors affect patients' well-being during cancer treatment is crucial. This study examined the contribution of spirituality and religiousness to the quality of life (QoL) of cancer patients undergoing radiotherapy in Accra, Ghana. Pre-validated questionnaires were used to collect data that were analysed using the Statistical Package for the Social Sciences software (version 20). Patient interviews were also conducted and analysed thematically. Most of the respondents were female (n = 58, 65%), whereas 32 (35%) were male. The mean age of the respondents was 45.8 years (SD 12.9). All the participants of the study were religious and considered themselves to be either Christian (n = 82, 91.1%) or Muslim (n = 8, 8.9%). Approximately 93% of the participants relied on their spiritual beliefs to cope with cancer. Many patients reported that spirituality and religious coping are important aspects of their experience, potentially influencing their perceived QoL during radiotherapy. Most patients considered attention to spiritual concerns an important part of cancer care by doctors (88%) and nurses (85%). Five themes were identified from the analysis of the qualitative data. These themes indicated nuanced insights into how spirituality and religiousness influence the experiences of cancer patients. The findings of this study demonstrate the need to cater not only to bodily but also to emotional, social and spiritual needs that arise in the lives of cancer patients.

A scoping review of global patterns in reporting race, ethnicity, nationality, or religion in palliative care randomized controlled trials: Recommendations for transparency

BACKGROUND

Though randomized controlled trials of non-pharmacological palliative care interventions have shown positive outcomes, findings are often generalized with limited consideration for the impact of the influence of race, ethnicity, nationality, or religion on said outcomes.

AIM

To identify trends and gaps in global reporting of racial, ethnic, nationality, and religious demographics in non-pharmacological palliative care randomized controlled trials.

DESIGN

We conducted a scoping review guided by the Joanna Briggs methodology.

DATA SOURCES

Global randomized controlled trials published in English, between 1999 and 2021 extracted from databases: Cochrane, PubMed, and Scopus. Inclusion criteria were non-pharmacological palliative care interventions for people with serious conditions reporting on one or more of the demographics of race, ethnicity, nationality, or religion.

RESULTS

Our review included 131 (44%) articles published from 19 countries, predominantly the USA (n = 84, 64%). Most studies focused on cancer (n = 71, 54%) in inpatient settings (n = 85, 64%). Race was the most commonly reported demographic (n = 93, 70%), followed by ethnicity (n = 54, 41%), religion (n = 46, 35%), nationality (n = 20, 15%). Within racial reporting, 86 (92%) indicating a majority White/Caucasian sample. Only 14 (10%) articles provided context connecting participant demographics to intervention outcomes. Demographic data was discussed only as a limitation to generalizability in 18 cases (41%).

CONCLUSIONS

Improving greater transparency in study reporting of social and historical context about population demographics, including specific demographic data collected, may better identify unmet palliative needs, facilitate cross-cultural interpretation, and improve adaptation and implementation of non-pharmacological palliative care interventions.

Impact of spiritual interventions in individuals with cancer: A systematic review and meta-analysis

PURPOSE

This meta-analysis aimed to determine how spiritual interventions affect cancer patients' physical, emotional, and spiritual outcomes and quality of life.

METHODS

Between 2012 and May 2024, the Cochrane Library, Scopus, PubMed, and Web of Science were searched considering the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Twenty-six randomized controlled trials were included, and 16 were synthesized in the meta-analysis. Bias risk was evaluated using the Cochrane risk-of-bias methodology for randomized studies. The Grading of Recommendations, Assessment, Development, and Evaluations tool was employed for evidence certainty. Heterogeneity was expressed through I2 and Q statistics. Hedge's g was calculated for effect sizes. Egger's and Kendall's Tau were used for publication bias.

RESULTS

Spiritual interventions yielded beneficial effects on fatigue (Hedges's g = 0.900, p < 0.001) and pain (Hedges's g = 0.670, p < 0.001) but not for overall symptom burden (Hedges's g = 0.208, p = 0.176). Significant effects were found for anxiety (Hedges's g = 0.301, p < 0.001), depression (Hedges's g = 0.175, p = 0.016), and psychological distress (Hedges's g = 0.178, p = 0.024), except for hopelessness (Hedges's g = 0.144, p = 0.091). Spiritual interventions enhanced faith (Hedges's g = 0.232, p = 0.035), the meaning of life (Hedges's g = 0.259, p = 0.002), spiritual well-being (Hedges's g = 0.268, p < 0.001), and quality of life (Hedges's g = 245, p < 0.001). Moderator analysis pointed out that cancer stage, total duration, delivery format, providers' qualification, content, and conceptual base of spiritual interventions significantly affect physical, emotional, and spiritual outcomes and quality of life.

CONCLUSION

This meta-analysis highlighted the benefits of spiritual interventions with varying effect sizes on patients' outcomes, as well as quality of life in cancer, and shed on how to incorporate these approaches into clinical practice.

Finnish Palliative Care Nurses' and Physicians' Perceptions of Spirituality and Spiritual Care Related to Their Attitudes toward End-of-Life Care

Background

Spiritual care constitutes an indispensable aspect of palliative care (PC). Health care professionals encounter challenges when addressing spiritual care at the end of life. Developing appropriate attitudes toward end-of-life care can facilitate the acquisition of competencies needed for effective delivery of spiritual care.

Aim

To explore the perceptions of spiritual care and attitudes toward end-of-life care among PC professionals.

Design

The Finnish version of the "Spirituality and Spiritual Care Rating Scale" (SSCRS-FIN) and a newly developed "Attitudes toward End-of-Life Issues" (AEOLI) questionnaire were validated and utilized.

Setting/Participants

Both questionnaires were distributed to PC professionals involved in PC through an online survey. Exploratory and confirmatory factor analyses were conducted. The newly derived factors were subsequently examined for their associations with age, gender, profession, affiliation with a religious community, personal interpretation of spirituality, and years of professional experience.

Results

A total of 204 participants took part in the study (163 nurses, 19 nursing students, and 22 physicians). Exploratory factor analysis demonstrated satisfactory internal consistency, as indicated by Cronbach's alpha coefficients, for the five factors of SSCRS-FIN: "Spirituality" (0.733), "Existential" (0.614), "Spiritual Needs" (0.599), "Passive Spiritual Care" (0.750), and "Active Spiritual Care" (0.665); and for the seven factors of AEOLI: "Anxiety" (0.823), "Discussion" (0.924), "End-of-Life" (0.573), "Education" (0.692), "Medically Induced Death" (0.859), "Suffering" (0.671), and "Knowledge" (0.444). Confirmatory factor analysis demonstrated satisfactory fit values for both questionnaires. Significant positive correlations were observed between end-of-life care and the factors "Existential," "Spiritual Needs," and spiritual care factors, whereas an inverse correlation was found among "Anxiety," "Medically Induced Death," and all factors of SSCRS-FIN.

Conclusions

Valid and reliable questionnaires for assessing spiritual care (SSCRS-FIN) and attitudes toward end-of-life care (AEOLI) were developed. Attitudes toward end-of-life care were positively correlated with perceptions of spiritual care.

The Impact of Negative Moral Character on Health and the Role of Spirituality: A Narrative Literature Review

Although negative moral character is highly prevalent, it is not included in the International Classification of Diseases (ICD). Along with the modification of WHO ICD-11, spirituality should be acknowledged for its potetnial role in the prevention of negative moral traits. This study aimed to explore the effects of negative moral character on health and determine the role of spirituality in improving negative moral traits. This narrative literature review was conducted from 2020 to 2023 in Kabul, Afghanistan. The articles were obtained from the Web of Science, PubMed, and Google Scholar databases. As demonstrated in this narrative literature review, most of the relevant experimental and observational studies have found that negative moral character can have significant negative impact on overall health and well-being. Many studies have established the positive role of spirituality in improving negative moral character. These studies concluded that facilities must be available within schools, universities, and communities for everyone to gain knowledge of spirituality and improve their negative moral character. Considering the adverse impacts of negative moral character on health, the current study proposes the addition of moral disorder to the WHO International Classification of Diseases. According to this literature review, spirituality will improve negative moral character and strengthen excellent moral traits.

The role of spirituality in pain experiences among adults with cancer: an explanatory sequential mixed methods study

PURPOSE

Foundational research demonstrates that spirituality may affect the way people with cancer experience pain. One potential route is through alterations in thoughts and beliefs, such as pain-related catastrophizing. The purpose of this study is to understand whether spirituality impacts pain experiences through pain-related catastrophizing.

METHODS

This explanatory sequential mixed methods study was informed by an adapted Theory of Unpleasant Symptoms. Data were collected via online surveys (N = 79) and follow-up qualitative interviews (N = 25). Phase 1 employed Empirical Bayesian analysis. Phase 2 used deductive content analysis. Phase 3 involved creating a mixed methods joint display to integrate findings and draw meta inferences.

RESULTS

Results indicate that total spiritual well-being was directly negatively associated with pain-related catastrophizing, and indirectly negatively associated with the outcomes of pain interference, pain severity, and pain-related distress. Qualitative categories highlight the supportive role of spirituality when facing pain, while also shedding light on the limitations of spirituality in the context of some pain (i.e., severe, neuropathic, and/or chronic). Mixed methods findings reveal the importance of spirituality for some people as they face cancer and cancer-related pain, as well as the need for integrating spirituality as part of a larger pain management plan.

CONCLUSIONS

This research advances supportive cancer care by exploring the complex role of spirituality in pain experiences. Findings will inform further exploration into the role of spirituality in supporting holistic symptom management in the context of cancer, as well as developing and testing interventions to enhance spirituality and address symptom-related suffering.

The Role of Spirituality in Pain Experiences among Adults with Cancer: An Explanatory Sequential Mixed Methods Study

Purpose

Foundational research demonstrates that spirituality may affect the way people with cancer experience pain. One potential route is through alterations in thoughts and beliefs, such as pain-related catastrophizing. The purpose of this study is to understand whether spirituality impacts pain experiences through pain-related catastrophizing.

Methods

This explanatory sequential mixed methods study was informed by an adapted Theory of Unpleasant Symptoms. Data were collected via online surveys (N = 79) and follow-up qualitative interviews (N = 25). Phase 1 employed Empirical Bayesian analysis. Phase 2 used deductive content analysis. Phase 3 involved creating a mixed methods joint display to integrate findings and draw meta inferences.

Results

Results indicate that spirituality was directly negatively associated with pain-related catastrophizing, and indirectly negatively associated with the outcomes of pain interference, pain severity, and pain-related distress. Qualitative categories highlight the supportive role of spirituality when facing pain, while also shedding light on the limitations of spirituality in the context of some pain (i.e., severe, neuropathic, and/or chronic). Mixed methods findings reveal the importance of spirituality for some people as they face cancer and cancer-related pain, as well as the need for integrating spirituality as part of a larger pain management plan.

Conclusions

This research advances supportive cancer care by exploring the complex role of spirituality in pain experiences. Findings will inform further exploration into the role of spirituality in supporting holistic symptom management in the context of cancer, as well as developing and testing interventions to enhance spirituality and address symptom-related suffering.