Spiritual Distress in Patients With Cancer Initiating Chemotherapy: A Cross‐Sectional Study

Abstract

Spirituality is broadly concerned with life's meaning, connection to a higher power, and the possibility of transcendence. Spirituality is included with religion, but these are related but different concepts. Religion has a community foundation and embraces beliefs, practices, and rituals related to the transcendent (Koenig, 2012). Spirituality is a different concept than religion, universal and related with individual meaning in life and connection (Koenig, 2012;Weathers, McCarthy, & Coffey, 2016). Spirituality and religion beliefs and practices play a critical role in serious health conditions, such as cancer, rising coping in dealing and overcoming this complex situation (Cipriano-Steffens et al., 2020). For many, spirituality contributes to the alleviation of suffering and a sense of well-being, peace, and inner strength, and allows for coping in the face of a severe illness (Weathers et al., 2016). Cancer is characterized as a traumatic life event in which patients may experience spiritual distress (Hui et al., 2011).Patients with cancer who experience spiritual distress often report feelings of struggle regarding existential issues, lack of meaning and purpose in life, disconnectedness, loneliness, isolation, and an uncertain future (Cobb & Chang, 2018). The start of receiving chemotherapy is a life-changing event for patients with cancer. This life event is considered a transition from the scope of health or illness (Meleis, Sawyer, Im, Hilfinger Messias, & Schumacher, 2000). Personal factors, such as patients' spiritual beliefs, can play a major role as facilitators to overcome this process (Meleis et al., 2000). Recently, spirituality has been discussed as an inherent dimension of the transition theory of Meleis (Martins & Caldeira, 2021). In addition, nurses in clinical practice have a therapeutic intervention in helping patients to achieve a successful and healthy transition (Schumacher, Jones, & Meleis, 1999).Patients with poor spiritual well-being have been reported to be overwhelmed by spiritual distress

Prevalence, defining characteristics, and predictors of the nursing diagnosis of spiritual distress in cancer patients undergoing chemotherapy: A longitudinal study

“…Concerning the reliability of the SDS used in the data collection of this study, it presents a Cronbach's alpha between 0.87 and 0.90 in the five cut‐off moments of the study, which is considered acceptable internal validity (Taber, 2018). This result regarding the internal validity of SDS is similar to others studies that were recently conducted (Martins et al, 2021; Silva et al, 2019).…”

“…Other predictors of spiritual distress may be identified in the literature, such as patients' self-perception of their critical clinical condition (Schultz et al, 2017), younger age, and no religious affiliation (Martins et al, 2021). Interestingly, hopelessness emerges as a predictor 9 months after patients have started chemotherapy.…”

Spiritual Distress in Patients with Dyspnea: A Review of Measurement Tools

“…Although initially developed in a Taiwanese cultural context, the SDS has also been translated into European Portuguese, adapted, validated, and found to be reliable in detecting SD in cancer patients initiating chemotherapy (Martins et al, 2021). Reliability in the initial cohort showed a total Cronbach's α score of 0.95, and Cronbach's α in the Portuguese study cohort was 0.91 (Ku et al, 2010; Martins et al, 2021). Ku et al also reported a total content validity index of 0.83 and conducted factor analysis, showing that the four domains explained 64.831% of the total variance.…”

“…The SDS was also validated and used in a study of 332 Portuguese patients with cancer who were initiating chemotherapy in a 2021 study (Martins et al, 2019(Martins et al, , 2021. This cohort was predominantly Catholic, and most participants were diagnosed within the previous six months.…”

Managing holistic nursing practice: The need for spiritual care competence in health care practice

“…Spiritual care can also involve the provision of or access to religious supports (Giske et al, 2021) and health care chaplaincy services. Patients may have spiritual and religious beliefs that when unattended in the hospital/health care setting, can cause loss, spiritual distress (Martins et al, 2021) and or disenfranchised grief further contributing to experiences of dehumanization. Patients who use spirituality and religion as distinct resources and coping mechanisms (Ross & Austin, 2015) may not be encouraged to use them within health care settings (Radford, 2008); in fact, they may be discouraged.…”