Factors related to spiritual well-being in the last days of life in three East Asian countries: An international multicenter prospective cohort study

Hiratsuka, Yusuke; Suh, Sang-Yeon; Kim, Sun Hyun; Cheng, Shao‐Yi; Yoon, Seok-Jun; Koh, Su‐Jin; Park, Shin Ae; Seo, Ji-Yeon; Kwon, Jung Hye; Park, Jeanno; Park, Young-Min; Hwang, Sun Wook; Lee, Eon Sook; Ahn, Hong‐Yup; Hui, David; Chen, Ping-Jen; Yamaguchi, Takashi; Morita, Tatsuya; Tsuneto, Satoru; Mori, Masanori; Inoue, Akira

doi:10.1177/02692163211022179

Cited by 6 publications

(3 citation statements)

References 46 publications

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“… 27 In this context, interventions that require family involvement to improve the quality of dying and death are likely to be disrupted by symptoms of dyspnea and delirium, especially as patients may have extreme difficulty communicating about related issues in a calm manner; this may influence families and medical teams to think patients are not accepting death and thus experiencing lower spiritual well-being. 28 Under persistent delirium conditions, the components of “accepting death peacefully,” “honoring patients’ wishes,” and “degree of physical comfort three days before death” were low, especially in the Asia-Pacific cultural context.…”

Section: Discussionmentioning

confidence: 99%

Improved Symptom Change Enhances Quality of Dying in Patients With Advanced Cancer: An East Asian Cross-Cultural Study

Huang,

Chen,

Mori

et al. 2023

The Oncologist

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Background Symptom burdens tend to increase for patients with cancer and their families over the disease trajectory. There is still a lack of evidence on the associations between symptom changes and the quality of dying and death. In this context, this research investigated how symptom changes influence the quality of dying and death. Methods This international prospective cohort study (the East Asian Collaborative Cross-Cultural Study to Elucidate the Dying Process (EASED), 2017-2019) included 22, 11, and 4 palliative care units across Japan, South Korea, and Taiwan. Eligible participants were adults (Japan and Korea, ≥18 years; Taiwan, ≥20 years) with locally advanced or metastatic cancer. Physical and psychological symptoms were assessed by physicians upon admission and within 3 days before death. Death quality was assessed using the Good Death Scale (GDS), developed in Taiwan. Univariate and multivariate regression analyses were used to identify correlations between symptom severity changes and GDS scores. Results Among 998 patients (542 [54.3%] men and 456 [45.7%] women; mean [SD] age = 70.1 [± 12.5] years), persistent dyspnea was associated with lower GDS scores when compared to stable dyspnea (β = −0.427, 95% CI = −0.783 to −0.071). Worsened (−1.381, −1.932 to −0.831) and persistent (−1.680, −2.701 to −0.659) delirium were also significantly associated with lower GDS scores. Conclusions Better quality of dying and death was associated with improved symptom control, especially for dyspnea and delirium. Integrating an outcome measurement for the quality of dying and death is important in the management of symptoms across the disease trajectory in a goal-concordant manner.

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Section: Discussionmentioning

confidence: 99%

Improved Symptom Change Enhances Quality of Dying in Patients With Advanced Cancer: An East Asian Cross-Cultural Study

Huang,

Chen,

Mori

et al. 2023

The Oncologist

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“…Regarding the psychosocial approach, it was noticed in the study that the psychological and social sphere were taken into account, but to the detriment of the spiritual, despite the benefits associated with quality of life when the spiritual sphere is included [ 27 , 28 ]. The professionals felt less prepared for the spiritual approach to the patient and the family [ 29 ], as well as for diagnoses and urgencies in palliative care [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Implementation and Knowledge of the Clinical Practice Guide for Palliative Care in the Ecuadorian Primary Care Level

Quintana

Davalos-Batallas

Vargas-Martínez

et al. 2021

IJERPH

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Ecuador assumed the commitment of including Palliative Care (PC) in its health policies. In 2014, the Ministry of Public Health (Ministerio de Salud Pública, MSP) approved the Clinical Practice Guide for Palliative Care (Guía de Práctica Clínica sobre Cuidados Paliativos, GPCCP), with application at the national level, as a mandatory internal regulation in all institutions belonging to the National Health System. In 2021, there is no evidence about the degree of implementation. The objective was to evaluate the implementation (I) of the GPCCP guide and the knowledge (C) of the health personnel working in the Zone 7 Health Centers (HCs). This is a cross-sectional, descriptive, and prospective study. A total of 292 professionals were interviewed: managers (38), physicians (150), and nurses (104). Three surveys based on the GPCCP guide were elaborated: one for the implementation, which was applied to the individuals in charge, and the others to assess the health professionals’ knowledge. The SPSS program was used, version 25. In the three groups, more than half of the participants had no training in PC, 91.2% of the HCs have the GPCCP guide, there is PC medical history (MH) in 38.2%, and morphine is used in 14.7%. The implementation of the GPCCP guide was inadequate in 52.9% of the cases. Only 25% treat the agony symptoms and 30%, delirium; 4.4% acknowledge the use of morphine in dyspnea, and 13.3% identify the subcutaneous route as the first choice for hydration at the end-of-life phase. Strategies to implement the GPCCP guide and to improve the health personnel’s knowledge must be implemented in Zone 7 centers.

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“…There is a growing body of literature on the spiritual needs of colorectal cancer patients and increasing evidence that these needs positively impact their prognosis 29,35,36 . Various factors determine patients' spiritual needs, and most existing studies focus on single in uencing factors 37,38,39,40 .…”

Section: Introductionmentioning

confidence: 99%

Factors influencing the spiritual needs of China’s colorectal cancer patients: A structural equation modeling exercise

Zhang,

Tu,

et al. 2023

Preprint

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Numerous studies indicate that long-term cancer treatment can significantly stress patients, adversely affecting both their emotional well-being and unaddressed spiritual needs. Despite this, there is a notable lack of research aimed at enhancing the spiritual well-being of these patients. Most studies that do touch on spiritual needs tend to be narrow in scope, focusing only on specific influencing factors. The spiritual needs of colorectal cancer patients in the postoperative rehabilitation phase are particularly under-researched. This study aims to identify the spiritual needs of colorectal cancer patients and to analyze the factors that influence these needs. We utilized Generalized Structural Equation Modeling to investigate the interrelationships between psychological resilience, social support, spiritual health, anxiety, depression, and spiritual needs. Additionally, the study delves into the potential mediating roles of psychological resilience, social support, anxiety, depression, and spiritual health in the relationship between selected risk factors and observed variables. In this research, we surveyed1,200 colorectal cancer patients using a range of scales, including the Psychological Resilience Scale (CD-RISC), the Perceived Social Support Scale (PSS), the Spiritual Wellness Scale (FACIT-Sp-12), the Hospital Depression and Anxiety Scale(HADS), and the Spiritual Needs Scale (SNS). We analyzed the data using SPSS 21.0 and AMOS 24.0software. The results indicate that the model is well-fitted, as confirmed by the goodness-of-fit indices (χ2/df = 2.921, TLI = 0.987, CFI = 0.997, NFI = 0.996, RMSEA = 0.046). The findings obtained highlight the critical need to address the spiritual well-being of Chinese colorectal cancer patients, which continues to be a significant health challenge. Factors such as social support, psychological resilience, spiritual health, anxiety, and depression have both direct and indirect impacts on these needs. As such, healthcare providers and family membersshould consider these factors when offering psychological and social support. This will enable them to provide morecomprehensive spiritual care, thereby enhancing the patients' overall quality of life.

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Factors related to spiritual well-being in the last days of life in three East Asian countries: An international multicenter prospective cohort study

Cited by 6 publications

References 46 publications

Improved Symptom Change Enhances Quality of Dying in Patients With Advanced Cancer: An East Asian Cross-Cultural Study

Improved Symptom Change Enhances Quality of Dying in Patients With Advanced Cancer: An East Asian Cross-Cultural Study

Implementation and Knowledge of the Clinical Practice Guide for Palliative Care in the Ecuadorian Primary Care Level

Factors influencing the spiritual needs of China’s colorectal cancer patients: A structural equation modeling exercise

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