The Role of Spirituality and Religious Coping in the Quality of Life of Patients With Advanced Cancer Receiving Palliative Radiation Therapy

Abstract

Objectives National palliative care guidelines outline spiritual care as a domain of palliative care, yet patients’ religiousness and/or spirituality (R/S) are underappreciated in the palliative oncology setting. Among patients with advanced cancer receiving palliative radiation therapy (RT), this study aims to characterize patient spirituality, religiousness, and religious coping; examine the relationships of these variables to quality of life (QOL); and assess patients’ perceptions of spiritual care in the cancer care setting. Methods This is a multisite, cross-sectional survey of 69 patients with advanced cancer (response rate = 73%) receiving palliative RT. Scripted interviews assessed patient spirituality, religiousness, religious coping, QOL (McGill QOL Questionnaire), and perceptions of the importance of attention to spiritual needs by health providers. Multivariable models assessed the relationships of patient spirituality and R/S coping to patient QOL, controlling for other significant predictors of QOL. Results Most participants (84%) indicated reliance on R/S beliefs to cope with cancer. Patient spirituality and religious coping were associated with improved QOL in multivariable analyses (β = 10.57, P < .001 and β = 1.28, P = .01, respectively). Most patients considered attention to spiritual concerns an important part of cancer care by physicians (87%) and nurses (85%). Limitations Limitations include a small sample size, a cross-sectional study design, and a limited proportion of nonwhite participants (15%) from one US region. Conclusion Patients receiving palliative RT rely on R/S beliefs to cope with advanced cancer. Furthermore, spirituality and religious coping are contributors to better QOL. These findings highlight the importance of spiritual care in advanced cancer care.

Psychosocial adjustment to cancer and its associated factors in patients undergoing chemotherapy: A cross-sectional study

“…In a study conducted by Vallurupalli et al, the majority of patients (84%) proposed reliance on religious beliefs as a way of coping with cancer (Vallurupalli et al, 2012). According to previous studies, in terms of culture, cancer patients in Iran are religious people who prefer to turn to religion for adjusting to critical situations in life, such as developing incurable diseases (Rezaei et al, 2008).…”

Chaplains on the Medical Team: A Qualitative Analysis of an Interprofessional Curriculum for Internal Medicine Residents and Chaplain Interns

“…In our curriculum, the interprofessional team approach--where participants 14 observe one another and discuss their experiences--allowed both sets of trainees to directly 15 apply new skills and knowledge. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 that through these activities they knew their patients better as individuals.…”

“…Spirituality has been defined as "the aspect of humanity 4 that refers to the way individuals seek and express meaning and purpose and the way they 5 experience their connectedness to the moment, to self, to others, to nature, and to the In current hospital practice, physicians and chaplains generally have limited understanding of 11 each other's expertise, and collaborate infrequently in patient care. Although others have 12 published interprofessional curricula pairing chaplains with nurses and social workers (Forrest & 13 Derrick, 2010; Otis-Green et al, 2009), and some curricula report involvement of chaplains in 14 medical student teaching (Talley & Magie, 2014), very little literature exists on interprofessional 15 education that pairs chaplain and physician learners (King & Crisp, 2005). 16 With regard to collaborating in patient care, physicians and chaplains each have gaps in their 17 training.…”

“…For many chaplain interns in our program, this is their first experience working in a 14 hospital and many have come to chaplaincy from other careers. These interns also have a 15 variety of religious traditions. 16 The goals of the curriculum are to improve medical residents' ability to provide care that is 17 sensitive to patients' spiritual needs, and to better equip chaplain trainees to work with 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 curriculum development team to guide the discussion (Table 1).…”

“…8 One chaplain intern noted: One attending noted mismatched expectations with a chaplain intern: 13 "We just never got a good system down of how and when to have these conversations. We had 14 15 we were in a hurry and would stop rounds and ask a lot of questions." 16 …”